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Human Reproduction, Vol. 14, No. 1, 110-113, January 1999
© 1999 European Society of Human Reproduction and Embryology

Assisted reproduction for infertile patients with 9+0 immotile spermatozoa associated with autosomal dominant polycystic kidney disease

Hiroshi Okada1,3, Hitoshi Fujioka1, Noboru Tatsumi1, Masato Fujisawa1, Kazuo Gohji1, Soichi Arakawa1, Hiroshi Kato2, Shin-Ichiro Kobayashi2, Shinzo Isojima2 and Sadao Kamidono1

1 Department of Urology, Kobe University School of Medicine, 7–5–1 Kusunoki-cho, Chuo-ku, Kobe 650–0017, and 2 Advanced Fertility Center, Fuchu Hospital, Izumifuchu, Japan

We investigated the clinical feature of patients with totally immotile spermatozoa due to 9+0 ultrastructural flagellar defects and polycystic kidney disease. We also tried to establish the feasibility of applying modern assisted reproduction technology (ART) in these patients. During 6-year interval a total of 1956 Japanese men were referred to the male infertility clinic. Of them, 16 were diagnosed to have immotile spermatozoa and four of them exhibited axonemal 9+0 defects in the sperm flagella. These four also had autosomal dominant polycystic kidney disease (ADPKD). Intrauterine insemination (IUI) and conventional in-vitro fertilization and embryo transfer failed to achieve fertilization. Intracytoplasmic sperm injection (ICSI) with 100% immotile spermatozoa was performed in all four cases. Two-pronuclear fertilization was obtained in 27 of the 70 (38.6%) of the successfully injected oocytes, but no pregnancy resulted. In one case, a few motile spermatozoa were present at the second cycle of ICSI, a pregnancy was successfully achieved using these spermatozoa. While immotile spermatozoa from patients with the axonemal 9+0 defect achieved fertilization by ICSI, the embryos failed to develop. Our results indicate that the central microtubules may play a role in fetal development. Since the 4 patients with 9+0 defects also had ADPKD, the genetic linkage between these two conditions should be studied by molecular biological methods so as to aid our ability to counsel such patients.

Key words: ART/flagellar ultrastructure/immotile spermatozoa/polycystic kidney

3 To whom correspondence should be addressed


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