Efficient modification of intracytoplasmic sperm injection technique for cases with total lack of sperm movement.

A rapid, simple and efficient method for selecting living spermatozoa for intracytoplasmic sperm injection (ICSI) in cases with total lack of sperm movement is described. The selection is based on a characteristic deformation of living spermatozoa exposed to hypo-osmotic conditions during short sequential exposures to modified culture medium and polyvinylpyrrolidone solution; the osmolarity of both of these solutions is reduced by one half by diluting them with an equal amount of water. The application of the sperm viability selection step in six ICSI treatment cycles with total absence of sperm movement resulted in a fertilization rate of 41.9% and the establishment of two ongoing clinical pregnancies. The method described for the selection of living spermatozoa makes it possible to reach acceptable fertilization rates and to obtain ongoing pregnancies by ICSI in cases with total lack of sperm movement. Because of its simplicity, this method can easily be improvised when the total lack of sperm movement is an unexpected finding made on the day of the planned ICSI.