Skip to main content
SpringerLink
Log in

Successful intracytoplasmic sperm injection with testicular spermatozoa from a man with multiple morphological abnormalities of the sperm flagella: a case report

  • Gamete Biology
  • Published:
Journal of Assisted Reproduction and Genetics Aims and scope Submit manuscript

Abstract

Purpose

The purpose of this study is to analyze the sperm morphology of a Chinese man affected with multiple morphological abnormalities of the sperm flagella (MMAF) and observe the intracytoplasmic sperm injection (ICSI) outcome.

Methods

A Chinese man was diagnosed with multiple morphological abnormalities of the sperm flagella by semen analysis and electron microscopy. Testicular spermatozoa were injected intracytoplasmically, and the following ICSI results were observed.

Results

All the spermatozoa from his ejaculate were immotile and morphologically abnormal in the flagellum. In transmission electron microscopy assays, most spermatozoa showed disorganized fibrous sheath, accompanied by distortion of various cytoskeletal components, and missing of the central pair microtubules. Testicular sperm was injected to the oocytes in two ICSI cycles, with fertilization rates of 45.5 and 40.0%. Finally, a healthy female infant was delivered at the second ICSI cycle.

Conclusions

Fertilization and pregnancy could be achieved by intracytoplasmic sperm injection, regardless of severe flagellar defects. ICSI is effective for MMAF-affected man, and testicular sperm is an alternative when no motile sperm is available.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Yang SM, Li HB, Wang JX, Shi YC, Cheng HB, Wang W, et al. Morphological characteristics and initial genetic study of multiple morphological anomalies of the flagella in China. Asian J Androl. 2015;17:513–5.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Ben Khelifa M, Coutton C, Zouari R, Karaouzene T, Rendu J, Bidart M, et al. Mutations in DNAH1, which encodes an inner arm heavy chain dynein, lead to male infertility from multiple morphological abnormalities of the sperm flagella. Am J Hum Genet. 2014;94:95–104.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Chemes HE, Brugo S, Zanchetti F, Carrere C, Lavieri JC. Dysplasia of the fibrous sheath: an ultrastructural defect of human spermatozoa associated with sperm immotility and primary sterility. Fertil Steril. 1987;48:664–9.

    Article  CAS  PubMed  Google Scholar 

  4. Stalf T, Sanchez R, Kohn FM, Schalles U, Kleinstein J, Hinz V, et al. Pregnancy and birth after intracytoplasmic sperm injection with spermatozoa from a patient with tail stump syndrome. Hum Reprod. 1995;10:2112–4.

    Article  CAS  PubMed  Google Scholar 

  5. Chemes HE, Alvarez SC. Tales of the tail and sperm head aches: changing concepts on the prognostic significance of sperm pathologies affecting the head, neck and tail. Asian J Androl. 2012;14:14–23.

    Article  PubMed  Google Scholar 

  6. Coutton C, Escoffier J, Martinez G, Arnoult C, Ray PF. Teratozoospermia: spotlight on the main genetic actors in the human. Hum Reprod Update. 2015;21:455–85.

    Article  PubMed  Google Scholar 

  7. Tang S, Wang X, Li W, Yang X, Li Z, Liu W, et al. Biallelic mutations in CFAP43 and CFAP44 cause male infertility with multiple morphological abnormalities of the sperm flagella. Am J Hum Genet. 2017;100:854–64.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Olmedo SB, Nodar F, Chillik C, Chemes HE. Successful intracytoplasmic sperm injection with spermatozoa from a patient with dysplasia of the fibrous sheath and chronic respiratory disease. Hum Reprod. 1997;12:1497–9.

    Article  CAS  PubMed  Google Scholar 

  9. Olmedo SB, Rawe VY, Nodar FN, Galaverna GD, Acosta AA, Chemes HE. Pregnancies established through intracytoplasmic sperm injection (ICSI) using spermatozoa with dysplasia of fibrous sheath. Asian J Androl. 2000;2:125–30.

    CAS  PubMed  Google Scholar 

  10. Yang SM, Yang XY, Ding Y, Li H, Wang W, Liu JY, et al. Intracytoplasmic sperm injection outcomes in Chinese men with multiple morphological abnormalities of sperm flagella. Asian J Androl. 2016;18:809–11.

    Article  PubMed  Google Scholar 

  11. Racowsky C, Ohno-Machado L, Kim J, Biggers JD. Is there an advantage in scoring early embryos on more than one day. Hum Reprod. 2009;24:2104–13.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Chemes HE, Olmedo SB, Carrere C, Oses R, Carizza C, Leisner M, et al. Ultrastructural pathology of the sperm flagellum: association between flagellar pathology and fertility prognosis in severely asthenozoospermic men. Hum Reprod. 1998;13:2521–6.

    Article  CAS  PubMed  Google Scholar 

  13. Chemes EH, Rawe YV. Sperm pathology: a step beyond descriptive morphology. Origin, characterization and fertility potential of abnormal sperm phenotypes in infertile men. Hum Reprod Update. 2003;9:405–28.

