Effect of oocyte activation with calcium ionophore on ICSI outcomes in teratospermia: Randomized clinical trial

This Prospective, randomized, unblinded clinical study aimed to evaluate the efficiency of calcium ionophore on fertilization and pregnancy rate after intracytoplasmic sperm injection (ICSI) in infertile men suffer from teratoospermia. Thirty eight women with teratoospermic partner underwent ICSI with GnRH-antagonist protocol. A total of 313 metaphase II (MII) oocytes were randomly divided after ICSI into two groups: In the oocytes of the control group (n=145), routine ICSI was applied. Oocytes in the AOA group (n=168) immediately after ICSI, were cultured in culture medium supplemented with 5 μΜ calcium/100 μM calcium ionophore (A23187) for 5 minutes and then washed at least three times with MOPS solution. In both groups, the fertilization was evaluated 16-18 hours after ICSI. The number of embryos obtained and fertilized oocytes were significantly different between two groups (p=0.04 for each). There was no significantly difference between the two studied groups in the fertilization and cleavage rate. (95.33% vs. 89.56 %; and 84.4% vs. 87.74%; respectively, p<0.05) Implantation rate was higher in AOA group than in control group, but the difference was not significant. (17.64% vs. 7.4%, p=0.14). No significant differences were observed in chemical and clinical pregnancy rate between groups (47.1% vs. 16.7%, P=0.07; and 41.2% vs. 16.7%; p=0.14, respectively). Oocyte activation with calcium ionophore may improve ICSI outcomes in infertile men suffer from teratoospermia. Although, we found no significant difference in the implantation and pregnancy rate between the two groups of patients. Further study with more cases can provide greater value.