A birth from the transfer of a single vitrified-warmed blastocyst using intracytoplasmic sperm injection with calcium ionophore oocyte activation in a globozoospermic patient

Objective: To present the effectiveness of diagnostic heterologous intracytoplasmic sperm injection (ICSI), mouse oocyte activation test (MOAT), and ICSI combined with assisted oocyte activation (AOA) in a globozoospermic patient. Design: A case report. Setting: A private IVF center, Japan. Patient(s): A patient with globozoospermia. Intervention(s): MOAT in a mouse and ICSI combined with AOA in a human. Main Outcome Measure(s): Ultrastructure, MOAT, fertilization, and pregnancy. Result(s): The transmission electron micrographs showed 100% round-headed spermatozoa lacking an acrosome. MOAT showed that the fertilization rate was 68.4% (13/19) when AOAwas used but 0% (0/19) when AOAwas not used. After the diagnosis of globozoospermia and sperm-related activation deficiency, 17 human mature oocytes were activated with calcium ionophore after ICSI was performed. The fertilization rate was 88.2% (15/17), and 11 blastocysts were cryopreserved using the vitrification method to prevent severe ovarian hyperstimulation syndrome. A single vitrified-warmed blastocyst was transferred. A gestational sac with fetal heart movements was recognized, and a healthy boy weighing 3180 g was born at 40 weeks of gestation by cesarean section without any congenital abnormality. Conclusion(s): MOAT allows discrimination between sperm-and oocyte-related fertilization failures and shows the effectiveness of AOA. (Fertil Steril (R) 2009;91:931.e7-e11. (C) 2009 by American Society for Reproductive Medicine.)