Aim: Dysplasia of the fibrous sheath (DFS) is an anomaly found in asthenozoospermic patients with extremely lowor absent motility. In order to determine the efficacy of ICSI in these patients, a retrospective analysis...Aim: Dysplasia of the fibrous sheath (DFS) is an anomaly found in asthenozoospermic patients with extremely lowor absent motility. In order to determine the efficacy of ICSI in these patients, a retrospective analysis of ICSI results inDFS patients has been done. Methods: Ten ICSI attempts were performed in 6 patients with diagnosis of Dysplasiaof the Fibrous Sheath studied by transmission and scanning electron microscopy. Results: In the cases studied,sperm concentration was (29.62 ± 18.05) × 10~6/mL, total motility was 1.14 ± 1.31%. Progressive motility was 0%except for one case with 0.1%. One hundred and three preovulatory oocytes were obtained and 94 metaphase Ⅱ oocyteswere injected. Sixty-nine of them showed two pronuclei (fertilization rate: 73.4% ). Forty-nine embryos were ob-tained and 34 were transferred (mean: 3.4 embryos per transfer). Five pregnancies were diagnosed by β-hCG plasmalevel determinations that resulted to be one preclinical abortion, one clinical abortion and three deliveries. Anotherpregnancy (ongoing) was achieved from a cryopreserved embryo transfer. Conclusion: These results showed thatICSI provides a suitable solution for patients suffering from irreversible sperm defects such as DFS. Nevertheless, it ismandatory to inform couples of possible transmission risks to offspring, which are unknown at present. Only when theetiology of this problem is disclosed, it will be possible to assess the real genetic risk.展开更多
文摘Aim: Dysplasia of the fibrous sheath (DFS) is an anomaly found in asthenozoospermic patients with extremely lowor absent motility. In order to determine the efficacy of ICSI in these patients, a retrospective analysis of ICSI results inDFS patients has been done. Methods: Ten ICSI attempts were performed in 6 patients with diagnosis of Dysplasiaof the Fibrous Sheath studied by transmission and scanning electron microscopy. Results: In the cases studied,sperm concentration was (29.62 ± 18.05) × 10~6/mL, total motility was 1.14 ± 1.31%. Progressive motility was 0%except for one case with 0.1%. One hundred and three preovulatory oocytes were obtained and 94 metaphase Ⅱ oocyteswere injected. Sixty-nine of them showed two pronuclei (fertilization rate: 73.4% ). Forty-nine embryos were ob-tained and 34 were transferred (mean: 3.4 embryos per transfer). Five pregnancies were diagnosed by β-hCG plasmalevel determinations that resulted to be one preclinical abortion, one clinical abortion and three deliveries. Anotherpregnancy (ongoing) was achieved from a cryopreserved embryo transfer. Conclusion: These results showed thatICSI provides a suitable solution for patients suffering from irreversible sperm defects such as DFS. Nevertheless, it ismandatory to inform couples of possible transmission risks to offspring, which are unknown at present. Only when theetiology of this problem is disclosed, it will be possible to assess the real genetic risk.
