Ongoing twin pregnancy after ICSI of PESA-retrieved spermatozoa into in-vitro matured oocytes

The recovery of immature oocytes from unstimulated ovaries followed by in-v itro maturation (IVM) is an attractive alternative to conventional IVF in t he treatment of female infertility. Similarly, surgical recovery of spermat ozoa from the epididymis by percutaneous sperm aspiration (PESA) has simpli fied the retrieval of the male gamete in treatment of men with obstructive azoospermia. We report the first ongoing clinical twin pregnancy resulting from intracytoplasmic sperm injection (ICSI) of spermatozoa retrieved by PE SA into IVM oocytes. In the treatment of a 24-year old woman, 12 immature o ocytes were retrieved. Six oocytes matured (maturation rate 50%) after 24-h our incubation and were inseminated by ICSI, Four oocytes had two pronuclei (fertilization rate 67%) and 3 good quality embryos were transferred. A vi able twin pregnancy was confirmed by ultrasound scan. This report illustrat es the use of a combination of less invasive assisted reproductive techniqu es in overcoming barriers to infertility.