Human Reproduction, Vol. 17, No. 10, 2694-2699,
October 2002
© 2002 European Society of Human Reproduction and Embryology
Laser-assisted ICSI: a novel approach to obtain higher oocyte survival and embryo quality rates
1 Clínica e Centro de Pesquisa em Reproducião Humana ‘Roger Abdelmassih’, Rua Maestro Elias Lobo, 805, 01433–000, São Paulo, SP, Brasil and 2 Reproductive Biology Associates, 1150 Lake Hearn Drive, Suite 400, Atlanta, Georgia 30342, USA
BACKGROUND: Degeneration of oocytes occurs even when maximum care is exercised during ICSI, especially when the oolemma is very fragile and/or the zona pellucida is resistant. In order to be able to minimize the risk of degeneration associated with microinjection this study applied a new method: a microhole on the zona pellucida of the oocyte was drilled by laser beam just prior to ICSI to permit the penetration of the microneedle without any trauma. METHODS: A total of 32 patients (32 cycles) who had one or more previously failed ICSI cycles with a high degeneration rate of oocytes (>20%) were included in the study. Oocytes of the same patients were randomly divided into the study group [laser-assisted ICSI (LA-ICSI)] and the control group [conventional ICSI (C-ICSI)]. The outcomes of the cycles were compared and analysed. RESULTS: After LA-ICSI compared with C-ICSI, survival rates of oocytes were 99.6 and 84% (P < 0.0001), fertilization rates were 76.6 and 68.6% (not significant) and embryo development rates (
6 cells on day 3) were 76.5 and 57.3% (P = 0.0024) respectively. CONCLUSIONS: Creating a microhole on the zona pellucida of the oocyte by laser beam prior to ICSI provides a less traumatic penetration of the injection needle into the ooplasm and results in lower degeneration and higher embryo development rates than C-ICSI in patients with fragile oocytes.
Key words: embryo degeneration/embryo development/fragile membrane/laser-assisted ICSI/oocyte
3 To whom correspondence should be addressed. E-mail: nagy.zsolt.peter{at}iol.it
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