Sperm retrieval and intracytoplasmic sperm injection in patients with prune-belly syndrome

Abstract

Prune-belly syndrome (PBS) is an idiopathic triad characterized by bilateral cryptorchidism, bilateral hydroureteronephrosis, and lax abdominal musculature. These men are infertile and there are no documented cases of paternity. Their infertility is multifactorial and is likely related to the undescended testes and the prostatic hypoplasia typically seen in these men. Furthermore, Wolffian duct anomalies, including absent seminal vesicles and vasa deferentia, and epididymal anomalies have been reported in patients with PBS (1, 2). The first pregnancy with intracytoplasmic sperm injection (ICSI) was reported in 1992 (3). Intracytoplasmic sperm injection is an accepted treatment for severe male factor infertility, and the published data suggest that there is no increased risk of major malformations associated with ICSI (4). We report the first pregnancy caused by a man with PBS and review our experience with sperm retrieval and ICSI in three men with this syndrome. Institutional review board approval was not obtained, but patients were counseled on the uncertain genetic risks to any potential offspring.