TERM DELIVERY FOLLOWING INTRACYTOPLASMIC SPERM INJECTION WITH TOTALLYIMMOTILE EJACULATORY SPERMATOZOA

Semen analyses on four occasions performed on a 43 years old man in 19 88 and again in 1996 revealed totally immotile spermatozoa with a coun t of 15 x 10(6) and 10 x 10(6)/ml in 1988, and 3 x 10(6) and 5 x 10(6) /ml in 1996. The duration of infertility was 16 years. Spermatozoa was not recovered during testicular spermatozoa extraction (TESE). A seme n sample just prior to TESE contained 100,000/ml of entirely totally i mmotile spermatozoa. Intracytoplasmic sperm injection (ICSI) with immo tile spermatozoa was performed. Immotile spermatozoa were separated us ing a mini-percoll density gradient centrifugation, washed twice and r esuspended in culture medium. A viability stain was performed which re vealed 44.6% of the spermatozoa to be viable. The recovered spermatozo a did not show any movement when examined at 0, 5 and 24 h after prepa ration. The patient's wife was 37 years old with unremarkable gynaecol ogical history. 11 eggs were retrieved. Following cumulus dispersion 9 metaphase II eggs were injected. Three eggs fertilized and cleaved to three three-cell embryos of fair, good and excellent quality. Embryo (n = 3) transfer was performed. B-hCG assay performed two weeks after her embryo transfer was positive (98.6 U/l). An ultrasound scan perfor med at 6.2 weeks of pregnancy revealed a single gestational sac with a fetal heart beat. The pregnancy proceeded to term. An apparently norm al female baby (2965 g) was delivered by LSCS forceps cephalic deliver y. These findings suggest that normal pregnancies can be achieved from embryos obtained following ICSI with totally immotile ejaculatory spe rmatozoa. The present report is believed to be the second report of a birth from embryos generated by ICSI of human eggs with total immotile spermatozoa. (C) 1998 Lippincott-Raven Publishers.