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Improving outcomes of after fertilization failure with intracytoplasmic sperm injection: the role of differentiating oocyte-related and sperm-related oocyte activation deficiency

      The paper by Cheung et al. in this month’s Fertility and Sterility establishes an interesting clinical pathway for patients who have had complete fertilization failure or very poor fertilization rates after in vitro fertilization (IVF) with intracytoplasmic sperm injection (ICSI) (
      • Cheung S.C.
      • Xie P.
      • Parrella A.
      • Keating D.
      • Rosenwaks Z.
      • Palermo G.D.
      Identification and treatment of men with PLCζ-defective spermatozoa.
      ). Although complete fertilization failure occurs rarely, in ∼1%–3% of couples undergoing IVF/ICSI, subsequent fertilization and pregnancy rates are lower without careful consideration of the clinical scenario (
      • Vanden Meerschaut F.
      • Nikiforaki D.
      • Heindryckx B.
      • de Sutter P.
      Assisted oocyte activation following ICSI fertilization failure.
      ). The main cause of fertilization failure after ICSI is thought to be oocyte activation deficiency (OAD), which can be due to oocyte-related factors or sperm-related factors (
      • Vanden Meerschaut F.
      • Nikiforaki D.
      • Heindryckx B.
      • de Sutter P.
      Assisted oocyte activation following ICSI fertilization failure.
      ).
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      References

        • Cheung S.C.
        • Xie P.
        • Parrella A.
        • Keating D.
        • Rosenwaks Z.
        • Palermo G.D.
        Identification and treatment of men with PLCζ-defective spermatozoa.
        Fertil Steril. 2020; 114: 535-544
        • Vanden Meerschaut F.
        • Nikiforaki D.
        • Heindryckx B.
        • de Sutter P.
        Assisted oocyte activation following ICSI fertilization failure.
        Reprod Biomed Online. 2014; 28: 560-571
        • Bonte D.
        • Ferrer-Buitrago M.
        • Dhaenens L.
        • Popovic M.
        • Thys V.
        • de Croo I.
        • et al.
        Assisted oocyte activation significantly increases fertilization and pregnancy outcome in patients with low and total failed fertilization after intracytoplasmic sperm injection: a 17-year retrospective study.
        Fertil Steril. 2019; 112: 266-274
        • Yu Y.
        • Saunders C.M.
        • Lai F.A.
        • Swann K.
        Preimplantation development of mouse oocytes activated by different levels of human phospholipase C zeta.
        Hum Reprod. 2008; 23: 365-373
        • Combelles C.M.
        • Morozumi K.
        • Yanagimachi R.
        • Zhu L.
        • Fox J.H.
        • Racowsky C.
        Diagnosing cellular defects in an unexplained case of total fertilization failure.
        Hum Reprod. 2010; 25: 1666-1671

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