PIEZO-ICSI increases fertilization rates compared with standard ICSI: a prospective cohort study

Area of Science:

• Reproductive Medicine
• Assisted Reproductive Technology
• Embryology

Background:

• Intracytoplasmic sperm injection (ICSI) is a cornerstone of assisted reproductive technology.
• Standard ICSI involves a 'cutting' action to introduce sperm into the oocyte.
• Novel techniques aim to improve ICSI efficiency and outcomes.

Purpose of the Study:

• To evaluate if PIEZO-intracytoplasmic sperm injection (ICSI), utilizing a novel fluid, is superior to standard ICSI.
• To compare fertilization rates, oocyte degeneration, abnormal fertilization, and embryo cryopreservation between PIEZO-ICSI and standard ICSI.

Main Methods:

• A prospective case-matched study of 69 patients undergoing microinjection.
• Inclusion criteria required six or more mature oocytes.
• PIEZO-ICSI uses high-speed drilling to penetrate the zona and oolemma, contrasting with standard ICSI's 'cutting' method.

Main Results:

• PIEZO-ICSI demonstrated significantly higher fertilization rates (80.5% vs 65.8%) and lower oocyte degeneration (4.4% vs 8.6%) and abnormal fertilization rates (2.9% vs 7.4%).
• These benefits were most pronounced in patients aged 38 years and older.
• PIEZO-ICSI resulted in more good-quality embryos available for cryopreservation (3.8 vs 3.1 per cycle).

Conclusions:

• PIEZO-ICSI significantly enhances fertilization rates and increases the number of cryopreserved embryos compared to standard ICSI.
• The technique shows particular promise for older patients undergoing IVF.
• Further research is needed to assess cumulative pregnancy rates.