    Article  PubMed  Google Scholar 

  14. Linck RW, Chemes H, Albertini DF. The axoneme: the propulsive engine of spermatozoa and cilia and associated ciliopathies leading to infertility. J Assist Reprod Genet. 2016;33:141–56.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Nordhoff V. How to select immotile but viable spermatozoa on the day of intracytoplasmic sperm injection? An embryologists view. Andrology. 2015;3:156–62.

  16. Ortega C, Verheyen G, Raick D, Camus M, Devroey P, Tournaye H. Absolute asthenozoospermia and ICSI: what are the options. Hum Reprod Update. 2011;17:684–92.

    Article  CAS  PubMed  Google Scholar 

  17. Nagy ZP, Verheyen G, Tournaye H, Van Steirteghem AC. Special applications of intracytoplasmic sperm injection: the influence of sperm count, motility, morphology, source and sperm antibody on the outcome of ICSI. Hum Reprod. 1998;13(Suppl 1):143–54.

    Article  PubMed  Google Scholar 

  18. Vandervorst M, Tournaye H, Camus M, Nagy ZP, Van Steirteghem A, Devroey P. Patients with absolutely immotile spermatozoa and intracytoplasmic sperm injection. Hum Reprod. 1997;12:2429–33.

    Article  CAS  PubMed  Google Scholar 

  19. Casper RF, Meriano JS, Jarvi KA, Cowan L, Lucato ML. The hypo-osmotic swelling test for selection of viable sperm for intracytoplasmic sperm injection in men with complete asthenozoospermia. Fertil Steril. 1996;65:972–6.

    Article  CAS  PubMed  Google Scholar 

  20. Kordus RJ, Price RL, Davis JM, Whitman-Elia GF. Successful twin birth following blastocyst culture of embryos derived from the immotile ejaculated spermatozoa from a patient with primary ciliary dyskinesia: a case report. J Assist Reprod Genet. 2008;25:437–43.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Kahraman S, Isik AZ, Vicdan K, Ozgur S, Ozgun OD. A healthy birth after intracytoplasmic sperm injection by using immotile testicular spermatozoa in a case with totally immotile ejaculated spermatozoa before and after Percoll gradients. Hum Reprod. 1997;12:292–3.

    Article  CAS  PubMed  Google Scholar 

  22. Kahraman S, Tasdemir M, Tasdemir I, Vicdan K, Ozgur S, Polat G, et al. Pregnancies achieved with testicular and ejaculated spermatozoa in combination with intracytoplasmic sperm injection in men with totally or initially immotile spermatozoa in the ejaculate. Hum Reprod. 1996;11:1343–6.

    Article  CAS  PubMed  Google Scholar 

  23. Shulman A, Feldman B, Madgar I, Levron J, Mashiach S, Dor J. In-vitro fertilization treatment for severe male factor: the fertilization potential of immotile spermatozoa obtained by testicular extraction. Hum Reprod. 1999;14:749–52.

    Article  CAS  PubMed  Google Scholar 

  24. McLachlan RI, Ishikawa T, Osianlis T, Robinson P, Merriner DJ, Healy D, et al. Normal live birth after testicular sperm extraction and intracytoplasmic sperm injection in variant primary ciliary dyskinesia with completely immotile sperm and structurally abnormal sperm tails. Fertil Steril. 2012;97:313–8.

    Article  PubMed  Google Scholar 

  25. Ravel C, Chantot-Bastaraud S, Siffroi JP, Escalier D, Antoine JM, Mandelbaum J. Tail stump syndrome associated with chromosomal translocation in two brothers attempting intracytoplasmic sperm injection. Fertil Steril. 2006;86:719.e1–7.

    Article  Google Scholar 

  26. Wambergue C, Zouari R, Ben F, Mustapha S, Martinez G, Devillard F, et al. Patients with multiple morphological abnormalities of the sperm flagella due to DNAH1 mutations have a good prognosis following intracytoplasmic sperm injection. Hum Reprod. 2016;31:1164–72.

    Article  CAS  PubMed  Google Scholar 

  27. Favero R, Rizzo F, Baccetti B, Piomboni P. Embryo development, pregnancy and twin delivery after microinjection of ‘stump’ spermatozoa. Andrologia. 1999;31:335–8.

    Article  CAS  PubMed  Google Scholar 

Download references

Funding

This study was funded by Maternal and Child Health Research Project of Jiangsu Province (F201521) and Suzhou Key laboratory for male reproduction (SZS201718).

Author information

Authors and Affiliations

  1. Center for Reproduction and Genetics, Suzhou Hospital Affiliated to Nanjing Medical University, Suzhou, 215002, China

    Shenmin Yang, Liang Gao, Wei Wang, Jie Ding, Yongle Xu & Hong Li

Authors
  1. Shenmin Yang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Liang Gao
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Wei Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jie Ding
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Yongle Xu
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Hong Li
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding authors

Correspondence to Yongle Xu or Hong Li.

Ethics declarations

Conflict of interest

The authors declare that they have no competing interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Yang, S., Gao, L., Wang, W. et al. Successful intracytoplasmic sperm injection with testicular spermatozoa from a man with multiple morphological abnormalities of the sperm flagella: a case report. J Assist Reprod Genet 35, 247–250 (2018). https://doi.org/10.1007/s10815-017-1057-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10815-017-1057-5

Keywords

Search

Navigation