Andrology: Fertilizing ability of immotile spermatozoa after intracytoplasmic sperm injection

Abstract

Sometimes spermatozoa from ejaculate, epididymis or testis show a total absence of motility. For some patients, however, very few spermatozoa with very poor motility can be found after several hours of incubation (initially immotile spermatozoa). Other samples show no motility at all even after extended culture (totally immotile spermatozoa). Intracytoplasmic sperm injection (ICSI) is the only method available to select and retrieve a single immotile or initially immotile spermatozoon and inject it into the oocyte. A total of 103 patients with asthenozoospermia underwent ICSI in this study. It was shown that initially immotile and totally immotile spermatozoa, whatever their origin, have the capacity to fertilize an oocyte after ICSI. No significant difference could be observed between the fertilizing capacity of testicular or epididymal spermatozoa. Totally immotile ejaculated spermatozoa, however, fertilized significantly fewer oocytes after ICSI when compared with initially immotile ejaculated spermatozoa. Embryos of lower quality tended to be produced when totally immotile spermatozoa of any origin were used, compared with embryos resulting from initially immotile spermatozoa. Ongoing pregnancies were conceived after ICSI with initially immotile spermatozoa from any origin and totally immotile spermatozoa retrieved from testis only. One biochemical pregnancy was the result of embryo transfer after ICSI with totally immotile ejaculated spermatozoa. No supernumerary embryos could be cryopreserved for patients with totally immotile spermatozoa from ejaculate or epididymis. For a Kartagener patient, subzonal insemination (SUZI) seemed to be a better approach for obtaining fertilization and pregnancy than ICSI because no fertilization occurred after ICSI on sibling oocytes. Hence a healthy pregnancy was obtained after SUZI.

Levels of Tektin 2 and CatSper 2 in normozoospermic and oligoasthenozoospermic men and its association with motility, fertilization rate, embryo quality and pregnancy rate

“…However, retrospective analysis of the ART outcomes have demonstrated that the fertilization rates, embryo qualities and pregnancy rates are poor when spermatozoa with low motility have been used for fertilization as compared to those with normal motility [14,17,28]. Surprisingly, the fertilization rate and embryo quality could only be marginally improved even after the use of ICSI [28]. These findings are further reconfirmed in our retrospective analysis where couples with oligoasthenozoospermia has poor ART outcome despite the use of ICSI (Table 2).…”

“…ART outcomes have demonstrated that the fertilization rates, embryo qualities and pregnancy rates are poor when spermatozoa with low motility have been used for fertilization as compared to those with normal motility [14,17,28]. A retrospective analysis of the data from our clinic in the last 5 years have reconfirmed the notion that the ART outcome is generally poor in couples with oligoasthenozoospermia despite the use of ICSI (Table 2).…”

“…Both IVF and ICSI have been successfully used in couples where the male partner has asthenozoospermia and not unexpectedly the success rates of ICSI are higher over IVF [10,31,46]. However, retrospective analysis of the ART outcomes have demonstrated that the fertilization rates, embryo qualities and pregnancy rates are poor when spermatozoa with low motility have been used for fertilization as compared to those with normal motility [14,17,28]. Surprisingly, the fertilization rate and embryo quality could only be marginally improved even after the use of ICSI [28].…”

“…While poor egg quality is associated with defective embryonic development, observational studies have demonstrated that despite the use of good quality eggs, the Grade 2 and 3 embryos were more in couples where the male partner has defective sperm motility, even after ICSI [25,28]. These observations together with the result that low Tektin 2 levels are associated with poor fertilization rates prompted us to investigate if Tektin 2 levels are also associated with embryo quality.…”

Healthy twin live-birth after ionophore treatment in a case of theophylline-resistant Kartagener syndrome

“…Before it was possible to directly inject a single spermatozoon into the ooplasm, subzonal injection (SUZI) of numerous sperms was a successful alternative [23,24]. However, SUZI required at least minimal sperm motility in order achieve fertilization.…”