# Successful pregnancy with intracytoplasmic sperm injection after bacterial contamination of embryo culture in in vitro fertilization: a case report

## TL;DR

A couple successfully achieved pregnancy using intracytoplasmic sperm injection after bacterial contamination in their in vitro fertilization process.

## Contribution

This case report demonstrates that intracytoplasmic sperm injection can overcome embryo culture contamination and lead to successful pregnancy.

## Key findings

- Bacterial contamination of embryo culture medium can be managed with intracytoplasmic sperm injection.
- Successful pregnancy and healthy newborn were achieved after bacterial contamination in a prior in vitro fertilization cycle.
- Contamination source was identified as semen, and intracytoplasmic sperm injection prevented further embryo culture infection.

## Abstract

Bacterial infection of embryo culture medium is rare but may be detrimental. The main source of embryo culture contamination is semen. Assisted reproduction centers currently lack consensus regarding the methods for preventing and managing embryo culture infection. In our recent case, a successful pregnancy was achieved with intracytoplasmic sperm injection after failed conventional in vitro fertilization owing to bacterial contamination.

We present a case report of two consecutive in vitro fertilization–intracytoplasmic sperm injection cycles with photo and video documentation of the bacterial growth. A 36-year-old Hungarian woman and her 37-year-old Hungarian partner came to our department. They had two normal births followed by 2 years of infertility. The major causes of infertility were a closed fallopian tube and asthenozoospermia. Bacterial infection of the embryo culture medium was observed during in vitro fertilization and all oocytes degenerated. The source was found to be the semen. To prevent contamination, intracytoplasmic sperm injection was used for fertilization in the subsequent cycle. Intracytoplasmic bacterial proliferation was observed in one of the three fertilized eggs, but two good-quality embryos were successfully obtained. The transfer of one embryo resulted in a successful pregnancy and a healthy newborn was delivered.

Intracytoplasmic sperm injection may be offered to couples who fail conventional in vitro fertilization treatment owing to bacteriospermia, as it seems to prevent infection of the embryo culture. Even if bacterial contamination appears, our case encourages us to continue treatment. Nevertheless, the development of new management guidelines for the prevention and management of bacterial contamination is essential.

The online version contains supplementary material available at 10.1186/s13256-024-04521-3.