Goksan Pabuccu E, Sinem Caglar G, Dogus Demirkiran O, Pabuccu R
Department of Obstetrics and Gynecology, Ufuk University Faculty of Medicine, Ankara, Turkey.
Centrum Clinic Assisted Reproductive Technology Unit, Ankara, Turkey.
Andrologia. 2016 Mar;48(2):164-70. doi: 10.1111/and.12427. Epub 2015 May 1.
Fertilisation with intracytoplasmic sperm injection (ICSI) is a consequence of complex molecular interactions between spermatozoon and oocyte. Disruption of the process obviously prompts a frustrating event called total fertilisation failure (TFF). Up to 3% of ICSI cycles may result in TFF, and brief counselling for subsequent cycle management is indispensable. Within this perspective, ICSI cycles of a centre over a 10-year period were analysed to document TFF cases. Initial TFF after ICSI and subsequent ICSI cycle of the same cases were documented to clarify predictive factors of successful outcomes after initial TFF. In subsequent cycles, assisted oocyte activation (AOA) with calcium ionophore and Hypo-osmotic swelling test (HOST)/pentoxifilline for sperm selection was used. In the current analysis, successful fertilisation was achieved in 85% of the cases with previous TFF. The significant contributing factors for successful fertilisation in the latter cycle were: improved oocyte quantity and better sperm morphology. In conclusion, sporadic TFF event in the first and only cycle is usually a technically modifiable condition, but repeated TFF could indicate possible gamete defects, which might not be overcomed in the next modified ICSI cycle.
卵胞浆内单精子注射（ICSI）受精是精子与卵母细胞之间复杂分子相互作用的结果。该过程的中断显然会引发一种令人沮丧的情况，即完全受精失败（TFF）。高达3%的ICSI周期可能会导致TFF，因此为后续周期管理提供简短咨询是必不可少的。从这个角度出发，对一个中心10年内的ICSI周期进行了分析，以记录TFF病例。记录了ICSI后的初始TFF以及同一病例的后续ICSI周期，以阐明初始TFF后成功结局的预测因素。在后续周期中，使用钙离子载体进行辅助卵母细胞激活（AOA），并采用低渗肿胀试验（HOST）/己酮可可碱进行精子筛选。在当前分析中，85%既往有TFF的病例实现了成功受精。后一周期成功受精的重要促成因素是：卵母细胞数量增加和精子形态改善。总之，在第一个也是唯一的周期中出现的散发性TFF事件通常是一种技术上可改变的情况，但反复出现TFF可能表明存在可能的配子缺陷，这在接下来改进的ICSI周期中可能无法克服。
