Pregnancy after laser-assisted selection of viable spermatozoa before intracytoplasmatic sperm injection in a couple with male primary cilia dyskinesia

Objective: To report an intracytoplasmatic sperm injection (ICSI) pregnancy achieved in a couple with male primary cilia dyskinesia (PCD) with viable sperm that were detected using a 1.48 mu m wavelength diode laser. Design: Case report. Setting: University hospital. Patient(s): A 37-year-old man with infertility due to primary cilia dyskinesia; semen analysis revealed a severe oligoasthenoteratozoospermia with absence of motile spermatozoa. A 34-year-old healthy woman with a 10-year history of primary infertility. Intervention(s): Selection of viable spermatozoa using the hypo-osmotic swelling (HOS) test or a 1.48 mm wavelength diode laser and subsequent ICSI. Main Outcome Measure(s): Sperm analysis. Fertilization and cleavage rates and pregnancy. Result(s): Semen samples showed no motile spermatozoa and high percentages of spermatozoa with curled flagella resembling HOS-reactive spermatozoa. To identify viable spermatozoa we used the HOS test or a 1.48 mu m diode laser. The ICSI using HOS-selected spermatozoa resulted in two fertilized out of four oocytes (50%), and injection of laser-selected spermatozoa resulted in four fertilized out of seven oocytes (57%). The transfer of two frozen/thawed oocytes of the laser group led to a singleton pregnancy. Conclusion(s): Use of a noncontact diode laser for sperm viability assessment may be a useful alternative, especially in cases where the HOS test is not informative. (Fertil Steril (R) 2008;89:1826.e9-12. (C) 2008 by American Society for Reproductive Medicine.)