Live birth after artificial oocyte activation using a ready-to-use ionophore: a prospective multicentre study

Area of Science:

• Reproductive Medicine
• Embryology
• Infertility Treatment

Background:

• Failed or impaired fertilization after intracytoplasmic sperm injection (ICSI) presents a significant challenge in assisted reproductive technologies.
• Artificial oocyte activation (AOA) is a potential strategy to address fertilization abnormalities.

Purpose of the Study:

• To evaluate the efficacy of artificial oocyte activation using a ready-to-use calcium ionophore solution (A23187) in patients with a history of fertilization failure post-ICSI.
• To compare fertilization, pregnancy, and live birth rates between cycles with and without AOA.

Main Methods:

• A multicentre study involving 101 patients with previous ICSI fertilization abnormalities.
• Oocytes were activated for 15 minutes post-ICSI using A23187 calcium ionophore solution.
• Outcomes were compared to a historical control group from preceding ICSI cycles without activation.

Main Results:

• The fertilization rate significantly increased from 25% in control cycles to 48% in AOA cycles (P < 0.001).
• All subgroups, including those with 0% fertilization, showed significant improvement with AOA (P < 0.001).
• Live birth rate was 28% (35 babies), with only 1/101 cancelled embryo transfers compared to 15/101 in control cycles.

Conclusions:

• Artificial oocyte activation with a ready-to-use calcium ionophore (A23187) is an effective method to overcome fertilization failure after ICSI.
• The application of AOA resulted in a substantial improvement in patient outcomes, including higher live birth rates.