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  • Title: A birth from the transfer of a single vitrified-warmed blastocyst using intracytoplasmic sperm injection with calcium ionophore oocyte activation in a globozoospermic patient.
    Author: Kyono K, Nakajo Y, Nishinaka C, Hattori H, Kyoya T, Ishikawa T, Abe H, Araki Y.
    Journal: Fertil Steril; 2009 Mar; 91(3):931.e7-11. PubMed ID: 19046584.
    Abstract:
    OBJECTIVE: To present the effectiveness of diagnostic heterologous intracytoplasmic sperm injection (ICSI), mouse oocyte activation test (MOAT), and ICSI combined with assisted oocyte activation (AOA) in a globozoospermic patient. DESIGN: A case report. SETTING: A private IVF center, Japan. PATIENT(S): A patient with globozoospermia. INTERVENTION(S): MOAT in a mouse and ICSI combined with AOA in a human. MAIN OUTCOME MEASURE(S): Ultrastructure, MOAT, fertilization, and pregnancy. RESULT(S): The transmission electron micrographs showed 100% round-headed spermatozoa lacking an acrosome. MOAT showed that the fertilization rate was 68.4% (13/19) when AOA was used but 0% (0/19) when AOA was not used. After the diagnosis of globozoospermia and sperm-related activation deficiency, 17 human mature oocytes were activated with calcium ionophore after ICSI was performed. The fertilization rate was 88.2% (15/17), and 11 blastocysts were cryopreserved using the vitrification method to prevent severe ovarian hyperstimulation syndrome. A single vitrified-warmed blastocyst was transferred. A gestational sac with fetal heart movements was recognized, and a healthy boy weighing 3180 g was born at 40 weeks of gestation by cesarean section without any congenital abnormality. CONCLUSION(S): MOAT allows discrimination between sperm- and oocyte-related fertilization failures and shows the effectiveness of AOA.
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