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Human Reproduction, Vol. 18, No. 3, 562-567, March 2003
© 2003 European Society of Human Reproduction and Embryology

Pregnancies after ICSI using sperm with abnormal head–tail junction from two brothers: Case report

G. Porcu1, G. Mercier2,3, P. Boyer2, V. Achard3, J. Banet1, M. Vasserot3, C. Melone2, J. Saias-Magnan4, C. D’Ercole5, C. Chau5 and M.R. Guichaoua4,6,7

1 Centre de Procréation Médicalement Assistée, AP-HM, Hôpital de la Conception, 147 Boulevard Baille, 13385 Marseille cedex 05, 2 Laboratoire de Procréation Médicalement Assistée, Hôpital Saint-Joseph, 26 Bd de Louvain, 13285 Marseille cedex 08, 3 Laboratoire d’Histologie et de Biologie de la Reproduction, Faculté de Médecine Timone, 27 Boulevard Jean Moulin, 13385 Marseille cedex 05, 4 Laboratoire de Biologie de la Reproduction, Hôpital de la Conception, 147 Boulevard Baille, 13385 Marseille cedex 05, 5 Service de Gynécologie Obstétrique, AP-HM, Hôpital Nord, Chemin des Bourrellys, 13915 Marseille cedex 20 and 6 Laboratoire de Biogénotoxicologie et Mutagenèse Environnementale (EA1784), IFR PMSE112, Faculté de médecine 27, Boulevard Jean Moulin, 13385 Marseille cedex 5 France

7 To whom correspondence should be addressed at: Laboratoire de Biologie de la Reproduction, Hôpital de la Conception, 147, Bd Baille, 13385 Marseille cedex 5, France. e-mail: mguichaoua{at}ap-hm.fr

We report ICSI pregnancies in two couples with a history of long standing primary infertility in which the sperm of the male partner were either acephalic or had abnormal head–midpiece attachments. The two couples, in which the men are brothers, underwent ICSI. Sperm were analysed by transmission electron microscopy and immunocytochemistry with an anti-MPM2 monoclonal antibody. The first couple underwent two ICSI cycles, each consisting of the injection of two mature oocytes and the transfer of two embryos. A successful pregnancy occurred after the second transfer and led to the birth to a healthy girl. The second couple underwent three ICSI cycles, each consisting of the injection of 18 oocytes and the transfer of two embryos; the last of these led to a triple ongoing pregnancy which included two identical twins. Caesarean section led to the birth of three fetal-growth restricted children. This case report demonstrates that ongoing pregnancies can be achieved in cases of abnormal development of the head–neck attachment. The genetic origin of this syndrome is generally accepted, but the phenotypic heterogeneity observed by light and electron microscopy among published cases suggests that there are a variety of genetic causes of this syndrome.

Key words: decapitated sperm defect/ICSI/male infertility/pregnancy


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