Abstract

Objectives: Evaluate the effect of artificial oocyte activation (AOA) using calcium ionophore (A23187) on the rate of fertilization and cleavage of embryos in surgically retrieved sperm of patients with non-obstructive azoospermia undergoing intracytoplasmic sperm injection (ICSI). Study design: This study was conducted on 60 infertile couples undergoing ICSI cycles as a randomized controlled parallel group’s experimental study in a private IVF center in Egypt from January 2018 to July 2019. ICSI cycles were divided into two groups: Group A: includes 30 ICSI patients with surgically retrieved sperms of non-obstructive azoospermia treated with calcium ionophore (A23187). Group C/Control: includes 30 ICSI patients with surgically retrieved sperms of non-obstructive azoospermia non-treated with calcium ionophore (A23187). Results: There was no statistical difference between both groups regarding the fertilization rate (p = 0.853). There was no statistical difference between them regarding implantation rate (p = 0.237). The percentage of Class A embryos in the ca ionophore group was 81.7%, while it was 82.8% in the control group. There was insignificant difference between them (p = 0.782). There was no statistical significant difference between the two groups regarding the clinical pregnancy rate, it was (56.7%) in the ca ionophore group while it was (53.3%) in the control group. Conclusion: AOA by Ca2++ ionophore didn’t improve the outcome of ICSI cycle in cases of non obstructive azoospermia in terms of fertilization, implantation and pregnancy rate.

Highlights

  • intracytoplasmic sperm injection (ICSI) cycles were divided into two groups: Group A: includes 30 ICSI patients with surgically retrieved sperms of non-obstructive azoospermia treated with calcium ionophore (A23187)

  • Group C/Control: includes 30 ICSI patients with surgically retrieved sperms of non-obstructive azoospermia non-treated with calcium ionophore (A23187)

  • The aim of this study is to evaluate the effect of artificial oocyte activation (AOA) using calcium ionophore (A23187) on the rate of fertilization and cleavage of embryos in surgically retrieved sperm of patients with non-obstructive azoospermia undergoing intracytoplasmic sperm injection (ICSI)

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Summary

Introduction

The injected oocyte may fail to initiate the biochemical processes necessary for oocyte activation [2]. The biochemical processes are initiated, but they may not occur normally, leading to incomplete activation. The sperm can be not accessible for chromatin decondensation and formation of the male pronucleus in the oocyte [3]. Both sperm and oocyte factors are assumed to be involved in failed oocyte activation after ICSI [4] [5]. The Incidence of total fertilization failure (TFF) after ICSI is 1% - 5% [6] [7] [8]

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