Pregnancy from intracytoplasmic sperm injection of a sperm head and detached tail.
OBJECTIVE
To evaluate sperm ultrastructure and the efficacy of intracytoplasmic sperm injection (ICSI) with careful positioning of the sperm midpiece next to the sperm head in a patient with easily decapitated sperm syndrome.


METHODS
In vitro fertilization case report with retrospective sperm ultrastructure analysis.


METHODS
In vitro fertilization clinic and andrology laboratory.


METHODS
A couple seeking treatment for diminished ovarian reserve and male factor infertility using donor oocyte IVF.


METHODS
Motile sperm inadvertently decapitated during micromanipulation were used for a modified ICSI procedure in which the midpiece was carefully positioned proximal to the sperm head. Sperm were also analyzed by transmission electron microscopy (TEM).


METHODS
Fertilization rate, embryo development, pregnancy, and the incidence of normal sperm ultrastructure.


RESULTS
The ICSI resulted in a fertilization rate of 63% and embryo development of good to moderate quality of 36% of the embryos. Transfer of two embryos resulted in a pregnancy and birth of a healthy child. Normal sperm centrosomes were identified retrospectively.


CONCLUSIONS
Pregnancy can result in patients where the sperm are decapitated during immobilization before ICSI if normal centrosomes are present and the head and midpiece are positioned closely together.
Emery
Benjamin R
BR
Department of Surgery, University of Utah School of Medicine, Salt Lake City, Utah 84108, USA.
Thorp
Cindy
C
Malo
John W
JW
Carrell
Douglas T
DT
D018385:Centrosome / Q000648:ultrastructure; D004624:Embryo Transfer; D005314:Embryonic and Fetal Development; D005260:Female; D005306:Fertilization; D005307:Fertilization in Vitro; D006801:Humans; D008297:Male; D008854:Microscopy, Electron; D008875:Middle Aged; D036801:Parturition; D011247:Pregnancy; D012189:Retrospective Studies; D013077:Sperm Head; D020554:Sperm Injections, Intracytoplasmic; D013094:Spermatozoa / Q000648:ultrastructure