Assisted Oocyte Activation With Calcium Ionophore Improves Pregnancy Outcomes and Offspring Safety in Infertile Patients: A Systematic Review and Meta-Analysis

Abstract

This study aimed to evaluate the efficacy and safety of calcium ionophore during assisted oocyte activation (AOA). This meta-analysis contained randomized controlled trials and prospective observational and retrospective trials. The summary odds ratio (OR) with 95% confidence intervals (CIs) was calculated for clinical pregnancy rate and live birth rate. Both fixed and random effects models were applied. A total of 22 studies were included into this meta-analysis. Seventeen of the included studies showed that calcium ionophore increased the clinical pregnancy rate (OR, 2.14; 95% CI, 1.38–3.31). Similarly, 14 studies indicated that AOA with calcium ionophore during intracytoplasmic sperm injection (ICSI) improved the live birth rate considerably (OR, 2.65; 95% CI, 1.53–4.60). Moreover, fertilization, blastocyst formation, and implantation rate were higher after using AOA with calcium ionophore combined with ICSI. In addition, calcium ionophore did not increase top-quality embryo rate, cleavage rate, miscarriage rate, congenital birth defects, and neonatal sex ratio. Therefore, calcium ionophore followed by ICSI not only significantly improved live birth and overall pregnancy, but also did not affect the incidence of miscarriage, congenital birth defects, and neonatal sex ratio. This meta-analysis indicated that using calcium ionophore to activate oocytes was beneficial for couples with poor fertilization rates following ICSI.

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

“…However, all the female patients enrolled in this study were under the age of 35 years old [ 39 ]. In an updated systemic review and meta-analysis, AOA with calcium ionophore treatment significantly improved the blastocyst formation rate (OR 3.59, 95% CI, 1.34–9.60, P = 0.01) but did not improve the cleavage rate (OR 1.68, 95% CI, 0.90–3.13, P = 0.10) or top-quality embryo rate (OR 1.15, 95% CI, 0.72–1.82, P = 0.55 ) [ 40 ]. Thus, more large-scale studies are needed to confirm whether AOA with calcium ionophores can improve embryo quality.…”

Healthy birth in a case of total globozoospermia after intracytoplasmic sperm injection and assisted oocyte activation

“…In this case, the activation of the oocytes is a spatiotemporal process, caused and adjusted by a series of intracellular Ca2+ oscillations from the moment that the sperm cell enters the ooplasma. This process is triggered by the PLCζ [ 19 ], which has been marked, through immunofluorescence analysis, to be predominantly present in the equatorial segment of the spermatozoon, but also in the acrosome, post-acrosome, tail or sometimes a combination of these segments [ 20 ]. Spermatozoa, which contain PLCζ, encourage the release of Ca2+ from the intracellular deposits of the oocyte through the hydrolysis of the membrane lipids phosphatidylinositol 4,5-bisphosphate (PIP2) and, in consequence, through the stimulation of the inositol 1,4,5-trisphosphate (InsP3) receptor’s Ca2+ signaling pathway.…”

Наступление Беременности И Роды У Пациенток После Коррекции Расположения Пронуклеусов В Ооцитах С Использованием Ионофора Кальция

“…Обсуждение: На сегодняшний день все большее число исследований показывают эффективность и безопасность применения для ИАО химических индукторов, таких как ионофоры. Это положительно влияет на частоту оплодотворения, образования бластоцист, имплантации, наступления беременности и повышает коэффициент живорождения, причем не сказывается на частоте выкидышей, врожденных аномалий и соотношении полов у рожденных детей [13,14]. E. Isachenko et al также рассмотрели применение ионофора кальция у пациентов с нецентральным расположением пронуклеусов и отметили успешное наступление беременности при коррекции ионофором [15].…”