Eftekhar Maryam, Janati Sima, Rahsepar Mozhgan, Aflatoonian Abbas
Research and Clinical Center for Infertility, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Research and Clinical Center for Infertility, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. ; Department of Obstetrics and Gynecology, Dezful University of Medical Sciences, Dezful, Iran.
Iran J Reprod Med. 2013 Nov;11(11):875-82.
Chemical activation is the most frequently used method for artificial oocyte activation (AOA), results in high fertilization rate.
This prospective, randomized, unblinded, clinical study aimed to evaluate the efficiency of oocyte activation with calcium ionophore on fertilization and pregnancy rate after intracytoplasmic sperm injection (ICSI) in infertile men suffer from teratoospermia.
Thirty eight women with teratoospermic partner underwent ICSI with antagonist protocol. A total of 313 metaphase II (MII) oocytes were randomly divided into two groups: In the oocytes of the control group (n=145), routine ICSI was applied. Oocytes in the AOA group (n=168) immediately after ICSI, were entered in culture medium supplemented with 5 µΜ calcium ionophore (A23187) for 5 minutes and then washed at least five times with MOPS solution. In both groups, the fertilization was evaluated 16-18 hours after ICSI.
The number of fertilized oocytes and embryos obtained were significantly different between two groups (p=0.04). There was no significant difference between the two studied groups regarding the fertilization and cleavage rate (95.33% vs. 84.4%, p=0.11; and 89.56% vs. 87.74%, p=0.76, respectively). Implantation rate was higher in AOA group than in control group, but the difference was not significant (17.64% vs. 7.4%, p=0.14). No significant differences were observed in chemical and clinical pregnancy rate between groups (47.1% vs. 16.7%, p=0.07; and 41.2% vs. 16.7%; p=0.14, respectively).
We didn't find significant difference in the implantation, fertilization, cleavage and pregnancy rates between the two groups but could significantly increase the number of fertilized oocytes and embryos obtained. Finally oocyte activation with calcium ionophore may improve ICSI outcomes in infertile men suffer from teratoospermia. Further study with more cases can provide greater value.
化学激活是人工卵母细胞激活（AOA）最常用的方法，可导致高受精率。
这项前瞻性、随机、非盲法临床研究旨在评估钙离子载体激活卵母细胞对患有畸形精子症的不育男性进行卵胞浆内单精子注射（ICSI）后的受精率和妊娠率的影响。
38名伴侣为畸形精子症患者的女性接受了拮抗剂方案的ICSI治疗。总共313个中期II（MII）卵母细胞被随机分为两组：对照组（n = 145）的卵母细胞采用常规ICSI。AOA组（n = 168）的卵母细胞在ICSI后立即放入添加了5 μΜ钙离子载体（A23187）的培养基中培养5分钟，然后用MOPS溶液洗涤至少5次。两组均在ICSI后16 - 18小时评估受精情况。
两组获得的受精卵母细胞和胚胎数量有显著差异（p = 0.04）。在受精率和卵裂率方面，两组之间无显著差异（分别为95.33%对84.4%，p = 0.11；以及89.56%对87.74%，p = 0.76）。AOA组的着床率高于对照组，但差异不显著（17.64%对7.4%，p = 0.14）。两组之间的化学妊娠率和临床妊娠率无显著差异（分别为47.1%对16.7%，p = 0.07；以及41.2%对16.7%；p = 0.14）。
我们发现两组在着床、受精、卵裂和妊娠率方面无显著差异，但可以显著增加获得的受精卵母细胞和胚胎数量。最后，钙离子载体激活卵母细胞可能改善患有畸形精子症的不育男性的ICSI结局。更多病例的进一步研究可提供更大价值。
