Human sperm can fertilize ova inside the Graafian follicles before ovulation.
OBJECTIVE
To report an incidental finding of fertilization of ova inside the ovarian follicles before ovulation.


METHODS
Case report.


METHODS
IVF Center, King Fahd Specialist Hospital, Buraidah, Al-Qassim, Saudi Arabia.


METHODS
One 31-year-old woman with 8 years of primary infertility.


METHODS
Long-protocol superovulation and ovum pickup (OPU).


METHODS
The retrieved nine oocytes were incubated and followed up closely.


RESULTS
Three hours after OPU and only after decoronization of oocytes, sperm were seen attached to the zonae pellucidae of six mature oocytes. Three of them were showing signs of fertilization (two pronuclei). Neither conventional IVF nor intracytoplasmic sperm injection was done, and we decided to continue incubation and observation of all oocytes. From the nine total oocytes, fertilization was demonstrated in six with attached sperm, of which four divided. On day 2 after OPU, three embryos were transferred into the uterus.


CONCLUSIONS
Human sperm can migrate and ascend through the female genital tract to get through the ovarian tissue. Moreover, under certain conditions, it can penetrate the wall of an intact ovarian follicle to reach the ovum and fertilize it just before ovulation.
Nada
Zakaria M
ZM
IVF Center, King Fahd Specialist Hospital, Buraidah, Al-Qassim, Saudi Arabia. zmmn@hotmail.com
Assaf
Nashaat F
NF
Dubey
Sushil K
SK
D000328:Adult; D005260:Female; D005306:Fertilization / Q000502:physiology*; D005307:Fertilization in Vitro; D006801:Humans; D006080:Ovarian Follicle / Q000502:physiology*; D010060:Ovulation / Q000502:physiology*; D010063:Ovum / Q000166:cytology; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000517:prevention & control*; D020554:Sperm Injections, Intracytoplasmic; D013084:Sperm-Ovum Interactions / Q000502:physiology*; D013480:Superovulation