title: Failure of oocyte activation after intracytoplasmic sperm injection using round-headed sperm.
abstract: OBJECTIVE
  To examine the outcome of intracytoplasmic sperm injection (ICSI) with round-headed sperm (globozoospermia).
  
  
  METHODS
  Retrospective analysis.
  
  
  METHODS
  In vitro fertilization laboratory with extensive ICSI experience.
  
  
  METHODS
  A patient couple with infertility because of globozoospermia seeking ICSI treatment.
  
  
  METHODS
  Fertilization, cleavage, and pregnancy rates.
  
  
  METHODS
  Intracytoplasmic sperm injection and calcium ionophore.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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 with globozoospermia, and further study of the etiology of this condition is needed.
authors.affiliation: Department of Obstetrics and Gynecology, University of Washington, Seattle 98195, USA. DBATTAG@U.WASHINGTON.EDU
authors.forename: D E
authors.initials: DE
authors.lastname: Battaglia
authors.forename: J K
authors.initials: JK
authors.lastname: Koehler
authors.forename: N A
authors.initials: NA
authors.lastname: Klein
authors.forename: M J
authors.initials: MJ
authors.lastname: Tucker
mesh_terms: D000328:Adult; D000001:Calcimycin / Q000494:pharmacology; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D006801:Humans; D007248:Infertility, Male / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D007476:Ionophores / Q000494:pharmacology; D008297:Male; D008845:Microinjections / Q000379:methods; D009865:Oocytes / Q000187:drug effects / Q000502:physiology*; D012189:Retrospective Studies; D013094:Spermatozoa / Q000002:abnormalities* / Q000502:physiology / Q000648:ultrastructure
chemical_list: D007476:Ionophores; D000001:Calcimycin