LETTER TO THE EDITOR
Ahead of print publication  

First successful pregnancy outcome after intracytoplasmic sperm injection with short-tailed sperm from an infertile Han Chinese man


 The Center for Reproductive Medicine, Xiamen Maternity and Child Care Hospital, Xiamen, Fujian Province, China

Date of Submission08-Sep-2015
Date of Decision23-Nov-2015
Date of Acceptance01-Apr-2016
Date of Web Publication15-Jul-2016

Correspondence Address:
Ping Li,
The Center for Reproductive Medicine, Xiamen Maternity and Child Care Hospital, Xiamen, Fujian Province
China
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Source of Support: None, Conflict of Interest: None


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How to cite this URL:
Sha YW, Zhang Q, Ding L, Li P. First successful pregnancy outcome after intracytoplasmic sperm injection with short-tailed sperm from an infertile Han Chinese man. Asian J Androl [Epub ahead of print] [cited 2017 Apr 26]. Available from: http://www.ajandrology.com/preprintarticle.asp?id=182395

Dear Editor,

Short-tailed sperms are rarely encountered in clinical practice, but they make achieving fertilization difficult. We encountered a very rare case of an infertile man having short-tailed sperm. A 32-year-old Chinese farmer and his 27-year-old wife were referred to Xiamen Maternity and Child Care Hospital for a fertility evaluation. They were married in March 2008, and after 3 years, his wife became pregnant. However, spontaneous abortion occurred 40 days later. Afterward, pregnancy was not achieved despite 4 years of unprotected coitus. The man reported that he had been smoking 10 cigarettes per day for the past 10 years. A semen sample was collected by masturbation after 4 days of sexual abstinence. The ejaculate was fully liquefied in 20 min, and a semen analysis was performed in our laboratory according to the standard World Health Organization (WHO) criteria. Through light microscopic evaluation, we found that the sperm concentration was 15.5 × 10 6 per ml, and the percentages of progressive (PR), nonprogressive (NP), and immotility (IM) were 14.5%, 11.7%, and 73.7%, respectively. Morphology analysis revealed that 99.5% of the spermatozoa showing a short-tail phenotype ([Figure 1]a) compared with normal sperm morphology ([Figure 1]b). Based on the results of the semen analyses, the patient was diagnosed with asthenoteratozoospermia.
Figure 1: Short tails were observed compared to the long head by light microscope. (a) Spermatozoa showing a short tail phenotype. (b) Sperms with normal morphology

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Because of the patient's asthenoteratozoospermia, we chose to perform intracytoplasmic sperm injection (ICSI) to fertilize oocytes. Twelve oocytes were obtained from his wife on day 0, and all oocytes were mature (MII). For the ICSI procedure, we prefer ejaculated spermatozoa that were fast-moving and had long tails. Eighteen hours after ICSI, a fertilization check was performed. Eight of the embryos had two pronuclei (2PN) ([Figure 2]a), one had 0 pronuclei (0PN) ([Figure 2]b), and the remaining three each had one pronucleus (1PN) ([Figure 2]c). On the second day after ICSI, cleavage was observed in nine embryos; one was grade 2.5 and the others were grade 3 or 3.5. Two embryos ([Figure 2]d and [Figure 2]e) were transferred on day 2. The other embryos were frozen. Pregnancy did not occur, as evidenced by the low levels of βhCG 15 days after transfer. Five months later, we thawed three embryos ([Figure 2]f-[Figure 2]h) (10C3.5; 9C3; 7C3) and transferred them to his wife's uterus. Fortunately, pregnancy was successful and the wife delivered a live baby. To our knowledge, this is the first report from the Han Chinese population of a child delivered following conception with ICSI.
Figure 2: (a) Diploid zygote (2PN). (b) 0 zygotes (0PN). (c) One zygote (1PN). (d and e) Two day-3 embryos were transferred. Day_3 embryo that was thawed and transferred (f : 10C3.5), (g : 9C3) and (h : 7C3).

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In humans, it is estimated that 15% of the couples are infertile, and one-third of these cases can be attributed solely to the male partner. [1] Defects of the sperm tail can affect sperm motility. The relationship between fertility and sperm activity is evident. Although sperm motility is one of the most important predictors of fertilization ability, the mechanisms underlying motility abnormalities are still poorly understood. The internal cytoskeletal structure of cilia, flagella, basal bodies, and centrioles, called the axoneme, has been shown to be essential for flagellar development and movement. [2],[3] Because of the highly conserved 250 polypeptides among eukaryotic cells, [4],[5] increasingly more molecular proteins which were important for tail defects have been identified, such as AKAP4, [6] KPL2, [7] RAB-like 2, [8] and MNS1. [9] In the present case, due to teratozoospermia, function defects may have lower fertilization, which is an indication for assisted reproductive technology. To our knowledge, this is the first report from the Han Chinese population of a delivery following ICSI.


  Author Contributions Top


YWS collected and provided all the clinic information; QZ wrote the paper; LD and PL participated in the collection of the specimens and helped to draft the manuscript and subsequently review the manuscript.


  Competing Interests Top


All authors declare no competing interests.

 
  References Top

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Kolettis PN. Evaluation of the subfertile man. Am Fam Physician 2003; 67: 2165-72.  Back to cited text no. 1
    
2.
Baccetti B, Bruni E, Gambera L, Moretti E, Piomboni P. An ultrastructural and immunocytochemical study of a rare genetic sperm tail defect that causes infertility in humans. Fertil Steril 2004; 82: 463-8.  Back to cited text no. 2
    
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Turner RM, Foster JA, Gerton GL, Moss SB, Patrizio P. Molecular evaluation of two major human sperm fibrous sheath proteins, pro-hAKAP82 and hAKAP82, in stump tail sperm. Fertil Steril 2001; 76: 267-74.  Back to cited text no. 3
    
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Inaba K. Molecular architecture of the sperm flagella: molecules for motility and signaling. Zoolog Sci 2003; 20: 1043-56.  Back to cited text no. 4
    
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Hackstein JH, Hochstenbach R, Pearson PL. Towards an understanding of the genetics of human male infertility: lessons from flies. Trends Genet 2000; 16: 565-72.  Back to cited text no. 5
    
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Moretti E, Scapigliati G, Pascarelli NA, Baccetti B, Collodel G. Localization of AKAP4 and tubulin proteins in sperm with reduced motility. Asian J Androl 2007; 9: 641-9.  Back to cited text no. 6
    
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Sironen A, Thomsen B, Andersson M, Ahola V, Vilkki J. An intronic insertion in KPL2 results in aberrant splicing and causes the immotile short-tail sperm defect in the pig. Proc Natl Acad Sci U S A 2006; 103: 5006-11.  Back to cited text no. 7
    
8.
Lo JC, Jamsai D, O′Connor AE, Borg C, Clark BJ, et al. RAB-like 2 has an essential role in male fertility, sperm intra-flagellar transport, and tail assembly. PLoS Genet 2012; 8: e1002969.  Back to cited text no. 8
    
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Zhou J, Yang F, Leu NA, Wang PJ. MNS1 is essential for spermiogenesis and motile ciliary functions in mice. PLoS Genet 2012; 8: e1002516.  Back to cited text no. 9
    


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