Clinical and Experimental Reproductive Medicine

The Korean Society for Reproductive Medicine (대한생식의학회)
권호 표지

Successful Clinical Pregnancy and Livebirth was Achieved after Intracytoplasmic Sperm Injection in a Globozoospermic Patient: A Case Report

Globozoospermia를 가진 불임환자에서 미세정자주입술을 이용한 체외수정시술 후 임신과 분만 1례 보고

  • 김은경 (차의과대학교 분당차여성병원) ;
  • 김은하 (차의과대학교 분당차여성병원) ;
  • 김은아 (차의과대학교 분당차여성병원) ;
  • 권황 (차의과대학교 분당차여성병원) ;
  • 홍재엽 (차의과대학교 분당차여성병원) ;
  • 최동희 (차의과대학교 분당차여성병원)
  • Published : 2010.03.31
Download PDF
⟨ Previous Next ⟩

Abstract

Objective: Globozoospermia is observed in <0.1% of male infertile patients. The aim of this study is to report the successful clinical outcome in man with globozoospermia. Design: A case report. Method: A 36-year-old man and 32-year-old partner visited our fertility center with 6 years infertility duration. The semen analysis revealed globozoospermia combined with oligozoospermia which was stained with Diff-Quick method. ICSI (Intracytoplasmic sperm injection) was performed on 12 matured oocytes. Result: 5 injected oocytes were fertilized normally. 5 embryos were transferred on day 3 after oocyte retrieval. The patient became pregnant and delivered a healthy boy at 39 weeks of gestation. Conclusion: In case of globozoospermia, it has a low fertilization rate even though ICSI method is used. The favorable technique is still needed to increase the fertilization rate.

목 적: Globozoospermia는 남성불임환자의 0.1%에서 발병되는 극히 드문 정자의 형태학적 이상 증상으로 본원에서 이 증례를 경험하여 문헌고찰과 함께 보고하는 바이다. 연구방법: 2회 반복적 임신에 실패한 불임기간은 6년인 32세의 부인, 36세의 남편 부부가 본원에 내원하였으며, 정액 특수염색결과 희소정자증을 동반한 globozoospermia로 판별이 되어 미세정자주입시술을 실시하였다. 결 과: 14개의 난자가 회수되었으며 이 중 총 12개를 미세정자주입시술을 이용 수정시도를 하였고, 이 중 5개가 수정이 되어 3일 배양 후 이식하였다. 이식 결과 임신이 되었으며, 임신 39주에 건강한 남아를 출산하였다. 결 론: Globozoospermia의 경우 ICSI(미세정자주입시술)방법을 실시하더라도 수정율이 낮다. 이에 수정율 및 임신율을 높일 수 있는 방법의 개발이 필요한 것으로 사료된다.

