Successful delivery following intracytoplasmic sperm injection with calcium ionophore A23187 oocyte activation in a partially globozoospermic patient

Purpose

To describe a successful pregnancy outcome following intracytoplasmic sperm injection (ICSI) with assisted oocyte activation (AOA) in a case of partial globozoospermia.

Methods

AOA was accomplished with calcium ionophore A23187. Sperm morphology was observed via light, fluorescent and electron microscopy following a Diff-Quik stain and fluorescein isothiocyanate-labeled peanut agglutinin (FITC-PNA) staining. An activation ability test was employed using a mouse oocyte exposed to strontium chloride.

Results

Via light microscopy, it was found that a large number of sperm possessed deficient acrosomes and a sharply rounded head; however, we observed both normal and the aforementioned abnormal sperm via FITC-PNA staining of a semen specimen. Mouse oocyte activation was 87.5?% via natural activation without AOA. With AOA after ICSI, 100?% oocyte activation was observed. Five oocytes were retrieved, and AOA with A23187 after ICSI resulted in a high fertilization rate (4 of 5, 80?%). Two embryos developed and the patient subsequently delivered a healthy female infant without any congenital abnormalities.

Conclusions

We report a successful pregnancy outcome using an early stage embryo, which developed following ICSI using sperm from a partially globozoospermic patient who possessed temporary potential oocyte activation.     

Successful pregnancy and delivery after calcium ionophore oocyte activation in a normozoospermic patient with previous repeated failed fertilization after intracytoplasmic sperm injection

To describe a successful pregnancy and delivery after calcium ionophore oocyte activation in a normozoospermic patient with previous repeated failed fertilization after intracytoplasmic sperm injection (ICSI).Case report. In vitro fertilization unit in a university affiliated medical center.A couple with 5 years of unexplained primary infertility who had repeated failed fertilization after ICSI. Controlled ovarian hyperstimulation, oocyte pick-up, ICSI, assisted oocyte activation with calcium ionophore, embryo culture, and ET. Fertilization rate, implantation, pregnancy, and delivery. Assisted oocyte activation with calcium ionophore A23187 after ICSI resulted in reasonable fertilization rates in three cycles (4/6, 5/16 and 7/20 oocytes). Two pregnancies were achieved; the first ended with second trimester miscarriage due to fetal anomaly and the second with a delivery of three healthy babies.Calcium ionophore oocyte activation seems to be a useful method in cases of repeated failed fertilization after ICSI.     

Successful fertilization and pregnancy after intracytoplasmic sperm injection and oocyte activation with calcium ionophore in a normozoospermic patient with extremely low fertilization rates in intracytoplasmic sperm injection cycles

OBJECTIVE: To investigate the effect of calcium ionophore on the fertilization rate of a patient with normozoospermia who nonetheless exhibited a low fertilization rate in intracytoplasmic sperm injection (ICSI). DESIGN: Case report. SETTING: In vitro fertilization center. PATIENT(S): A male patient whose sperm, though diagnosed as normal by semen analysis, exhibited a severely low fertilization rate in ICSI cycles. INTERVENTION(S): Oocytes were activated by calcium ionophore after ICSI. MAIN OUTCOME MEASURE(S): Fertilization rate after oocyte activation; ultrastructure and protein expression of the patient's sperm. RESULT(S): The fertilization rate of oocytes activated with calcium ionophore (12 of 15, 80.0%) was higher than that of the nonactivated oocytes (4 of 16, 25.0%). Four embryos derived from the activated oocytes were transferred, resulting in a twin pregnancy. Further investigation revealed abnormalities in the patient's sperm: many nuclear vacuoles were observed and the expression of some proteins was absent. CONCLUSION(S): Oocyte activation with calcium ionophore was effective at increasing the fertilization rate of dysfunctional sperm characterized by ultrastructural and protein expression anomalies.     

Successful pregnancy and delivery from frozen-thawed embryos after intracytoplasmic sperm injection using round-headed spermatozoa and assisted oocyte activation in a globozoospermic patient with mosaic Down syndrome

