# Resolving Secondary Infertility: A Case Report of the Successful Treatment of Sperm DNA Fragmentation Through the Physiological Intracytoplasmic Sperm Injection Method

## TL;DR

A couple with secondary infertility due to sperm DNA fragmentation successfully conceived using PICSI, a specialized sperm selection method.

## Contribution

This case report demonstrates the successful application of PICSI in treating secondary infertility caused by sperm DNA fragmentation.

## Key findings

- PICSI improved embryo development potential by selecting sperm with low DNA fragmentation.
- The treatment led to a healthy singleton pregnancy and successful delivery.
- Integration of PICSI with ICSI shows promise for secondary infertility cases involving SDF.

## Abstract

This case report presents an illustrative account of a couple experiencing secondary infertility attributed to the fragmentation of DNA in sperm. Secondary infertility, the inability to conceive after having previously successfully conceived a child, can be due to various factors, including male infertility issues. Sperm DNA fragmentation (SDF) has emerged as a major factor influencing male fertility, resulting in poor embryo development and lower pregnancy rates. This case is about the use of advanced assisted reproductive technologies, specifically physiological intracytoplasmic sperm injection (PICSI) and intracytoplasmic sperm injection (ICSI), to treat secondary infertility caused by fragmentation of sperm DNA. PICSI enables the identification and selection of spermatozoa with optimal functional integrity using hyaluronan, a natural binding substance. Preparing a PICSI dish requires skill and precision. Sperm exhibiting a high DNA fragmentation index were excluded from the selection process to enhance embryo development potential. The couple underwent controlled ovarian stimulation, egg retrieval, and ICSI with PICSI. The treatment resulted in the successful conception of a singleton pregnancy. Subsequent prenatal monitoring indicated a healthy pregnancy progression, ultimately culminating in the delivery of a healthy baby girl at term. This case report highlights the efficacy of integrating PICSI as a sperm selection method preceding ICSI, specifically in cases of secondary infertility related to SDF. Further research and larger-scale studies are warranted to approve the findings of this case report and establish the broader applicability of this treatment approach.