Pregnancy with spermatozoa from a globozoospermic man after intracytoplasmic sperm injection

By Dr. Krinos Trokoudes, N.Danos, N.Danos, R.Vlachou, T.Lysiotis, N.Georghiades, N.Georghiades, K.Kyriacou

We present a case of third-trimester pregnancy occurring in a 29-year-old woman after intracytoplasmic sperm injection (ICSI) treatment with spermatozoa from a globozoospermic man. We believe this is the first reported case (1995). A 37-year-old man was diagnosed with globozoospermia with normal sperm count and motility. In-vitro fertilization and subzonal insemination treatments failed to achieve the fertilization of any eggs. The ICSI method produced 50% fertilization, 75% cleavage rate, and a singleton pregnancy with a female fetus. No pregnancy or fetal abnormalities have been noted after >7 months of gestation.

Globozoospermia is a rare condition of the unknown mode of inheritance which is characterized by the complete absence of the acrosome, disorganized mid-piece, lack of zona binding and infertility (Aitken et al, 1990). Because of the above, classical in-vitro fertilization (IVF) has not been successful in fertilization. Subzonal insemination (SUZI) has similarly been unsuccessful in producing sperm—oocyte fusion (Dale et al, 1994). The new technique of intracytoplasmic sperm injection (ICSI) involves the direct deposition of the spermatozoon in the cytoplasm of the oocyte (Palermo et al, 1993). It is a much more powerful method of fertilization than IVF or SUZI in cases of severe sperm problems. It was therefore natural for us to apply this method of fertilization to globozoospermic cases once the opportunity arose.