Landes- Frauen- und Kinderklinik, Kinderwunschzentrum, Linz, Austria.
Fertil Steril. 2012 Dec;98(6):1432-7. doi: 10.1016/j.fertnstert.2012.07.1134. Epub 2012 Aug 24.
To analyze whether a ready-to-use calcium ionophore improves outcomes, from fertilization to live birth, in patients with severe male factor infertility.
Artificial oocyte activation offered to applicable patients over a 20-month period.
Specialized in vitro fertilization (IVF) centers in Austria and Germany.
PATIENT(S): Twenty-nine azoospermic and 37 cryptozoospermic men.
INTERVENTION(S): Mature oocytes treated with a ready-to-use Ca(2+)-ionophore (GM508 Cult-Active) immediately after intracytoplasmic sperm injection (ICSI).
MAIN OUTCOME MEASURE(S): Rates of fertilization, implantation, clinical pregnancy, and live birth.
RESULT(S): Patients had had 88 previous cycles without artificial activation that resulted in a fertilization rate of 34.7%, 79 transfers (89.8%), and 5 pregnancies, which all spontaneously aborted except one. After artificial oocyte activation, the fertilization rate was 56.9%. In terms of fertilization rate, both azoospermic (64.4%) and cryptozoospermic (48.4%) men statistically significantly benefited from use of the ionophore. In 73 transfer cycles, positive β-human chorionic gonadotropin levels were observed in 34 cases (46.6%) and 29 cycles (39.7%) that ended with a clinical pregnancy. The corresponding implantation rate was 33.3%. Four spontaneous abortions occurred (11.8%), and 32 healthy children were born.
CONCLUSION(S): This is the first prospective multicenter study on artificial oocyte activation in severe male factor infertility. Present data indicate that a ready-to-use calcium ionophore can yield high fertilization and pregnancy rates for this particular subgroup. In addition to fertilization failure after ICSI, severe male factor infertility is an additional area for application of artificial oocyte activation.
分析在严重男性因素不育患者中，使用即用型钙离子载体是否能提高受精率至活产率。
在 20 个月的时间内，为符合条件的患者提供卵母细胞人工激活。
奥地利和德国的专门体外受精（IVF）中心。
29 名无精子症患者和 37 名隐匿精子症患者。
在胞浆内单精子注射（ICSI）后立即用即用型钙离子载体（GM508 Cult-Active）处理成熟卵母细胞。
受精率、着床率、临床妊娠率和活产率。
患者此前有 88 个未经人工激活的周期，受精率为 34.7%，进行了 79 次移植（89.8%），发生了 5 例妊娠，但均自然流产，仅 1 例除外。人工卵母细胞激活后，受精率为 56.9%。在受精率方面，无精子症（64.4%）和隐匿精子症（48.4%）患者均从使用离子载体中获益。在 73 个移植周期中，有 34 例（46.6%）和 29 个周期（39.7%）检测到β-人绒毛膜促性腺激素水平阳性，最终临床妊娠。相应的着床率为 33.3%。发生 4 例自然流产（11.8%），32 名健康儿童出生。
这是首例关于严重男性因素不育症卵母细胞人工激活的前瞻性多中心研究。现有数据表明，即用型钙离子载体可使这一特定亚组的受精率和妊娠率显著提高。除 ICSI 后受精失败外，严重男性因素不育也是卵母细胞人工激活的另一个应用领域。