Keywords

References

  1. Castellani L, Chiara F, Cotelli F. Fine structure and cytochemistry of the morphogenesis of the round headed sperm. Arch Androl 1978; 1: 291-7. https://doi.org/10.3109/01485017808988349
  2. Meyhofer W. Beitrag zur cytophotometrischen beurteilung pathologisch veranderter samenzellen unter besonderer berucksicjtiging der runspermatozen nach.
  3. Feulgen-end Fast greenfärbung. Z Haut-Geschlechtskrankheiten 1965; 39: 174-82.
  4. Schirren CG, Holstein AF, Schirren C. Uber die Morphogenese rundkopfiger spermatozoen des menschen. Andrologie 1971; 3: 117-25.
  5. Kullander S, Rausing A. On round-headed acrosomeless spermatozoa. Int J Fertil 1975; 20: 33-40.
  6. Stanislavov R, Ganev V. A clinical-genetic study of male infertility with globozoospermia. Akush Ginekol (Sofia). 1998; 37: 20-2.
  7. Carrel DT, Wolcox AL, Udoff LC, Thorp C, Campbell B. Chromosome 15 aneuploidy in the sperm and conceptus of a sibling with variable familial expression of round-headed sperm syndrome. Fertil Steril 2001; 76: 1258-60. https://doi.org/10.1016/S0015-0282(01)02904-1
  8. Holstein AF, Schirren CG, Schirren C, Mauss J. Round headed spermatozoa; a cause a male infertility. Dtsch Med Wochenschr 1973; 98: 61-2. https://doi.org/10.1055/s-0028-1106747
  9. Pederson H, Rebbe H. Fine structure of round-headed human spermatozoa. J Reprod Fertil 1974; 37: 51-4. https://doi.org/10.1530/jrf.0.0370051
  10. Wolff HH, Schill WB, Moritz P. Round-headed spermatozoa: a rare andrologic finding. Hautarzt 1976; 27: 111-6.
  11. Bacetti B, Renieri T, Rosati F, Selmi MG, Casanova S. Further observations on the morphogenesis of the round headed human spermatozoa. Andrologia 1977; 9: 255-64.
  12. Bacetti B, Renieri T, Soldani P. Scanning electron microscopy and human sperm pathology. Scan Electron Microsc 1981; 4: 151-6.
  13. Kalahanis J, Rousso D, Kourtis A, Mavromatidis G, Makedos G, Panidis D. Round-headed spermatozoa in semen specimens from fertile and subfertile men. J Reprod Med 2002; 47: 498-3.
  14. Aitken RJ, Kerr L, Bolton V, Hargreave T. Analysis of sperm function in globozoospermia: implications for the mechanism of sperm-zona interaction. Fertil Steril 1990; 54: 701-7. https://doi.org/10.1016/S0015-0282(16)53833-3
  15. Zeyneloglu HB, Baltaci V, Duran HE, Erdemli E, Batioglu S. Achievement of pregnancy in globozoospermia with Y chromosome microdeletion after ICSI. Hum Reprod 2002; 17: 1833-6. https://doi.org/10.1093/humrep/17.7.1833
  16. Anton-Lamprecht I, Kotzur B, Schopf E. Round-headed human spermatozoa. Fertil Steril 1976; 27: 685-93. https://doi.org/10.1016/S0015-0282(16)41900-X
  17. Santi de M, Gardi C, Lungarella G. Severe teratospermia in an infertile man with bronchiectasis. Fertil Steril 1985; 44: 849-52. https://doi.org/10.1016/S0015-0282(16)49053-9
  18. Hamberger L, Lundin K, Sjogren A, Soderlund B. Indications for inctacytoplasmic sperm injection. Hum Reprod 1998; 13 (suppl 1): 128-33. https://doi.org/10.1093/humrep/13.1.128
  19. Lundin K, Sjogren A, Nilsson L, Hamberger L. Fertilization and pregnancy after intracytoplasmic microinjection of acrosomeless spermatozoa. Fertil Steril 1994; 62: 1266-7. https://doi.org/10.1016/S0015-0282(16)57197-0
  20. 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 20 Reprod 1998; 136(suppl 1): 143-54.
  21. Heindryckx B, Van der Elst J, De Sutter P, Dhont M. Treatment option for sperm- or oocyte-related fertilization failure: assisted oocyte activation following diagnostic heterogous ICSI. Hum Reprod 2005; 20: 2237-41. https://doi.org/10.1093/humrep/dei029
  22. Castellani L, Chiara F, Citelli F. Fine structure and cytochemistry of the morphogenesis of round-headed human sperm. Arch Androl 1978; 1: 291-7. https://doi.org/10.3109/01485017808988349
  23. Nistal M, Paniagua R. Morphogenesis of round-headed human spermatozoa lacking acrosomes in a case of severe teratozoospermia. Andrologia 1978; 10: 49-51.
  24. Longo FJ, Krohne G, Franke WW. Basic proteins of the perinuclear theca of mammalian spermatozoa and spermatids: a novel class of cytoskeletal elements. J Cell Biol 1987; 105: 1105-20. https://doi.org/10.1083/jcb.105.3.1105
  25. Escalier D, Silvius D, Xu X. Spermatogenesis of mice lacking CK2alpha: failure of germ cell survival and characteristic modifications of the spermatid nucleus. Mol Reprod Dev 2003; 66: 190-201. https://doi.org/10.1002/mrd.10346
  26. Coutot AM. Presence and localization of the 60 KD calcin in human spermatozoa presenting postacrosomal sheath defects: preliminary results. Mol Reprod Dev 1991; 28: 272-9. https://doi.org/10.1002/mrd.1080280309
  27. Carrel DT, Emery BR, Liu L. Characterization of aneuploidy rates, protamine levels, ultrastructure and functional ability of round- headed sperm from two siblings and implications for intracytoplasmic sperm injection. Fertil Steril 1999; 71: 511-6. https://doi.org/10.1016/S0015-0282(98)00498-1
  28. Larson KL, Brannian JD, Singh NP, Burbach JA, Jost LK, Hansen KP, Kreger DO, Evenson DP. Cromatin structure in globozoospermia: a case report. J Androl 2001; 22: 424-31.
  29. Machev N, Gosset P, Viville S. Chromosome abnormalities in sperm from infertile men with normal somatic karyotypes: teratozoospermia. Cytogenet genome Res 2005; 111: 352-7. https://doi.org/10.1159/000086910
  30. Xu X, Toselli PA, Russel LD, Seldin DC. Globozoospermia in mice lacking the casein kinase II alpha catalytic subunit. Nat Genet 1999; 23: 118-21. https://doi.org/10.1038/12729
  31. Rocha D, Affara NA. The genetic basis of impaired spermatogenesis and male infertility. Curr Obst Gyn 2000; 10: 139-45. https://doi.org/10.1054/cuog.2000.0125
  32. Truong BN, Moses EK, AArmes JE, Venter DJ, Baker HW. Searching for candidate genes for male infertility. Asian J Androl 2003; 5: 137-47.