Artificial oocyte activation may improve embryo quality in older patients with diminished ovarian reserve undergoing IVF-ICSI cycles

Abstract

Background Artificial oocyte activation (AOA) is used to improve fertilization rate following fertilization failure after intracytoplasmic sperm injection (ICSI). Several studies have also shown that AOA may be involved in embryo development. Women with poor ovarian response are more likely to encounter in vitro fertilization (IVF) failure due to poor embryo quality. The aim of this study was to investigate whether AOA could improve embryo quality in older patients with diminished ovarian reserve undergoing IVF-ICSI cycles. Methods The retrospective cohort study consisted of 308 patients who fulfilled the POSEIDON Group 4 criteria and received IVF-ICSI cycles. The study group included 91 patients receiving AOA with calcium ionophores following ICSI. A total of 168 patients in the control group underwent ICSI without AOA. The baseline and cycle characteristics and embryo quality were compared between the two groups. Results At baseline, there were more IVF attempts, greater primary infertility, higher basal FSH levels and lower anti-Müllerian hormone (AMH) levels in the AOA group than in the non-AOA group. In terms of embryo quality, there were higher cleavage rates and top-quality Day 3 embryo (TQE) rates, as well as higher percentages of more than 1 TQE and TQE rates ≥50 in the AOA group than in the non-AOA group. The multivariate analysis revealed that AOA was positively associated with more than 1 TQE (adjusted OR 3.24, 95% CI 1.63–6.45, P = 0.001) and a TQE rate ≥ 50 (adjusted OR 2.14, 95% CI 1.20–3.80, P = 0.010). When the study population was divided into 2 subgroups based on the age of 40 years old, the beneficial effects of AOA on embryo quality were only observed in the subgroup of age ≥ 40 years old. Conclusions Our data suggest that AOA with calcium ionophores may improve embryo quality in older patients with diminished ovarian reserve undergoing IVF-ICSI cycles, especially in women aged ≥40 years.

Artificial oocyte activation with Ca2+ ionophore improves reproductive outcomes in patients with fertilization failure and poor embryo development in previous ICSI cycles

“…Based on our study, we found that AOA treatment can improve the embryo development and reproductive outcome of patients with poor embryo development. This result is consistent with other studies, which demonstrated that AOA treatment can overcome the developmental incompetence of embryos and is an additional indication for ionophore treatment ( 14 , 28 ). It was reported that the different frequencies and patterns of calcium oscillations could affect the induction of oocyte activation and embryo development ( 29 ).…”

Artificial oocyte activation with Ca2+ ionophore improves reproductive outcomes in patients with fertilization failure and poor embryo development in the previous ICSI cycles

“…Based on our study, we found that AOA treatment can improve the embryo development and reproduction outcome of patients with poor embryo development. This result is consistent with another study, which demonstrated that AOA treatment can overcome developmental incompetence of embryos and which is an additional indication for ionophore treatment [11,23]. It was reported the different frequencies and patterns of calcium oscillations could affect the induction of oocyte activation and embryo development [24].…”

Live birth rate following a failed first in vitro fertilization cycle with no embryos for transfer

“…Despite the modest size and limited scope of this group, it can still provide us with some useful information. Additionally, this supports some literature reports on the significance of oocyte activation 16 , 17 . In addition, we observed that patients with IVF low fertilization in the first cycle also resulted in higher live birth rates.…”