Successful fertilization and pregnancy after intracytoplasmic sperm injection and oocyte activation with calcium ionophore in a normozoospermic patient with extremely low fertilization rates in intracytoplasmic sperm injection cycles.
OBJECTIVE
To investigate the effect of calcium ionophore on the fertilization rate of a patient with normozoospermia who nonetheless exhibited a low fertilization rate in intracytoplasmic sperm injection (ICSI).


METHODS
Case report.


METHODS
In vitro fertilization center.


METHODS
A male patient whose sperm, though diagnosed as normal by semen analysis, exhibited a severely low fertilization rate in ICSI cycles.


METHODS
Oocytes were activated by calcium ionophore after ICSI.


METHODS
Fertilization rate after oocyte activation; ultrastructure and protein expression of the patient's sperm.


RESULTS
The fertilization rate of oocytes activated with calcium ionophore (12 of 15, 80.0%) was higher than that of the nonactivated oocytes (4 of 16, 25.0%). Four embryos derived from the activated oocytes were transferred, resulting in a twin pregnancy. Further investigation revealed abnormalities in the patient's sperm: many nuclear vacuoles were observed and the expression of some proteins was absent.


CONCLUSIONS
Oocyte activation with calcium ionophore was effective at increasing the fertilization rate of dysfunctional sperm characterized by ultrastructural and protein expression anomalies.
Chi
Hee-Jun
HJ
IVF Center, Hanna Women's Clinic, 1540-11 Seocho-dong, Seocho-gu, Seoul, South Korea. hanna129@hanmail.net
Koo
Jung-Jin
JJ
Song
Sang-Jin
SJ
Lee
Ji-Youn
JY
Chang
Sang-Sik
SS
D000328:Adult; D000818:Animals; D000001:Calcimycin / Q000627:therapeutic use*; D006224:Cricetinae; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D007476:Ionophores / Q000627:therapeutic use*; D008297:Male; D009865:Oocytes / Q000187:drug effects / Q000502:physiology*; D011247:Pregnancy; D020554:Sperm Injections, Intracytoplasmic / Q000379:methods*; D013084:Sperm-Ovum Interactions / Q000502:physiology*; D013094:Spermatozoa / Q000502:physiology / Q000648:ultrastructure
D007476:Ionophores; D000001:Calcimycin