Poor fertilization may be related to oocyte or zona pellucida recognition defects specific to certain hyperstimulation regimens and limited to some males but not others: a case report.
OBJECTIVE
To determine if the controlled ovarian hyperstimulation (COH) regimen may cause sperm to appear subfertile only to improve considerably by changing the COH protocol.


METHODS
Case report with retrospective review of previous fertilization rates according to COH protocol used.


METHODS
Fertilization and pregnancy rates (PRs) after IVF-ET.


RESULTS
Known fertile donor sperm failed to fertilize any of 11 oocytes compared with 14 of 18 for processed retrograde ejaculate using the same oocyte pool. Retrospective analysis of other cycles for different female patients but same donor found 16.6% fertilization rate whenever luteal phase leuprolide acetate (LA)-hMG regimen was used compared with 70.6% with short-flare regimen.


CONCLUSIONS
Some COH regimens may cause oocyte or zona pellucida changes that create recognition defects for some sperm but not others. Interestingly, the sperm with the binding defect with the luteal phase LA-hMG COH protocol exhibited good fertilization rates with oocytes prepared with the short-flare protocol and demonstrated high in vivo PRs after IUI.
Check
J H
JH
Department of Obstetrics and Gynecology, University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School at Camden, USA.
Long
R
R
Allen
J
J
Hoover
L
L
D000328:Adult; D004624:Embryo Transfer; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D007248:Infertility, Male / Q000628:therapy*; D016729:Leuprolide / Q000627:therapeutic use; D008297:Male; D008596:Menotropins / Q000627:therapeutic use; D009865:Oocytes / Q000378:metabolism*; D010062:Ovulation Induction; D011247:Pregnancy; D015044:Zona Pellucida / Q000378:metabolism*
D008596:Menotropins; D016729:Leuprolide