Single and twin ongoing pregnancies in two cases of previous ART failure after ICSI performed with sperm sorted using annexin V microbeads.

OBJECTIVE

To treat couples with intracytoplasmic sperm injection (ICSI) after annexin V sperm sorting.

DESIGN

Two case reports.

SETTING

Department of Reproductive Medicine at a private medical institute.

PATIENT(S): Couples on infertility treatment, donor oocytes.

INTERVENTION(S): Sperm sorted with annexin V magnetic microbeads before ICSI, day 3 embryo transfer; case 1: ovum donation; case 2: patient oocytes.

MAIN OUTCOME MEASURE(S): 1) Sperm DNA fragmentation (terminal deoxynucleotide transferase-mediated dUTP nick-end labeling [TUNEL]) and active caspase-3 (immunocytochemistry); 2) fertilization rate, embryonic quality, blastocyst development of nontransferred embryos, and pregnancy outcome after ICSI of sorted sperm.

RESULT(S): Case 1: Premature ovarian failure patient with previous fertilization failures: asthenoteratozoospermia, abnormal DNA fragmentation (TUNEL 30%; normal <20%). ICSI with annexin V-treated sperm done on six donated metaphase II (MII) oocytes; four fertilized, and a 5-cell/grade-2 and a 6-cell/grade-2-3 embryo were transfered. A day 5 blastocyst was cryopreserved. The patient was in the last trimester of gestation. Case 2: Couple with >4 years of primary infertility and recent ICSI failure. Semen with teratozoospermia (5% normal forms [Kruger]) and abnormal active caspase-3 (16%; normal <11%). ICSI with annexin V-treated sperm done on 9 MII oocytes. All fertilized; a 7-cell/grade-1 and an 8-cell/grade-1-2 embryo were transferred. A day 5 expanded blastocyst was cryopreserved. The patient was in the second trimester of a twin normal pregnancy.

CONCLUSION(S): Sperm sorting with annexin V columns was effective in the treatment of two cases of ICSI failure, resulting in a single and a twin pregnancy after transfer of two embryos in each case.