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Failed fertilization: is it predictable?
1Department of Obstetrics and Gynecology, Yale University, New Haven, Connecticut 06520-8063, USA.
Current Opinion in Obstetrics & Gynecology
|July 15, 2003
Summary
Screening tests can predict fertilization failure, a common issue in assisted reproduction. Advanced methods like strict sperm morphology assessment improve prediction accuracy, aiding treatment decisions.
Area of Science:
- Reproductive Medicine
- Infertility Research
- Assisted Reproductive Technologies
Background:
- Failed fertilization occurs in 5-10% of in-vitro fertilization (IVF) and 2-3% of intracytoplasmic sperm injection (ICSI) cycles.
- Causes include impaired sperm, oocyte deficiencies, or medium defects, with male factors common in IVF and oocyte activation failure in ICSI.
Purpose of the Study:
- To critically review the predictive capabilities of screening tests for fertilization failure.
- To identify methods that enhance the ability to avoid failed fertilization outcomes.
Main Methods:
- Review of existing literature on fertilization failure prediction in IVF and ICSI.
- Analysis of the efficacy of standard semen analysis and advanced sperm function tests.
Main Results:
- Standard semen analysis has limited predictive power for fertilization failure.
- Strict sperm morphology, sperm-zona binding ratios, and zona pellucida-induced acrosome reaction tests offer improved prediction.
- Semen quality on oocyte retrieval day and prior IVF performance can guide ICSI use.
Conclusions:
- Improving screening techniques enhance the ability to predict and potentially prevent fertilization failure.
- Routine ICSI is contraindicated for non-male factor infertility.