The value of second polar body detection 4 hours after insemination and early rescue ICSI in preventing complete fertilisation failure in patients with borderline semen

Abstract

Abstract. In this study we evaluated the value of short-time insemination and early rescue intra-cytoplasmic sperm injection (ICSI) in preventing the occurrence of complete fertilisation failure for mild or moderate male infertility patients. A total of 866 couples with borderline semen who underwent in vitro fertilisation treatment in 2010 were included. Regular insemination was performed between January and June of 2010 and short-term insemination was performed from July through December 2010, where, as early as 4 h after insemination, oocytes were denuded from cumulus cells and extrusion of the second polar body was evaluated. Of the 4153 mature oocytes with a detectable second polar body 4 h after insemination, 3874 (93.3%) showed signs of fertilisation on Day 1. Where no second polar body was present in any of the retrieved oocytes for a given patient, rescue ICSI was performed immediately. Similar rates of normal fertilisation and percentage of good-quality embryos were obtained between early rescue ICSI and regular ICSI. Clinical pregnancy occurred in 16 of 43 patients (37.2%) receiving early rescue ICSI. Our results showed early rescue ICSI in combination with evaluation of the second polar body 4 h following insemination is an effective method to prevent complete fertilisation failure for patients with mild or moderate male infertility.Additional keywords: borderline semen, clinical outcome, early rescue ICSI, failed fertilization, second polar body.

Determining the need for rescue intracytoplasmic sperm injection in partial fertilisation failure during a conventional IVF cycle

“…To determine the need for rescue ICSI based on the extrusion of 2PB 4-6 h after insemination has become a widely recognised approach (Chen & Kattera, 2003;Xiong et al, 2011;Zhu et al, 2011a,b). At 4-6 h after fertilisation, the extrusion rate of 2PB ranges from 78 to 86% ( Van den Bergh et al, 1995;Suppinyopong et al, 2000;Jin et al, 2014). For a few cases where more than 6 h is required for the extrusion of 2PB, rescue ICSI may misjudge the fertilised oocytes with the 2PB not extruded as unfertilised oocytes, leading to polyploidy.…”

“…Observing the extrusion of the 2PB after granular cell removal is a key indicator of fertilisation. Jin et al (2014) observed the 2PB of 5696 IVF oocytes 4 h after their fertilisation and found that extrusion of the 2PB occurs 4 h after fertilisation for 86.3% of the oocytes, of which 93.3% of the oocytes are found to be fertilised on the day after OPU. The oocytes extruded from the 2PB observed in group 2 in our study had a fertilisation rate of only 59.13%, which is lower than that observed in group 3 (93.3%).…”

Pregnancy with oocytes characterized by narrow perivitelline space and heterogeneous zona pellucida: is intracytoplasmic sperm injection necessary?

“…Xiong's report indicated that cumulus cells removal at 6 h of insemination was a relatively safe operation with comparable normal fertilization rate and clinical pregnancy rate [26]. Short term co-culture for 4 h after insemination was also used for preventing complete fertilization failure in patients with bordline semen [27]. In our center, early rescue ICSI was performed after 5 h post-insemination for none of the MII oocytes had second polar body extrusion, which meant complete fertilization failure.…”

Homozygous missense mutation Arg207Cys in the WEE2 gene causes female infertility and fertilization failure

“…The patient underwent two failed IVF/ICSI attempts ( Table 2). In the first IVF cycle, she underwent short-time insemination and early-rescue ICSI at AnHui Women and Child Health Care Hospital as previously described [17,18]. Twenty-three MII oocytes were retrieved, but none were normally fertilized after early-rescue ICSI.…”