International Journal of Infertility & Fetal Medicine

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VOLUME 14 , ISSUE 1 ( January-April, 2023 ) > List of Articles


Ionomycin Oocyte Activation with Teratozoospermic Male Partners in Couples Undergoing Intracytoplasmic Sperm Injection: A Comparative Prospective Study

Amr El-Helaly, Khaled Moussa, Hassan Morsi, Dalia Abu-Sharia, Jack Hamer, Amr Farag

Keywords : Infertility, Intracytoplasmic, Oocyte, Original research, Sperm, Teratozoospermia

Citation Information : El-Helaly A, Moussa K, Morsi H, Abu-Sharia D, Hamer J, Farag A. Ionomycin Oocyte Activation with Teratozoospermic Male Partners in Couples Undergoing Intracytoplasmic Sperm Injection: A Comparative Prospective Study. Int J Infertil Fetal Med 2023; 14 (1):12-17.

DOI: 10.5005/jp-journals-10016-1304

License: CC BY-NC 4.0

Published Online: 28-04-2023

Copyright Statement:  Copyright © 2023; The Author(s).


Background: Fertilization failure can be defined as the improper transition of the metaphase G1 phases within metaphase II (MII) oocytes. This can be partially attributed to the sperms’ inability to appropriately activate the oocyte. To overcome failed oocyte activation after intracytoplasmic sperm injection (ICSI), many different measures have been previously trialed. Aim: To evaluate the efficacy of artificial oocyte activation (AOA) using ionomycin in improving fertilization and pregnancy rates in ICSI for couples with teratozoospermic male partners. Materials and methods: A total of 114 infertile couples having ICSI, with 100% teratozoospermic male partners, were divided after ovum pick up. Group I included 61 cases that underwent ICSI using surgically retrieved sperms with ionomycin AOA immediately after sperm injection. Group II included 53 cases which underwent ICSI using fresh semen samples, with some oocytes activated from each sample using ionomycin (case group), and the rest were not activated (control group). Embryos were assessed for cleavage and quality 48–72 hours after ICSI and two high-quality embryos were transferred on day 3 or 5 of fertilization. Results: Within all activated and nonactivated samples, the median number of cultured oocytes of each sample was 7 (5–11) vs 4 (3–6), respectively, while the median number of fertilized oocytes was 4 (3–8) vs 3 (2–4), respectively. The median fertilization rate was 72.1 vs 66.7% (p = 0.156). The median number of grade A embryos was 2 (1–3) vs 1 (1–2), respectively. Among group II, grade A embryo production rate was greater within the activated group (40%) as compared to the nonactivated group (33.3%); however, statistical significance was not achieved (p = 0.051). The overall pregnancy rate was 58/114 (50.9%). Conclusion and clinical significance: Ionomycin oocyte activation may help increase fertilization and pregnancy rates; however, in this study, the effect was not clinically significant. Albeit, there may be a favorable effect on early cleavage and grade A embryo production pending further research.

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