Could Antimullerian Hormone Play a Role in Fertilization Failure in ICSI Application

Tulay Irez,Onur Güralp,Semra Kahraman,Hakan Yelke

doi:10.11648/j.abb.20210903.14

Abstract

Aim: Failed fertilization (FF) occurs in approximately 2–3% of ICSI cycles and is mainly due to lack of oocyte activation. The reasons of total fertilization insufficiency in ICSI applications can be listed as mitosis errors, sperm aster formation defects, sperm decondensation defects, PN formation defects and oocyte activation defects. In this study, sperm functions, oocyte morphology, hormone levels and possible effects of gonadotropins used in the treatment were investigated retrospectively. Material and Methods: In this study, semen parameters and sperm functions, oocyte morphology, basal hormone values and treatment processes of 32 fertilization failure cases and 91 fertile controls were compared. Results: It was found that age of female and male, basal FSH value and gonadotropin used in the treatment process were higher in total fertilization failure cases compared to fertile controls (p = 0.004, p = 0.041, p = 0.008, p = 0.004). Basal AMH level, total oocyte count, M2 oocyte count, quality oocyte count and normal ZP percentage were lower in fertilization failure cases (p = 0.002, p = 0.000, p = 0.000, p = 0.008, p = 0.000). There was no statistically significant difference between the two groups in terms of sperm functions. Conclusions: It was understood that high FSH and low AMH levels and high-dose gonadotropin treatment in cases with optimal sperm quality may cause oocyte cytoplasmic and zona pellucida abnormalities, and it should be discussed as a cause of fertilization failure.

Highlights

With ICSI, the sperm is inserted directly into the oocyte cytoplasm and IVF failure is treated in this way
After 36 hours, follicles were aspirated under transvaginal ultrasound guidance with a single lumen aspiration needle. 2 hours post-collection, the oocytes were denuded of their surrounding cumulus cells with hyaluronidase (Vitrolife, Sweden) and mechanical pipeting, which allows a precise determination of nuclear maturation status and oocyte morphology. 91 fertil controls and 32 total fertilization failure in last two cycles, cases with sperm function test results included the study
When the data of the groups are examined in the study; total fertilization failure was observed in women and men ages were higher (Table 1)

Summary

Introduction

With ICSI, the sperm is inserted directly into the oocyte cytoplasm and IVF failure is treated in this way. After ICSI oocyte activation is characterized by a two-stage increase pattern of intracellular Ca2+ concentrations. The first Ca2+ increase (triggers) originates from the oocyte cortex following sperm-oocyte membrane interaction and follows a series of shorter Ca2+ transient amplitudes (oscillators) that continue for 3-4 hours (oscillator) after 30 minutes [1]. Oscillator function is due to the release of a sperm-associated oocyte activation factor that requires oocyte to sustain recurrent Ca2+ releases from intracellular stores [2]. Inadequacies in this oocyte-related osillator function have been shown as a result of auxiliary oocyte activation studies [3]

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