{Reference Type}: Case Reports
{Title}: Successful intracytoplasmic sperm injection with testicular spermatozoa from a man with multiple morphological abnormalities of the sperm flagella: a case report.
{Author}: Yang S;Gao L;Wang W;Ding J;Xu Y;Li H;
{Journal}: J Assist Reprod Genet
{Volume}: 35
{Issue}: 2
{Year}: Feb 2018
{Factor}: 3.357
{DOI}: 10.1007/s10815-017-1057-5
{Abstract}: <B>OBJECTIVE: </B>The purpose of this study is to analyze the sperm morphology of a Chinese man affected with multiple morphological abnormalities of the sperm flagella (MMAF) and observe the intracytoplasmic sperm injection (ICSI) outcome.<BR><B>METHODS: </B>A Chinese man was diagnosed with multiple morphological abnormalities of the sperm flagella by semen analysis and electron microscopy. Testicular spermatozoa were injected intracytoplasmically, and the following ICSI results were observed.<BR><B>RESULTS: </B>All the spermatozoa from his ejaculate were immotile and morphologically abnormal in the flagellum. In transmission electron microscopy assays, most spermatozoa showed disorganized fibrous sheath, accompanied by distortion of various cytoskeletal components, and missing of the central pair microtubules. Testicular sperm was injected to the oocytes in two ICSI cycles, with fertilization rates of 45.5 and 40.0%. Finally, a healthy female infant was delivered at the second ICSI cycle.<BR><B>CONCLUSIONS: </B>Fertilization and pregnancy could be achieved by intracytoplasmic sperm injection, regardless of severe flagellar defects. ICSI is effective for MMAF-affected man, and testicular sperm is an alternative when no motile sperm is available.