Neonatal and neurodevelopmental outcome of children aged 3–10years born following assisted oocyte activation

Abstract

Assisted oocyte activation (AOA) using a calcium ionophore has been used for more than a decade following intracytoplasmic sperm injection (ICSI) fertilization failure. However, since AOA does not mimic precisely the physiological fertilization process, concerns exist about its use in human assisted reproduction. This study assessed the neonatal and neurodevelopmental outcome of children aged ≥ 3 years who had been born following AOA in our centre. Twenty-one children participated in the study (81% response rate; mean age 63.6 ± 21.07 months). Neonatal data were collected via questionnaires. Neurodevelopmental outcome was tested using the Reynell Developmental Language Scales or Clinical Evaluation of Language Fundamentals, Wechsler Preschool and Primary Scale of Intelligence or Wechsler Intelligence Scale for Children, and the Movement Assessment Battery for Children III. Behaviour was scored by the Social Communication Questionnaire, the Child Behaviour Checklist and the Teachers Report Form. For all tests and questionnaires, the mean outcomes lay within the expected ranges. These are first data on the developmental outcome of AOA children. The high response rate and the robustness of the tests support the data, which are reassuring although still considered preliminary. Therefore, AOA should still be performed only in selected couples.

The combination of calcium ionophore A23187 and GM-CSF can safely salvage aged human unfertilized oocytes after ICSI

“…However, this may only have a clinical value if the procedure is safe. Indeed, most of the studies on AOA safety have been conducted in cases where the AOA stimulus was applied during or immediately after ICSI [54,55]. Furthermore, if the procedure proves to be safe by appropriate studies, it may lead to yet another general source of human embryonic stem cell lines [56] for therapeutic purposes.…”

Phospholipase C-zeta deficiency as a cause for repetitive oocyte fertilization failure during ovarian stimulation for in vitro fertilization with ICSI: a case report

“…Data regarding Ca 2+ ionophore use with ICSI and its relationship to human oocyte competence, embryo development, and neurodevelopmental outcomes in children appear reassuring [17,37,38], but immature oocytes or mature oocytes failing to fertilize may harbor inherent defects that potentially harm the embryo [39]. Also relevant is the potential impact of Ca 2+ ionophore use with ICSI on the rates of miscarriage, genetic abnormalities, and minor as well as major congenital malformations [15,40].…”

Clinical Application of Calcium Ionophore (A23187) Oocyte Activation in Fertilization Failure after ICSI

“…The studies cited above were conducted with small subject populations, and at present the accumulated data is insufficient for assessing the safety of AOA yet. [41] An abnormality of the babies born after oocyte activation has not yet been reported, for the moment. But the data confirming the safety of AOA is scarce at present.…”