title: Intracytoplasmic sperm injection and pregnancy with decapitated sperm.
abstract: OBJECTIVE
  To perform intracytoplasmic sperm injection (ICSI) in couples with primary infertility owing to sperm defects causing total immotility.
  
  
  METHODS
  Case report.
  
  
  METHODS
  Couple Sterility Center, University of Siena.
  
  
  METHODS
  Two infertile couples, the male members of which had "detached tail" genetic sperm defect.
  
  
  METHODS
  Physical and hormonal assays, semen analysis by light and electron microscopy, Y microdeletion screening, immunofluorescence, fluorescence in situ hybridization analysis of sperm nuclei, and PCR for partial sequences of AKAP4/AKAP3 binding regions were performed. The couples then underwent ICSI.
  
  
  RESULTS
  Transmission electron microscopic analysis showed that the cause of sterility was "detached tail" genetic sperm defect. Immunofluorescence staining confirmed sperm structural alterations. Screening of Y microdeletions, partial sequences of AKAP4/AKAP3 binding regions, and fluorescence in situ hybridization did not show any sperm nucleus abnormalities. Three and two ICSI cycles were performed in the two couples. One pregnancy was achieved and a healthy baby with a normal female karyotype was born.
  
  
  CONCLUSIONS
  One couple successfully underwent ICSI with "detached tail" sperm and gave birth to a healthy baby, suggesting that this structural abnormality may be bypassed by injecting sperm with a normal centriolar region.
authors.affiliation: Department of Pediatrics, Obstetrics and Reproductive Medicine, Policlinico S. Maria alle Scotte, University of Siena, 53100 Siena, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Gambera
authors.forename: Patrizia
authors.initials: P
authors.lastname: Falcone
authors.forename: Luca
authors.initials: L
authors.lastname: Mencaglia
authors.forename: Giulia
authors.initials: G
authors.lastname: Collodel
authors.forename: Francesca
authors.initials: F
authors.lastname: Serafini
authors.forename: Vincenzo
authors.initials: V
authors.lastname: De Leo
authors.forename: Paola
authors.initials: P
authors.lastname: Piomboni
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007248:Infertility, Male / Q000175:diagnosis / Q000628:therapy*; D008297:Male; D011247:Pregnancy; D020554:Sperm Injections, Intracytoplasmic / Q000379:methods*; D013082:Sperm Tail / Q000473:pathology* / Q000648:ultrastructure; D013094:Spermatozoa / Q000473:pathology / Q000648:ultrastructure