Battaglia D E, Koehler J K, Klein N A, Tucker M J
Department of Obstetrics and Gynecology, University of Washington, Seattle 98195, USA.
Fertil Steril. 1997 Jul;68(1):118-22. doi: 10.1016/s0015-0282(97)81486-0.
To examine the outcome of intracytoplasmic sperm injection (ICSI) with round-headed sperm (globozoospermia).
Retrospective analysis.
In vitro fertilization laboratory with extensive ICSI experience.
PATIENT(S): A patient couple with infertility because of globozoospermia seeking ICSI treatment.
MAIN OUTCOME MEASURE(S): Fertilization, cleavage, and pregnancy rates.
INTERVENTION(S): Intracytoplasmic sperm injection and calcium ionophore.
RESULT(S): This couple experienced only 7% fertilization after ICSI in their first cycle. Treatment of the unfertilized oocytes with calcium ionophore 20 hours after ICSI-induced fertilization and cleavage of 70% of the oocytes. Embryo quality was fair to good. On the second cycle, 8 of the injected oocytes were treated with ionophore immediately after ICSI and the remaining 20 oocytes were untreated. Normal fertilization was achieved in 75% of the treated and 10% of the untreated oocytes. Treatment of these unfertilized oocytes with ionophore 20 hours after ICSI resulted in fertilization in 73%. Pregnancy was not achieved after either ICSI cycle. Ultrastructural analysis indicated multiple structural abnormalities in the sperm.
CONCLUSION(S): These results indicate that the round-headed sperm from this patient were incapable of oocyte activation after ICSI. This may be the reason for the frequent ICSI fertilization failure seen with this condition. Current ICSI procedures may not always overcome the infertility associated with globozoospermia, and further study of the etiology of this condition is needed.
研究采用圆头精子（圆头精子症）进行卵胞浆内单精子注射（ICSI）的结果。
回顾性分析。
具有丰富ICSI经验的体外受精实验室。
一对因圆头精子症导致不孕而寻求ICSI治疗的夫妇。
受精率、卵裂率和妊娠率。
卵胞浆内单精子注射和钙离子载体。
这对夫妇在第一个ICSI周期后的受精率仅为7%。在ICSI诱导受精20小时后，用钙离子载体处理未受精的卵母细胞，70%的卵母细胞发生卵裂。胚胎质量为中等至良好。在第二个周期，8个注射的卵母细胞在ICSI后立即用离子载体处理，其余20个卵母细胞未处理。处理后的卵母细胞正常受精率为75%，未处理的为10%。在ICSI后20小时用离子载体处理这些未受精的卵母细胞，受精率为73%。两个ICSI周期后均未实现妊娠。超微结构分析表明精子存在多种结构异常。
这些结果表明，该患者的圆头精子在ICSI后无法激活卵母细胞。这可能是这种情况下ICSI受精频繁失败的原因。目前的ICSI程序可能并不总能克服与圆头精子症相关的不孕问题，需要对这种情况的病因进行进一步研究。
