J 2021

Live birth achieved despite the absence of ejaculated spermatozoa and mature oocytes retrieved: a case report

HOLUBCOVÁ, Zuzana, Pavel OTEVREL, Marek KOUDELKA and Sona KLOUDOVA

Basic information

Original name

Live birth achieved despite the absence of ejaculated spermatozoa and mature oocytes retrieved: a case report

Authors

HOLUBCOVÁ, Zuzana (203 Czech Republic, guarantor, belonging to the institution), Pavel OTEVREL (203 Czech Republic), Marek KOUDELKA (203 Czech Republic) and Sona KLOUDOVA (203 Czech Republic)

Edition

Journal of Assisted Reproduction and Genetics, NEW YORK, SPRINGER/PLENUM PUBLISHERS, 2021, 1058-0468

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

10604 Reproductive biology

Country of publisher

United States of America

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

Impact factor

Impact factor: 3.357

RIV identification code

RIV/00216224:14110/21:00121111

Organization unit

Faculty of Medicine

UT WoS

000609041700001

Keywords in English

IVF add-ons; Oocyte maturity; Polarized light microscopy; Theophylline; Testicular sperm

Tags

Tags

International impact, Reviewed
Změněno: 17/5/2022 08:39, Mgr. Tereza Miškechová

Abstract

V originále

The most common reason for in vitro fertilization (IVF) cycle cancelation is a lack of quality gametes available for intracytoplasmic sperm injection (ICSI). Here we present the successful fertility treatment of the couple affected by obstructive azoospermia combined with suboptimal response to controlled ovarian stimulation. Since the conventional approach appeared ineffective to overcome both partners| specific problems, the targeted interventions, namely, (1) pharmacological enhancement of sperm motility and (2) polarized light microscopy (PLM)-guided optimization of ICSI time, were applied to rescue the cycle with only immature oocytes and immotile testicular sperm retrieved. The treatment with theophylline aided the selection of viable spermatozoa derived from cryopreserved testicular tissue. When the traditional stimulation protocol failed to produce mature eggs, non-invasive spindle imaging was employed to adjust the sperm injection time to the maturational stage of oocytes extruding a polar body in vitro. The fertilization of 12 late-maturing oocytes yielded 5 zygotes, which all developed into blastocysts. One embryo was transferred into the uterus on day 5 post-fertilization, and another 3 good quality blastocysts were vitrified for later use. The pregnancy resulted in a full-term delivery of a healthy child. This case demonstrates that the individualization beyond the standard IVF protocols should be considered to maximize the chance of poor-prognosis patients to achieve pregnancy with their own gametes.