OBJECTIVE: To describe a successful pregnancy and delivery from frozen-thawed embryos after intracytoplasmic sperm injection (ICSI) and assisted oocyte activation in a globozoospermic patient with mosaic Down syndrome. DESIGN: Controlled clinical study. SETTING: IVF Laboratory, PL Infertility Clinic, Seoul, Korea. PATIENT(S): A couple with infertility resulting from globozoospermia with mosaic Down syndrome: 47,XY,+21[7]/46,XY[33]. INTERVENTION(S): Semen analysis, karyotyping, ICSI, assisted oocyte activation, assisted hatching, and frozen-thawed ET. MAIN OUTCOME MEASURE(S): Fertilization rate, implantation, pregnancy, and delivery. RESULT(S): Thirty-eight oocytes were aspirated, and round-headed spermatozoa were injected into 35 oocytes in metaphase II. Assisted oocyte activation with calcium ionophore A23187 after ICSI resulted in a high fertilization rate (21 of 35, 60%; 2 pronuclei in 18 of 21; 3 pronuclei in 3 of 21) and good embryo development. At 3 days after ICSI, 5 embryos of good quality were surgically transferred to the endometrium after assisted hatching, but no pregnancy occurred. After 2 months, the surgical transfer of 4 frozen-thawed embryos after assisted hatching led to an ongoing pregnancy. A female infant weighing 3,000 g was delivered at 38 weeks of gestation by cesarean section. CONCLUSION(S): We report the first successful pregnancy and delivery from frozen-thawed embryos after ICSI and assisted oocyte activation in a globozoospermic patient with mosaic Down syndrome.     

Fertilization and pregnancy after assisted oocyte activation and intracytoplasmic sperm injection in a case of round-headed sperm associated with deficient oocyte activation capacity

Objective: To investigate a method of assisted activation of human oocytes for the treatment of infertility resulting from globozoospermia associated with deficient oocyte activation capacity.

Design: The mouse oocyte activation test was used to analyze the oocyte activation capacity of the sperm cells of a patient with globozoospermia. Fresh donor human oocytes were used for determining the most appropriate procedure for oocyte activation.

Setting: Infertility Center, University Hospital of Ghent.

Patient(s): A couple with infertility resulting from globozoospermia.

Intervention(s): Intracytoplasmic sperm injection, assisted oocyte activation, and embryo transfer.

Main Outcome Measure(s): Oocyte activation and fertilization rates, implantation, and pregnancy.

Result(s): Deficiency in oocyte activation capacity was found in the sperm of a patient with globozoospermia. This deficiency was proven by the mouse oocyte activation test and was confirmed further by lack of activation of human oocytes after simple sperm injection. Only human oocytes that were injected with sperm and subjected to calcium chloride and ionophore treatment underwent activation. Transfer of embryos obtained by this procedure of assisted oocyte activation resulted in an ongoing pregnancy.

Conclusion(s): Assisted oocyte activation of human oocytes is useful when globozoospermia is associated with absence of oocyte activation capacity in the sperm. These cases can be identified by the mouse oocyte activation test.     

Correlation between oocyte preincubation time and pregnancy rate after intracytoplasmic sperm injection

Background and aim. Both nuclear and cytoplasmic maturation of oocytes have to be completed in a coordinated manner to ensure optimal conditions for fertilization. This is well known for in vitro fertilization, but is debated for intracytoplasmic sperm injection (ICSI). It has been reported that preincubation of oocytes prior to ICSI is associated with improved maturation of oocytes, fertilization and embryo quality. Therefore, in the present study, we evaluated the fertilization rate, embryo quality and pregnancy rate in relation to incubation times of metaphase-II oocytes before ICSI.

Method. We analyzed 135 selected ICSI cycles. Subjects were assigned to six groups according to oocyte incubation time before ICSI: 2–4 h, 5 h, 6 h, 7 h, 8 h and 9–12 h.

Results. We observed that the fertilization rate increased slightly at short (2 to 6 h) and then decreased at longer preincubation times (7 to 12 h). Concomitantly, cleavage rate increased up to 6 h of preincubation and decreased significantly in the groups in which ICSI was carried out after 7 to 12 h of incubation. With regard to clinical pregnancy rate, we observed a significant increase from 2 to 5 h of preincubation, when this parameter reached its maximum value (35%), tapering to 33% after 6 h and then dropping sharply to 12 h.

Conclusions. These data confirm that the most appropriate incubation time for mature oocytes before ICSI is 5–6 h. This time improves embryo quality and pregnancy rate in ICSI cycles.     

Successful pregnancy after intracytoplasmic sperm injection with testicular spermatozoa transported only under refrigeration

Purpose  

This case report describes two successful pregnancies after intracytoplasmic sperm injection (ICSI) with testicular spermatozoa that were transported under refrigeration.     

