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Pregnancy after the Calcium Ionophore Activation

Globozoospermia is a rare type of teratozoospermia, first described in 1971. Biochemically, the spermatozoa are characterized by the absence, or reduced activity of acrosin (acrosome protease) and of calicin (a cytoskeletal protein) resulted in fertilization impaired due to absence of oocyte activation. The mode of inheritance for this condition has not yet been established. Dominant inheritance, homozygous autosomal gene defect, and a possible environmental effect have been suggested [2].

Affected men suffer from reduced fertility or even infertility; no other physical characteristics can be associated with this condition. An increased aneuploidy rate has been observed in some cases, on cytogenetic analysis, mostly in the acrocentric (13, 14, 15, 18 and 21) and sex chromosomes but the findings are similar to other types of male infertility [3]. Increased DNA fragmentation and DNA damage has also been noted [4,5] The pathogenesis of globozoospermia most probably originates in spermiogenesis, especially in acrosome formation and sperm head elongation [2,6].

ICSI is the most powerful tool in ART. With the advent of ICSI, globozoospermia became one of the many severe male factor conditions that could be effectively treated. Although the fertilization rate with ICSI is considered to be the highest among all available assisted reproduction techniques, complete fertilization failure has been reported [7]. Ultra structural analysis of fertilization failure after ICSI has revealed that a deficiency in the mechanism of oocyte activation is the most common cause [1]. Activation of the oocyte results in a cascade of events including extrusion of the second polar body, decondensation of a haploid set of chromosomes, formation of a nuclear membrane around the chromosomes, and initiation of embryonic development. Oocyte activation is also characterized by two main molecular events including an increase in intracellular Ca2+ concentrations followed by meiotic promoting factor inactivation for M–G1 transition. There are numerous approaches to overcome the problem of activation/fertilization failure after ICSI. Among others, application of calcium ionophores has proved particularly advantageous because of their ease of implementation. As exposure of human gametes to calcium ionophores has not yet been found to be associated with evidence of toxicity or detrimental outcome, its widespread use in cases of previous fertilization failure has become a routine technique. To date, no data on A23187 and gene expression are available. Although ionophores are not always successful [8], deliveries even in the presence of nonviable testicular spermatozoa are conceivable after treatment with A23187 [9]. Here we report the successful case of pregnancy and delivery in couples with globozoospermia after ICSI using calcium ionophore for oocyte activation, and pre implantation genetic screening for 23 pair chromosomes using array CGH.

Citation: Phan VY, Littman E, Harris D, La A (2015) Pregnancy after the Calcium Ionophore Activation and Aneuploid Screening Using A-CGH in Globozoospermia Patient. Human Genet Embryol 5:123. doi: 10.4172/2161-0436.1000123

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