Failure of Fertilization Following Intracytoplasmic Injection of Round-Headed Sperm

Abstract

Intracytoplasmic sperm injection (ICSI) is a very effective technique for the treatment of male factor infertility, even in severe cases. An exception to this rule is round-headed acrosomeless sperm, for which there is an extremely low success rate. The objective of this study was to report our first experience with ICSI using round-headed spermatozoa. A total of four infertile males with globozoospermia underwent the conventional ICSI program during the period from 1995 to 1997. Semen parameters were evaluated according to the WHO criteria. Twenty-eight oocytes were collected following conventional ovarian superovulation. Volume, pH, and viscosity of the semen were within normal range. Sperm counts and progressive motility were from >1 to 90x10 6 mL, and from 0% to 60%, respectively. Distinct 100% acrosomeless morphology was observed with Giemsa staining. Twenty-two metaphase II oocytes (78.6% of the total) from four ICSI cases were injected with the husbandâs round-headed spermatozoa. Total fertilization failure was observed in all these cases. The results clearly demonstrate the important role of normal head morphology in activating the oocytes, as well as the need to develop a modified but safe ICSI technique, which will be effective in overcoming this severe type of male infertility.