Department of Reproductive Medicine, CER Medical Institute, School of Medicine, University of Buenos Aires, Buenos Aires, Argentina.
Fertil Steril. 2010 Jun;94(1):351.e15-8. doi: 10.1016/j.fertnstert.2009.12.037. Epub 2010 Feb 10.
To treat couples with intracytoplasmic sperm injection (ICSI) after annexin V sperm sorting.
Two case reports.
Department of Reproductive Medicine at a private medical institute.
PATIENT(S): Couples on infertility treatment, donor oocytes.
INTERVENTION(S): Sperm sorted with annexin V magnetic microbeads before ICSI, day 3 embryo transfer; case 1: ovum donation; case 2: patient oocytes.
MAIN OUTCOME MEASURE(S): 1) Sperm DNA fragmentation (terminal deoxynucleotide transferase-mediated dUTP nick-end labeling [TUNEL]) and active caspase-3 (immunocytochemistry); 2) fertilization rate, embryonic quality, blastocyst development of nontransferred embryos, and pregnancy outcome after ICSI of sorted sperm.
RESULT(S): Case 1: Premature ovarian failure patient with previous fertilization failures: asthenoteratozoospermia, abnormal DNA fragmentation (TUNEL 30%; normal <20%). ICSI with annexin V-treated sperm done on six donated metaphase II (MII) oocytes; four fertilized, and a 5-cell/grade-2 and a 6-cell/grade-2-3 embryo were transfered. A day 5 blastocyst was cryopreserved. The patient was in the last trimester of gestation. Case 2: Couple with >4 years of primary infertility and recent ICSI failure. Semen with teratozoospermia (5% normal forms [Kruger]) and abnormal active caspase-3 (16%; normal <11%). ICSI with annexin V-treated sperm done on 9 MII oocytes. All fertilized; a 7-cell/grade-1 and an 8-cell/grade-1-2 embryo were transferred. A day 5 expanded blastocyst was cryopreserved. The patient was in the second trimester of a twin normal pregnancy.
CONCLUSION(S): Sperm sorting with annexin V columns was effective in the treatment of two cases of ICSI failure, resulting in a single and a twin pregnancy after transfer of two embryos in each case.
通过使用膜联蛋白 V 精子分选术治疗接受胞浆内单精子注射（ICSI）的夫妇。
两项病例报告。
私人医学研究所生殖医学系。
接受不孕治疗的夫妇，供卵者。
在 ICSI 前使用膜联蛋白 V 磁珠对精子进行分选，行第三天胚胎移植；病例 1：卵母细胞捐赠；病例 2：患者卵母细胞。
1）精子 DNA 碎片（末端脱氧核苷酸转移酶介导的 dUTP 缺口末端标记法[TUNEL]）和活性半胱天冬酶-3（免疫细胞化学）；2）ICSI 后分选精子的受精率、胚胎质量、未移植胚胎的囊胚发育和妊娠结局。
病例 1：患有早发性卵巢功能衰竭且既往受精失败的患者：弱精畸形症，异常 DNA 碎片（TUNEL 30%；正常<20%）。对 6 枚中期 II 期（MII）供卵行 ICSI 联合膜联蛋白 V 处理的精子；4 枚受精，移植 2 枚 5 细胞/2 级和 6 细胞/2-3 级胚胎。1 枚 5 天的囊胚被冷冻保存。患者已进入妊娠晚期。病例 2：患有原发性不孕>4 年且最近 ICSI 失败的夫妇。精子存在畸形症（5%正常形态[克鲁格]）和异常活性半胱天冬酶-3（16%；正常<11%）。对 9 枚 MII 卵母细胞行 ICSI 联合膜联蛋白 V 处理的精子。所有均受精；移植 2 枚 7 细胞/1 级和 8 细胞/1-2 级胚胎。移植后获得 1 枚 5 天的扩张囊胚，冷冻保存。患者处于双胞胎正常妊娠的中期。
使用膜联蛋白 V 柱进行精子分选术治疗 ICSI 失败的 2 例患者是有效的，在每例患者中移植 2 枚胚胎后，分别获得了单胎和双胎妊娠。
