An interesting case of male infertility

Abstract

OBJECTIVE: The aim of this report is to highlight the importance of assessing sperm morphology adequately and its impact on a couple if not done so. DESIGN: A case of a couple is highlighted to discuss the above. MATERIALS AND METHODS: A 28 year old lady and a 32 year old man were trying to conceive for the past 7 years. The lady had regular menstrual cycles and no signs of hirsuitism or galactorrhoea. Tubal testing done 6 years ago revealed bilateral patent tubes. The semen analysis done on various occasions has shown a count between 60-80 million/ml with 60% motility. The couple were diagnosed with unexplained subfertility. Treatment with ovulation induction and intrauterine insemination was done for 4-5 cycles in the initial 3 years of treatment. This was followed by laparoscopy and hysteroscopy. Laparoscopy revealed normal uterus with normal tubes and ovary. Hysteroscopy revealed normal endometrial cavity. This was followed by further attempts of ovulation induction and intrauterine insemination (IUI). In total there were 10 attempts of Ovulation Induction and IUI before coming to our centre. After going through all the reports we conducted a semen analysis at our centre. We were surprised to see the results. There was complete globozoospermia!. RESULTS: This is a case report. CONCLUSIONS: This case has been highlighted to indicate the usefulness of a thorough semen analysis and the awareness of this condition amongst infertility specialists. If this diagnosis would have been made earlier, then this patient would have been spared years of unnecessary treatment including a surgical intervention in the lady. The prognosis and the option of ICSI/donor sperms could have been given long ago.