Outcome of ICSI with ejaculated spermatozoa in a series of men with distinct ultrastructural flagellum anomalies

Centre Hospitalier Régional Universitaire de Lille, Lille, Nord-Pas-de-Calais, France
Human Reproduction (Impact Factor: 4.57). 09/2006; 21(8):2065-74. DOI: 10.1093/humrep/del130
Source: PubMed


Severe sperm motility impairment results in human infertility, which can be overcome by ICSI. Whether some particular, possibly genetic, flagellar abnormalities can influence embryonic development is a matter of debate.
Analysis of ultrastructural flagellar abnormalities and ICSI outcomes with ejaculated spermatozoa in a series of 21 infertile patients with asthenozoospermic or dyskinetic spermatozoa due to a primary and specific flagellar abnormality was carried out.
Patients were sorted into six categories according to flagellar ultrastructural defects. Oocyte fertilization occurred in the 21 couples with a mean 2PN fertilization rate reaching 61.85%. No difference was observed in the kinetics of in vitro development or in the morphological quality of the embryos between the different types of flagellar abnormalities. Pregnancy occurred in 12 couples (57.1%) and delivery in nine couples (42.86%). Both the implantation rate and the clinical pregnancy rate per cycle were lower in type III abnormalities and in patients with an initial sperm motility less than 5%.
The rate of ICSI success may be influenced by the type of flagellar abnormality. ICSI provides a suitable solution for patients with sperm flagellar defects but raises the question of the consequences of a specific (and primary flagellar) abnormality on oocyte fertilization, on embryo and fetal development as well as on live birth.

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Available from: Brigitte Clavier, Jan 10, 2014
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    • "L'ICSI permet a ` des patients infertiles de devenir pè res avec leurs propres gamè tes malgré des dé ficiences spermatiques sé vè res. Dans les pathologies flagellaires, des dysfonctionnements apparaissent allant de l'e ´ chec de fé condation ou paucifé condation et absence de naissance [4] [25] et le projet parental de ces couples peut ne pas se concré tiser. Certains de ces couples se dirigeront alors vers le don de sperme. "
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