Results of intracytoplasmic sperm injection in two infertile patients with abnormal organization of sperm mitochondrial sheaths and severe asthenoteratozoospermia.

RAWE V Y; HERMES R.; NODAR FN; FISZBAIN G; CHEMES HE

FERTILITY AND STERILITY

Año: 2006

0015-0282

­­STRUCTURED ABSTRACT Objective: To report Assisted Reproduction Technologies (ART) outcome and characterize severe mitochondrial sheath (MS) anomalies in two infertile asthenoteratozoospermic patients. Setting: Private IVF Clinic and  Academic Research Institution. Patients: Two infertile men with asthenoteratozoospermia. Interventions: ICSI was performed in both cases. Main outcome measures: Clinical and laboratory evaluation were performed and spermatozoa studied by epifluorescence microscopy and transmission electron microscopy. Results: Patient 1 had sperm with acute bendings at the level of the narrow mid-pieces. Mitochondria were either scarce or absent. Three ICSI embryos were transferred. A pregnancy was achieved followed by a miscarriage at the end of the first trimester. Patient 2 had sperm with very long mitochondrial sheaths. The number of gyres was increased to more than 30.  Two ICSI cycles were performed with good fertilization rates and embryo quality but no pregnancy was achieved. Conclusions: MS defects were studied by phase contrast, Epifluorescence microscopy and TEM that afforded a detailed view of the sperm mid-piece and the topography of the whole flagellum. The results indicate that mid-piece defects, while causing severe asthenozoospermia and lower fertilizing potential, may not necessarily represent negative prognostic factors in ART.