Mark P Green1,2, Deirdre Zander-Fox1,3,4,5, Sophie Popkiss6, Fabrizzio Horta1,7, Beverley Vollenhoven1,7,8. 1. Monash IVF, Epworth Hawthorn, Hawthorn, Melbourne, VIC, 3122, Australia. 2. School of BioSciences, University of Melbourne, Melbourne, Australia. 3. University of Adelaide, Adelaide, Australia. 4. University of South Australia, Adelaide, Australia. 5. Department of Science, Monash University, Melbourne, Australia. 6. Monash IVF, Epworth Hawthorn, Hawthorn, Melbourne, VIC, 3122, Australia. sophie.popkiss@monashivf.com. 7. Department of Obstetrics and Gynaecology, School of Clinical Science, Monash University, Melbourne, Australia. 8. Monash Health, Melbourne, Australia.
Abstract
PURPOSE: To determine if 5mM calcium chloride dihydrate supplementation of the Polyvinylpyrrolidone (PVP) media at the time of ICSI (ICSI-Ca) improves fertilization, utilization, and clinical pregnancy rates compared to ICSI alone, particularly in patients with a history of low fertilization (< 50%). METHODS: Retrospective study between 2016 and 2021 at Monash IVF Victoria on a paired cohort of patients (n = 178 patients) where an ICSI cycle was analyzed coupled with the subsequent ICSI-Ca cycle. The paired cohort was further subdivided into a low-fertilization cohort (< 50% fertilization on previous cycles: n = 66 patients) compared to the remaining patients with fertilization ≥ 50% (n = 122). Exclusion criteria included donor cycles, PGT patients, surgical sperm retrieval, women ≥ 45 years old, patients with > 6 cycles, and patients with ≤ 5 inseminated oocytes. RESULTS: Calcium supplementation significantly increased both fertilization (28.8% ICSI vs 49.7% ICSI-Ca, P < 0.0001) and clinical pregnancy rate (4.9% ICSI vs 25.0% ICSI-Ca: P < 0.05) in the low-fertilization cohort but not in the normal-fertilization cohort. Interestingly, utilization rate significantly increased in the normal-fertilization cohort (32.6% ICSI vs ICSI-Ca: 44.9%, P < 0.01) but not in the low-fertilization cohort, although the number of embryos utilized per patient after ICSI-Ca increased in both groups. CONCLUSION: Calcium supplementation does not appear to be a detrimental addition to ICSI and may improve IVF outcomes, particularly for patients with a history of low fertilization. Further investigations including prospective case-matched studies or a RCT are required to confirm these findings.
PURPOSE: To determine if 5mM calcium chloride dihydrate supplementation of the Polyvinylpyrrolidone (PVP) media at the time of ICSI (ICSI-Ca) improves fertilization, utilization, and clinical pregnancy rates compared to ICSI alone, particularly in patients with a history of low fertilization (< 50%). METHODS: Retrospective study between 2016 and 2021 at Monash IVF Victoria on a paired cohort of patients (n = 178 patients) where an ICSI cycle was analyzed coupled with the subsequent ICSI-Ca cycle. The paired cohort was further subdivided into a low-fertilization cohort (< 50% fertilization on previous cycles: n = 66 patients) compared to the remaining patients with fertilization ≥ 50% (n = 122). Exclusion criteria included donor cycles, PGT patients, surgical sperm retrieval, women ≥ 45 years old, patients with > 6 cycles, and patients with ≤ 5 inseminated oocytes. RESULTS: Calcium supplementation significantly increased both fertilization (28.8% ICSI vs 49.7% ICSI-Ca, P < 0.0001) and clinical pregnancy rate (4.9% ICSI vs 25.0% ICSI-Ca: P < 0.05) in the low-fertilization cohort but not in the normal-fertilization cohort. Interestingly, utilization rate significantly increased in the normal-fertilization cohort (32.6% ICSI vs ICSI-Ca: 44.9%, P < 0.01) but not in the low-fertilization cohort, although the number of embryos utilized per patient after ICSI-Ca increased in both groups. CONCLUSION: Calcium supplementation does not appear to be a detrimental addition to ICSI and may improve IVF outcomes, particularly for patients with a history of low fertilization. Further investigations including prospective case-matched studies or a RCT are required to confirm these findings.
Authors: Björn Heindryckx; Stefanie De Gheselle; Jan Gerris; Marc Dhont; Petra De Sutter Journal: Reprod Biomed Online Date: 2008-11 Impact factor: 3.828
Authors: Dean E Morbeck; Rebecca L Krisher; Jason R Herrick; Nikola A Baumann; Dietrich Matern; Thomas Moyer Journal: Fertil Steril Date: 2014-07-04 Impact factor: 7.329
Authors: Wardah Alasmari; Sarah Costello; Joao Correia; Senga K Oxenham; Jennifer Morris; Leonor Fernandes; Joao Ramalho-Santos; Jackson Kirkman-Brown; Francesco Michelangeli; Stephen Publicover; Christopher L R Barratt Journal: J Biol Chem Date: 2013-01-23 Impact factor: 5.157