The effectiveness of intracytoplasmic sperm injection combined with piezoelectric stimulation in infertile couples with total fertilization failure

Objective

To assess the effectiveness of intracytoplasmic sperm injection (ICSI) combined with piezoelectric stimulation in infertile couples with a history of total fertilization failure (TFF).

Design

Prospective controlled trial.

Setting

Clinical IVF laboratory.

Patient(s)

Seventy-one couples undergoing ICSI on sibling oocytes having at least one previous ICSI attempt with TFF.

Intervention(s)

ICSI or ICSI with piezoelectric activation.

Main Outcome Measure(s)

Fertilization rate.

Result(s)

The patients were allocated to two groups: group I included 21 patients with only one previous TFF and group II included 50 patients with more than one previous TFF. Collectively, a total of 823 metaphase II (MII) oocytes were retrieved in 78 oocyte retrievals. In Group I, combined ICSI with piezoelectric stimulation was applied to 123/211 (58.2%) of MII oocytes (group IA), whereas standard ICSI procedure was applied to 88/211 (41.8%) of MII oocytes (group IB). The fertilization rate was 62% and 12% in group IA and group IB respectively. In group II, piezoelectric activation was applied in all 612 MII oocytes, of which 296 (48.3%) were fertilized. The rates for implantation and pregnancy/embryo transfer were obtained as 30.6% and 44.1%, respectively.

Conclusion(s)

Piezoelectric activation seems to improve IVF outcome in patients with previous TFF history.

Key Words: ICSI, electrical activation, fertilization rate, embryo grade, pregnancy