Successful fertilization and establishment of pregnancies after intracytoplasmic sperm injection in patients with globozoospermia.

Globozoospermia or round-headed spermatozoa is a rare type of teratozoospermia where the acrosome is absent resulting in male infertility with no known therapy. A few studies have shown that round-headed spermatozoa cannot bind to or penetrate the zona pellucida, and no normal fertilization has been observed in in-vitro fertilization (IVF) after insemination of human oocytes with round-headed spermatozoa. In this study, the fertilization capacity of round-headed spermatozoa after intracytoplasmic sperm injection (ICSI) into human oocytes has been examined. In pre-clinical experiments, 45 oocytes were injected; 41 oocytes were intact after injection, 15 oocytes were fertilized normally, and 13 of these 15 oocytes developed further in vitro. ICSI was carried out in 11 treatment cycles of seven infertile couples with globozoospermia. Normal fertilization and embryo transfer occurred in four cycles (three patients). Positive serum human chorionic gonadotrophin was observed in three cycles (two patients); one patient had a pre-clinical abortion and the other patient became pregnant twice; the first pregnancy was ectopic and the second pregnancy is a twin pregnancy which is currently at 16 weeks of gestation.