Kochhar Puneet Kaur, Ghosh Pranay
Elixir Fertility Centre, New Delhi, India.
J Hum Reprod Sci. 2018 Jan-Mar;11(1):72-74. doi: 10.4103/jhrs.JHRS_47_17.
Globozoospermia, characterized by round-headed acrosomeless sperm, is a rare and severe form of teratozoospermia. We report a successful pregnancy in two cases of total globozoospermia after intracytoplasmic sperm injection (ICSI) with oocyte activation with calcium ionophore. In thefirst case, globozoospermia was diagnosed on the day of oocyte retrieval. Among 11 retrieved oocytes, only one fertilized after ICSI. The pregnancy test 2 weeks after embryo transfer was negative. Two months later, the patient underwent ovarian stimulation again. The 12 retrieved oocytes were exposed to calcium ionophore medium following ICSI. Four oocytes were fertilized and two blastocysts were transferred resulting in a clinical pregnancy. In the second case, among seven retrieved oocytes, three fertilized after ICSI and assisted oocyte activation, and two 8-cell embryos were transferred, resulting in a positive pregnancy. The successful outcome here justifies the use of ICSI with oocyte activation to improve the pregnancy rate significantly when dealing with globozoospermia.
圆头无顶体精子症以圆头无顶体精子为特征,是一种罕见且严重的畸形精子症。我们报告了两例完全性圆头无顶体精子症患者在卵胞浆内单精子注射(ICSI)联合钙离子载体激活卵母细胞后成功妊娠的案例。在第一例中,取卵当天诊断为圆头无顶体精子症。在取出的11枚卵母细胞中,ICSI后仅有1枚受精。胚胎移植2周后的妊娠试验为阴性。两个月后,患者再次接受卵巢刺激。取出的12枚卵母细胞在ICSI后置于钙离子载体培养基中。4枚卵母细胞受精,移植了2枚囊胚,结果临床妊娠。在第二例中,在取出的7枚卵母细胞中,3枚在ICSI和辅助卵母细胞激活后受精,移植了2枚8细胞胚胎,结果妊娠阳性。此处的成功结果证明,在处理圆头无顶体精子症时,使用ICSI联合卵母细胞激活可显著提高妊娠率。