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Role of diagnostic intracytoplasmic sperm injection (ICSI) in the management of genetically determined zona pellucida-free oocytes during in vitro fertilization: a case report

Published online by Cambridge University Press:  27 August 2020

Ahmad Metwalley Open the ORCID record for Ahmad Metwalley [Opens in a new window] ,
Nabeel Brasha ,
Sandro C. Esteves ,
Mohamed Fawzy ,
Hadiya Brasha ,
Ali Hellani ,
Manal El Hamshary  and
Omaima Khamiss
Ahmad Metwalley*
Affiliation:
Genetic Engineering and Biotechnology Institute, Sadat City, Egypt IVF Lab Director at Reproductive Medicine and Genetics Unit, Eed Clinic, Jeddah, KSA
Nabeel Brasha
Affiliation:
Consultant Reproductive Medicine and in vitro fertilization, National Guard Hospital, Jeddah, KSA
Sandro C. Esteves
Affiliation:
ANDROFERT, Andrology and Human Reproduction Clinic, Referral Center for Male Reproduction, Campinas, SP, Brazil
Mohamed Fawzy
Affiliation:
IbnSina and Banon IVF Centers, IbnSina Hospital, El Aref Squeer, Sohag, Egypt
Hadiya Brasha
Affiliation:
Consultant Reproductive Medicine and in vitro fertilization, National Guard Hospital, Jeddah, KSA
Ali Hellani
Affiliation:
Viafet Genomic Laboratories
Manal El Hamshary
Affiliation:
Genetic Engineering and Biotechnology Institute, Sadat City, Egypt
Omaima Khamiss
Affiliation:
Genetic Engineering and Biotechnology Institute, Sadat City, Egypt
*
Author for correspondence: Ahmad Metwalley. IVF Lab Director, Reproductive Medicine and Genetics Unit, Eed Clinic, Jeddah, KSA. Tel: +966 567567556. E-mail: ahmadmetwalley@yahoo.com
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Abstract

Purpose:

To report the utilization of diagnostic intracytoplasmic sperm injection (D-ICSI), an ICSI cycle performed in the natural cycle, to obtain information about embryo development potential after sperm injection into zona pellucida (ZP)-free oocytes.

Materials and Methods:

We report the case of a couple with primary unexplained infertility with a history of previous failed, in vitro fertilization intracytoplasmic sperm injection (IVF-ICSI) cycles characterized by the presence of ZP-free oocytes. Whole exome sequencing (WES) was carried out to analyse the possible genetic basis of oocyte abnormality.

Results:

Diagnostic ICSI provided information about the embryo development potential from ZP-free oocytes and allowed better planning of the subsequent ICSI cycle. WES revealed that the absence of ZP was likely to be due to a new (ZP1) mutation. The subsequent ICSI cycle resulted in the delivery of a healthy baby.

Discussion:

To the best of our knowledge, our report is the first to describe the use of D-ICSI to determine the feasibility of embryo development and implantation in a patient with ZP1 mutation, resulting in the subsequent delivery of a healthy baby. We used ‘diagnostic’ ICSI in the normal menstrual cycle to explore the feasibility of embryo development after sperm injection into ZP-free oocytes. Our results may expand the spectrum of diagnostic procedures associated with unexplained infertility.

Keywords

Diagnostic intracytoplasmic sperm injectionZona-free oocyteZona pellucidaZona pellucida gene mutationZP1ZP abnormality
Type
Method
Information
Zygote , Volume 28 , Issue 6 , December 2020 , pp. 519 - 523
Copyright
© The Author(s), 2020. Published by Cambridge University Press

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