Single- and double-strand sperm DNA breaks was assessed in a Kartagener's syndrome with four failures of fertilization after ISCI in TESA samples. It is concluded that in addition to failure of sperm motility, this patient was infertile because a high level of non-reparable sperm DNA damage was present. Although four cycles of insemination were performed at patient's request, if the argument of an exacerbated level of sperm DNA damage could be used at the time of the medical advice, repeated failed cycles of insemination using ICSI could be avoided. Pregnancy was achieved with a semen donor.
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