ABSTRACT
Main findings: An intriguing yet perplexing case report of a successful pregnancy and live birth with intracytoplasmic sperm injection using normal testicular sperm, after the finding of azoospermia in the semen analysis and discovering only tail stump abnormal sperm in the epididymis. Case hypothesis: A tail stump sperm defect of genetic origin was suspected. However, after obtaining normal testicular sperm we concluded that obstructive azoospermia, either idiopathic or secondary to multiple minor genital trauma was the plausible scenario. This has rendered the search of previous reports on a similar condition, but none was found. However, it has raised scientific thoughts for future research. Promising future implications: The importance of reporting this case is to alert urologists performing sperm retrieval that healthy and morphologically normal sperm may be found in the testis of azoospermic men with 100% tail stump epididymal sperm. Retrieval of normal testicular sperm obviates the need of a more complex investigation, including sperm electron microscopy. It also offers the possibility of utilizing such gametes for sperm injections rather than abnormal tail stump sperm that may be associated with a poor reproductive outcome.
Subject(s)
Adult , Female , Humans , Male , Pregnancy , Azoospermia , Live Birth , Sperm Retrieval , Sperm Injections, Intracytoplasmic/methods , Spermatozoa/abnormalities , Epididymis , Sperm Tail , TestisABSTRACT
Existen diferentes metodologías para evaluar la calidad seminal, siendo la valoración de la movilidad y de la morfología espermática los indicadores más comúnmente utilizados, sin embargo, los espermatozoides poseen ciertas características que no siempre pueden analizarse a través del examen tradicional. En esta revisión de la literatura se describen algunas metodologías alternativas empleadaspara observar y evaluar las características seminales. La movilidad, la viabilidad y la morfología espermática pueden evaluarse empleando metodologías manuales y análisis asistidos por computador. Otras características evaluables de la biología espermática son la producción de especies reactivas del oxígeno, la calidad mitocondrial y el ADN espermático. Esta revisión demuestra que existe una amplia disponibilidad de metodologías para el análisis seminal, sin embargo, cada día se siguen implementando nuevas técnicas, lo que impactará en el entendimiento de la fisiología espermática. En un futuro estas herramientas diagnósticas podrán incidir en el beneficio de los pacientes con infertilidad.
There are different methodologies for assessing semen quality assessment of mobility and sperm morphology are the most commonly used indicators. However, sperm have certain characteristics that cannot always be analyze through the traditional examination. In this review are describe some alternativemethodologies to observe and assess the seminal characteristics. Motility, viability and sperm morphology can be evaluated using manual methodologies and computational analysis. Other quantifiable characteristics of sperm biology are the production of reactive oxygen species, mitochondrial and DNA sperm quality. Here is shown that there are many methodologies for seminal analysis, however, each day are going to implementing new techniques, which will impact on the understanding of sperm physiology and in the future, they may improve the diagnosis of individuals.