Successful pregnancy and delivery from frozen-thawed embryos after intracytoplasmic sperm injection using round-headed spermatozoa and assisted oocyte activation in a globozoospermic patient with mosaic Down syndrome.
OBJECTIVE
To describe a successful pregnancy and delivery from frozen-thawed embryos after intracytoplasmic sperm injection (ICSI) and assisted oocyte activation in a globozoospermic patient with mosaic Down syndrome.


METHODS
Controlled clinical study.


METHODS
IVF Laboratory, PL Infertility Clinic, Seoul, Korea.


METHODS
A couple with infertility resulting from globozoospermia with mosaic Down syndrome: 47,XY,+21[7]/46,XY[33].


METHODS
Semen analysis, karyotyping, ICSI, assisted oocyte activation, assisted hatching, and frozen-thawed ET.


METHODS
Fertilization rate, implantation, pregnancy, and delivery.


RESULTS
Thirty-eight oocytes were aspirated, and round-headed spermatozoa were injected into 35 oocytes in metaphase II. Assisted oocyte activation with calcium ionophore A23187 after ICSI resulted in a high fertilization rate (21 of 35, 60%; 2 pronuclei in 18 of 21; 3 pronuclei in 3 of 21) and good embryo development. At 3 days after ICSI, 5 embryos of good quality were surgically transferred to the endometrium after assisted hatching, but no pregnancy occurred. After 2 months, the surgical transfer of 4 frozen-thawed embryos after assisted hatching led to an ongoing pregnancy. A female infant weighing 3,000 g was delivered at 38 weeks of gestation by cesarean section.


CONCLUSIONS
We report the first successful pregnancy and delivery from frozen-thawed embryos after ICSI and assisted oocyte activation in a globozoospermic patient with mosaic Down syndrome.
Kim
S T
ST
PL Infertility Clinic, 952-10 Dogok-Dong, Kangnam-Ku, Seoul 135-270, Seoul, South Korea. stkim@kyuh.co.kr
Cha
Y B
YB
Park
J M
JM
Gye
M C
MC
D000328:Adult; D000001:Calcimycin / Q000494:pharmacology; D002585:Cesarean Section; D015925:Cryopreservation; D004314:Down Syndrome / Q000150:complications* / Q000235:genetics; D010064:Embryo Implantation; D004624:Embryo Transfer; D004622:Embryo, Mammalian / Q000502:physiology; D005260:Female; D006801:Humans; D007248:Infertility, Male / Q000150:complications / Q000628:therapy*; D007476:Ionophores / Q000494:pharmacology; D008297:Male; D009030:Mosaicism; D009865:Oocytes / Q000187:drug effects / Q000502:physiology; D011247:Pregnancy; D011256:Pregnancy Outcome; D013077:Sperm Head; D020554:Sperm Injections, Intracytoplasmic; D013094:Spermatozoa / Q000002:abnormalities*
D007476:Ionophores; D000001:Calcimycin