Single and twin ongoing pregnancies in two cases of previous ART failure after ICSI performed with sperm sorted using annexin V microbeads.
OBJECTIVE
To treat couples with intracytoplasmic sperm injection (ICSI) after annexin V sperm sorting.


METHODS
Two case reports.


METHODS
Department of Reproductive Medicine at a private medical institute.


METHODS
Couples on infertility treatment, donor oocytes.


METHODS
Sperm sorted with annexin V magnetic microbeads before ICSI, day 3 embryo transfer; case 1: ovum donation; case 2: patient oocytes.


METHODS
1) Sperm DNA fragmentation (terminal deoxynucleotide transferase-mediated dUTP nick-end labeling [TUNEL]) and active caspase-3 (immunocytochemistry); 2) fertilization rate, embryonic quality, blastocyst development of nontransferred embryos, and pregnancy outcome after ICSI of sorted sperm.


RESULTS
Case 1: Premature ovarian failure patient with previous fertilization failures: asthenoteratozoospermia, abnormal DNA fragmentation (TUNEL 30%; normal <20%). ICSI with annexin V-treated sperm done on six donated metaphase II (MII) oocytes; four fertilized, and a 5-cell/grade-2 and a 6-cell/grade-2-3 embryo were transfered. A day 5 blastocyst was cryopreserved. The patient was in the last trimester of gestation. Case 2: Couple with >4 years of primary infertility and recent ICSI failure. Semen with teratozoospermia (5% normal forms [Kruger]) and abnormal active caspase-3 (16%; normal <11%). ICSI with annexin V-treated sperm done on 9 MII oocytes. All fertilized; a 7-cell/grade-1 and an 8-cell/grade-1-2 embryo were transferred. A day 5 expanded blastocyst was cryopreserved. The patient was in the second trimester of a twin normal pregnancy.


CONCLUSIONS
Sperm sorting with annexin V columns was effective in the treatment of two cases of ICSI failure, resulting in a single and a twin pregnancy after transfer of two embryos in each case.
Polak de Fried
Ester
E
Department of Reproductive Medicine, CER Medical Institute, School of Medicine, University of Buenos Aires, Buenos Aires, Argentina. ester_polak@cermed.com
Denaday
Flavia
F
D000328:Adult; D017304:Annexin A5 / Q000008:administration & dosage*; D002469:Cell Separation / Q000379:methods; D053938:DNA Fragmentation; D005260:Female; D006801:Humans; D008297:Male; D008863:Microspheres; D011247:Pregnancy; D011256:Pregnancy Outcome; D020554:Sperm Injections, Intracytoplasmic / Q000379:methods*; D013094:Spermatozoa / Q000166:cytology* / Q000187:drug effects; D017211:Treatment Failure; D014427:Twins
D017304:Annexin A5