钙离子载体A23187联合嘌呤霉素激活行卵母细胞质内单精子注射后未受精卵母细胞的研究

目的观察钙离子载体A23187联合嘌呤霉素对卵母细胞质内单精子注射（ICSI）后未受精卵母细胞的激活作用。方法将体外成熟（IVM）-ICSI和常规ICSI后未受精卵母细胞,按行ICSI后体外培养的时间,分为IVM-ICSI 22h组（33个）、IVM—ICSI 44h组（18个）、ICSI44h组（37个）、ICSI68h组（25个）,分别采用钙离子载体A23187联合嘌呤霉素进行激活处理。应用荧光原位杂交（FISH）技术,对来源于双原核合并第二极体合子的激活胚胎进行性染色体分析。结果钙离子载体A23187联合嘌呤霉素能激活行ICSI后22—68h未受精的卵母细胞。其中IVM-ICSI22h组卵母细胞激活率为88％（29／33）、总卵裂率为62％（18／29）、4细胞阶段胚胎发育率为28％（5／18）,1个胚胎发育到桑椹胚阶段;而IVM-ICSI44h组、ICSI44h组、ICSI68h组的未受精卵母细胞激活率分别为56％（10／18）、65％（24／37）、52％（13／25）;总卵裂率分别为20％（2／10）、42％（10／24）、46％（6／13）,仅ICSI44h组有1个胚胎发育到4细胞阶段。FISH对激活胚胎的分析显示,4个胚胎为XX,9个胚胎为XY。结论钙离子裁体A23187联合嘌呤霉素能有效激活行ICSI失败的卵母细胞;行ICSI后22h内,是对未受精卵母细胞进行辅助激活较为理想的时机。激活的双原核合并第二极体胚胎中有雄原核的存在。     

Pregnancy after immature oocyte donation and intracytoplasmic sperm injection

Objective: To report a case of pregnancy from in vitro-matured primary oocytes fertilized by ICSI. The pregnancy occured in a woman who was in an oocyte donation program; the woman's husband had normal sperm parameters.

Design: Case report.

Setting: Private general hospital affiliated with a university hospital.

Patient(s): A recipient with premature ovarian failure, a recipient's husband with normal sperm, and a pregnant woman who donated her oocytes.

Intervention(s): Aspiration of immature oocytes during cesarean section, in vitro culture for maturation, ICSI of matured oocytes, coculture of fertilized oocytes.

Main Outcome Measure(s): Fertilization of oocytes by ICSI, and cleavage of embryos by Vero cell coculture.

Result(s): Two of seven immature oocytes became metaphase II oocytes, and both were fertilized by ICSI. The two zygotes were cocultured on Vero cells to become grade 1 two-cell embryos. Pregnancy was obtained after transfer.

Conclusion(s): More studies are necessary to clarify whether ICSI can increase the fertilization rate of in vitro-matured primary oocytes, and to clarify the role of coculture in fertilization.     

Artificial oocyte activation after intracytoplasmic morphologically selected sperm injection: A prospective randomized sibling oocyte study

This study aimed to evaluate the effect of artificial oocyte activation (AOA) by calcium ionophore after intracytoplasmic morphologically selected sperm injection (IMSI) on fertilization, cleavage rate and embryo quality. A total of 194 oocytes from 21 cycles from women with a history of low fertilization rate accompanying teratozoospermia were enrolled over a 3-month period. Mature oocytes from each patient were randomly allocated into two groups after IMSI. In the study group, half of the patients’ oocytes (n?=?97) were exposed to AOA, and in the control group (n?=?97), AOA was not applied. The mean number of mature oocytes, fertilization and cleavage rates were similar between the study and control groups (p?>?0.05 for each). However, fertilized oocytes of the AOA group were less likely to produce top quality embryos when calculated per fertilized oocyte (28/80; 35.0% versus 38/71; 53.5%, respectively; p?=?0.024) and also per cycle (13/21; 61.9% versus 20/21; 95.24%, respectively; p?=?0.006). Our study indicates that AOA may not improve fertilization rates after IMSI and may even reduce the ability of a successfully fertilized oocyte to develop into a top quality embryo. AOA should, therefore, be applied to cases with a defined oocyte activating deficiency.     

Subsequent successful pregnancy and delivery after intracytoplasmic sperm injection in a patient with XY gonadal dysgenesisms

Report of a rare case of subsequent twin delivery after intracytoplasmic sperm injection (ICSI) into donated oocytes in a 30-year-old woman with a diagnosis of XY dysgenesis, who underwent a gonadectomy at the age of 13 years. Her husband suffers from severe oligo-astheno-terato-spermia.     

Ovarian ectopic pregnancy after intracytoplasmic sperm injection

A ruptured primary ovarian pregnancy occurred following ovulation induction, intracytoplasmic sperm injection (ICSI) and embryo transfer (ET). The exact mechanism of ovarian pregnancy after intracytoplasmic sperm injection is unclear, but, it is possible that there may be an association between blastocyst transfer and ovarian pregnancy in infertile patients who underwent ICSI, prolonged in vitro culture and fifth day embryo transfer at blastocyst stage.