Abstract:

Objective To explore the effect of assisted oocyte activation （AOA）with ionomycin in patients with previous fertilization failure after intracytoplasmic sperm injection（ICSI）. Methods In this study， 56 patients who received ICSI⁃AOA treatment at the Center for Reproductive Medicine of the Third Affiliated Hospital of Guangzhou Medical University were analyzed retrospectively. The fertilization，embryo development clinical outcomes and neonatal outcomes after AOA treatment were observed. Results The fertilization and normal fertiliza⁃ tion rates were significantly increased（P < 0.001）after AOA treatment with ionomycin，while the total fertilization failure and low fertilization rate were significantly reduced（P < 0.001）. Interestingly，when compared to the con⁃ trol group，the rate of transferable embryos and good⁃quality embryos on day 3 was significantly higher in the AOA group（P < 0.05）. In addition，the AOA group had a significantly higher rate of cycles with no transferable embryo （P < 0.05）. Consequently，the rates of clinical pregnancy，implantation，as well as live birth were significantly increased（P < 0.001）. In terms of neonatal outcomes，the data derived from conventional ICSI performed at our center during the same time period served as the control group. There were no significant differences in twins，ges⁃ tational weeks，birthweight，gender ratio，preterm birth，large for gestational age，and low birth weight between the two groups（P > 0.05）. Conclusions These findings demonstrated that AOA with ionomycin was beneficial for patients who had previously failed fertilization. However，more research with larger groups of couples is needed， particularly for safety assessment.

Key words:

intracytoplasmic sperm injection（ICSI）, fertilization failure, assisted oocyte activation （AOA）, ionomycin, congenital defects