Surrogate pregnancies in patients with Mayer-Rokitansky-Kustner-Hauser syndrome and severe teratozoospermia.

The challenge of the case presented was threefold: congenital absent uterus (Mayer-Rokitansky-KustnerHauser syndrome), a request for surrogacy, and teratozoospermia in the husband (6% normal morphology according to the Tygerberg strict criteria). Surrogacy was dealt with by means of guidelines proposed by the SA Law Commission after a surrogate mother was found. The gestational carrier was synchronized with the genetic donor with congenital absent uterus, the main aim being assisted reproduction. Two gamete intrafallopian transfer (GIFT) procedures were performed, both unsuccessful. Poor fertilization of excess GIFT oocytes was also observed. Three intracytoplasmic sperm injection procedures were then performed. The first two were unsuccessful and the third ensued in a singleton pregnancy. Hormonal support (progesterone and estradiol valerate until 12 weeks pregnancy duration) was given. The pregnancy resulted in the normal delivery of a healthy male infant at full term. Psychological support was given to mother and surrogate throughout pregnancy, as well as thereafter. The success of this case gives hope to infertile couples with severe infertility factors.