BACKGROUND: Failed fertilization occurs in 2-3% of ICSI cycles and is mainly due to lack of oocyte activation. Heterologous ICSI of patient's sperm in mouse oocytes allows discrimination between sperm- and oocyte-related aetiologies of activation failure. Assisted oocyte activation (AOA) by Ca-ionophore treatment can initiate fertilization in subsequent therapeutic ICSI. We report on diagnosis and clinical treatment in 17 patients with previously failed fertilization. METHODS: Sperm from patients were injected into mature mouse oocytes. Activation capacity was assessed by 2-cell formation (mouse oocyte activation test, MOAT). When no activation occurred, it was assumed that the spermatozoon was deficient; otherwise an oocyte-related factor was suspected. In a subsequent ICSI cycle, AOA was done by ICSI with CaCl2 followed by a Ca2+ ionophore exposure. Fertilization was checked 16-20 h later. Embryo transfer was on day 2 or 3. RESULTS: MOAT showed sperm-related activation deficiency in six globozoospermic patients and two patients with extreme oligoasthenoteratozoospermia. One patient with small sperm acrosomes had a normal activation percentage. In eight other patients, the MOAT revealed a relatively normal activation capacity of the sperm, indicating an oocyte-related defect. After AOA, fertilization rates were 77 and 71% in the sperm- and oocyte-related groups respectively. Five pregnancies were achieved in the globozoospermia group and three in cases of oocyte-related activation failure. CONCLUSIONS: Assisted oocyte activation enables normal fertilization and pregnancy in sperm- and oocyte-related fertilization failure.
BACKGROUND: Failed fertilization occurs in 2-3% of ICSI cycles and is mainly due to lack of oocyte activation. Heterologous ICSI of patient's sperm in mouse oocytes allows discrimination between sperm- and oocyte-related aetiologies of activation failure. Assisted oocyte activation (AOA) by Ca-ionophore treatment can initiate fertilization in subsequent therapeutic ICSI. We report on diagnosis and clinical treatment in 17 patients with previously failed fertilization. METHODS: Sperm from patients were injected into mature mouse oocytes. Activation capacity was assessed by 2-cell formation (mouse oocyte activation test, MOAT). When no activation occurred, it was assumed that the spermatozoon was deficient; otherwise an oocyte-related factor was suspected. In a subsequent ICSI cycle, AOA was done by ICSI with CaCl2 followed by a Ca2+ ionophore exposure. Fertilization was checked 16-20 h later. Embryo transfer was on day 2 or 3. RESULTS: MOAT showed sperm-related activation deficiency in six globozoospermic patients and two patients with extreme oligoasthenoteratozoospermia. One patient with small sperm acrosomes had a normal activation percentage. In eight other patients, the MOAT revealed a relatively normal activation capacity of the sperm, indicating an oocyte-related defect. After AOA, fertilization rates were 77 and 71% in the sperm- and oocyte-related groups respectively. Five pregnancies were achieved in the globozoospermia group and three in cases of oocyte-related activation failure. CONCLUSIONS: Assisted oocyte activation enables normal fertilization and pregnancy in sperm- and oocyte-related fertilization failure.
Authors: Hye Jin Yoon; In Hee Bae; Hyoung Jun Kim; Jung Mi Jang; Yong Su Hur; Hae Kwon Kim; San Hyun Yoon; Won Don Lee; Jin Ho Lim Journal: J Assist Reprod Genet Date: 2013-10-10 Impact factor: 3.412
Authors: Astrid Stecher; Magnus Bach; Anton Neyer; Pierre Vanderzwalmen; Martin Zintz; Nicolas Herbert Zech Journal: J Assist Reprod Genet Date: 2011-03-22 Impact factor: 3.412
Authors: Hoi Chang Lee; Margaret Arny; Daniel Grow; Daniel Dumesic; Rafael A Fissore; Teru Jellerette-Nolan Journal: J Assist Reprod Genet Date: 2014-04-23 Impact factor: 3.412
Authors: Christian S Ottolini; Antonio Capalbo; Louise Newnham; Danilo Cimadomo; Senthilkumar A Natesan; Eva R Hoffmann; Filippo M Ubaldi; Laura Rienzi; Alan H Handyside Journal: Nat Protoc Date: 2016-06-16 Impact factor: 13.491