ABSTRACT
BACKGROUND: Severe sperm motility impairment results in human infertility, which can be overcome by ICSI. Whether some particular, possibly genetic, flagellar abnormalities can influence embryonic development is a matter of debate. METHODS: Analysis of ultrastructural flagellar abnormalities and ICSI outcomes with ejaculated spermatozoa in a series of 21 infertile patients with asthenozoospermic or dyskinetic spermatozoa due to a primary and specific flagellar abnormality was carried out. RESULTS: Patients were sorted into six categories according to flagellar ultrastructural defects. Oocyte fertilization occurred in the 21 couples with a mean 2PN fertilization rate reaching 61.85%. No difference was observed in the kinetics of in vitro development or in the morphological quality of the embryos between the different types of flagellar abnormalities. Pregnancy occurred in 12 couples (57.1%) and delivery in nine couples (42.86%). Both the implantation rate and the clinical pregnancy rate per cycle were lower in type III abnormalities and in patients with an initial sperm motility less than 5%. CONCLUSIONS: The rate of ICSI success may be influenced by the type of flagellar abnormality. ICSI provides a suitable solution for patients with sperm flagellar defects but raises the question of the consequences of a specific (and primary flagellar) abnormality on oocyte fertilization, on embryo and fetal development as well as on live birth.
Subject(s)
Ejaculation , Sperm Injections, Intracytoplasmic , Sperm Tail/ultrastructure , Spermatozoa/abnormalities , Adult , Fertilization , Fetal Development , Humans , Male , Middle Aged , Sperm Motility , Treatment OutcomeABSTRACT
UNLABELLED: The prevention of mother-to-child transmission is important in the control of HIV. Despite preventive measures, the objective of a zero transmission rate from mother to child has not yet been reached even in Northern countries. OBSERVATION: A retrospective study covering a 14-year period (January 1988 through December 2001) examined records of 80 children born to HIV-positive mothers at Rouen University Hospital Center. Four children were contaminated. We report several particularities of these four children, contaminated despite the preventive measures taken. CONCLUSION: Prevention of mother-to-child transmission involves not only administration of antiretrovirals during pregnancy, but also better follow-up of pregnancy and delivery and more effective management of risk factors such as drug addiction and poverty. Multidisciplinary follow-up is needed for these children in view of our current lack of knowledge of the long-range side effects of these antiretrovirals.
