Smooth endoplasmic reticulum aggregations in all retrieved oocytes causing recurrent multiple anomalies: case report

Objective: To document the relationship between smooth endoplasmic reticulum (SER) aggregations and recurrent fetal anomalies. Design: Case report. Setting: Private IVF center. Patient(s): A 28-year-old woman with an 11-year history of primary infertility. Intervention(s): Three consecutive cycles of intracytoplasmic sperm injection (ICSI) in the same patient. Main Outcome Measure(s): Clinical pregnancy, live birth, fetal anomaly. Result(s): In three consecutive ICSI cycles, a total of 59 MII oocytes were retreived in the same patient, all displaying SER aggregations. The fertilization rate per cycle was 80%, 50%, and 42%, respectively. A total of 12 embryos were transferred in three ICSI cycles, of which 11 were grade 1 embryos. Two of the three cycles ended up with clinical ongoing pregnancies but with multiple fetal anomalies. Conclusion(s): This is the first case reported with SER aggregations in all retrieved oocytes in three consecutive ICSI cycles. The repetetive multiple fetal anomalies possibly related to oocyte dysmorphism are of concern. (Fertil Steril (R) 2009; 92: 1496.e1-e3. (C) 2009 by American Society for Reproductive Medicine.)