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Hum. Reprod. Advance Access published online on May 27, 2004
Human Reproduction, doi:10.1093/humrep/deh325
© 2004 by European Society of Human Reproduction and Embryology
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Received January 27, 2004
Accepted April 27, 2004

Article

Complete oocyte activation failure after ICSI can be overcome by a modified injection technique

T. Ebner 1*, M. Moser 1, M. Sommergruber 1, K. Jesacher 1, G. Tews 1

1 Women's General Hospital, IVF-Unit, Lederergasse 47, A-4010 Linz, Austria

* To whom correspondence should be addressed. E-mail: Thomas.ebner{at}gespag.at.


  Abstract

BACKGROUND: Complete fertilization failure after ICSI is a rare event, and it may happen repeatedly even in cases of normal sperm parameters and good ovarian response. In these cycles, alternative ICSI techniques may prove useful. METHODS: Our modified ICSI (mICSI) is characterized by aspiration close to the opposite membrane (the region of the mitochondria with a high inner mitochondrial membrane potential) which is followed by central deposition of the sperm. The method was applied prospectively to ICSI cycles of patients with a history of complete fertilization failure in previous ICSI cycles. In parallel, mICSI was compared with conventional ICSI in terms of further preimplantation development and treatment outcome. RESULTS: In patients with previous ICSI failures using conventional ICSI (no 2Pn zygotes out of 70 oocytes that had been injected) application of mICSI led to adequate fertilization (53.6%) and pregnancy rates (33.3%) (P<0.001; P<0.01). In patients without previous failed fertilization, no improvement in the rates of fertilization, blastocyst formation, implantation or clinical pregnancy could be seen. CONCLUSIONS: Our data indicate that the present version of ICSI is a reliable alternative to conventional ICSI. However, although it overcomes oocyte-dependent activation failure, routine application does not improve the overall results.

Key words: cytoplasmic maturation, fertilization failure, mitochondria, mitochondrial membrane potential, oocyte activation


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