Failure of oocyte activation after intracytoplasmic sperm injection using round-headed sperm
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Objective To examine the outcome of intracytoplasmic sperm injection (ICSI) with round-headed sperm (globozoospermia). Design Retrospective analysis. Setting In vitro fertilization laboratory with extensive ICSI experience. Patient(s) A patient couple with infertility because of globozoospermia seeking ICSI treatment. Main outcome measure(s) Fertilization, cleavage, and pregnancy rates. Intervention(s) Intracytoplasmic sperm injection and calcium ionophore. Result(s) This couple experienced only 7% fertilization after ICSI in their first cycle. Treatment of the unfertilized oocytes with calcium ionophore 20 hours after ICSI-induced fertilization and cleavage of 70% of the oocytes. Embryo quality was fair to good. On the second cycle, 8 of the injected oocytes were treated with ionophore immediately after ICSI and the remaining 20 oocytes were untreated. Normal fertilization was achieved in 75% of the treated and 10% of the untreated oocytes. Treatment of these unfertilized oocytes with ionophore 20 hours after ICSI resulted in fertilization in 73%. Pregnancy was not achieved after either ICSI cycle. Ultrastructural analysis indicated multiple structural abnormalities in the sperm. Conclusion(s) These results indicate that the round-headed sperm from this patient were incapable of oocyte activation after ICSI. This may be the reason for the frequent ICSI fertilization failure seen with this condition. Current ICSI procedures may not always overcome the infertility associated w…
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Globozoospermic men are infertile and some are able to achieve a pregnancy after ICSI.
“Globozoospermic men were infertile and some were able to achieve a pregnancy after ICSI.”
From Recommendations for Human Sperm Morphology Assessment in 2025: An Expert Review From the French BLEFCO Group (2026) · cites this paper as [31]
ICSI success rates in globozoospermia remain rather low, with many failures or lower fertilisation rates.
“Success rates of ICSI remain rather low, with many failures or with lower fertilisation rates [30, 31, 32, 33].”
From Recommendations for Human Sperm Morphology Assessment in 2025: An Expert Review From the French BLEFCO Group (2026) · cites this paper as [31]
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References 18 · Cited by 138
- Authors
- Battaglia, D. E., Koehler, J. K., Klein, N. A., & Tucker, M. J.
- Affiliations
- University of Washington (US)
- ORCID
- Tucker, Michael J.
- Venue
- Fertility and Sterility
- Publisher
- Elsevier BV
- Published
- 1997-07
- Volume
- 68
- Issue
- 1
- Pages
- 118-122
- ISSN
- 0015-0282 (ISSN-L)
- OpenAlex
- W1969150786
- Cited by
- 138
- References
- 18
- Citations by year
- 2025: 2 · 2024: 2 · 2023: 4 · 2022: 3 · 2021: 2 · 2020: 1 · 2019: 3 · 2018: 3 · 2017: 2 · 2016: 1 · 2015: 5 · 2014: 5 · 2013: 7 · 2012: 14
- FWCI
- 4.38
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Fertility and Sterility (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Sperm and Testicular Function
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Reproductive Biology and Fertility
- Health Sciences › Medicine › Reproductive Medicine › Reproductive Health and Technologies
- Keywords
- globozoospermia, intracytoplasmic sperm injection, oocyte activation, fertilization failure, calcium ionophore, male infertility, fertilization rate, cleavage
- MeSH terms
- Calcimycin, Adult, Female, Fertilization in Vitro, Humans, Infertility, Male, Ionophores, Male, Microinjections, Oocytes, Retrospective Studies, Spermatozoa
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