BACKGROUND: Globozoospermia is a rare (incidence of 0.1% among andrological patients) and poorly understood condition, but a severe disorder in male infertility.
This case report detailed the course of treatment and protocol of a patient with type 1 globozoospermia using Intracytoplasmic Sperm Injection (ICSI) and oocyte activation by calcium ionophore, which yielded conception and birth of a healthy baby after six previous unsuccessful attempts, using ICSI alone.
CASE PRESENTATION: A 39-year-old male with normal findings on routine examination presented to TDV 29 Mayis Hospital, Assisted Reproduction Unit (ART) with his 37-year-old wife. Her examination was also within normal limits and ovulatory cycle was regular. The male's diagnostic screening revealed normal karyotype (46, XY) and no Y-microdeletion. However, the spermogram was abnormal; sperm count of 14 million/ml with 35% active motility and 100% morphologically abnormal sperm, indicating globozoospermia. Ovarian stimulation was provided using classic long down-regulation protocol and 13 MII oocytes were collected. Next, calcium ionophore was applied following the ICSI procedure to improve the chances for fertilization. The case report compared quantitative procedural and diagnostic screening data, and fertilization rates. On day 5, two grade 1 blastocysts out of 5 embryos were transferred, yielding positive beta-human chorionic gonadotropin (beta hCG), and ultimately a healthy delivery.
CONCLUSION: ICSI with assisted oocyte activation by calcium ionophore may overcome male infertility where there is total globozoospermia.
Karaca N, Akpak YK, Oral S, Durmus T, Yilmaz R. Are you the author?
TDV 29 Mayis Hospital, Department of Assisted Reproduction, Istanbul, Turkey; Ankara Mevki Military Hospital, Department of Obstetrics and Gynecology, Ankara, Turkey; LIV Hospital, Department of Assisted Reproduction, Istanbul, Turkey.
Reference: J Reprod Infertil. 2015 Apr-Jun;16(2):116-20.