Reproductive Medicine Center of Shanghai First Maternity and Infant Hospital, School of Life Sciences and Technology, Tongji University, Shanghai, China.
Shanghai Institute of Maternal-Fetal Medicine and Gynecologic Oncology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China.
Front Endocrinol (Lausanne). 2023 Aug 11;14:1244507. doi: 10.3389/fendo.2023.1244507. eCollection 2023.
Does artificial oocyte activation (AOA) by a calcium ionophore (ionomycin) improve the previous fertilization failure or poor embryo development of intracytoplasmic sperm injection (ICSI) account for male factor infertility or other infertility causes?
This retrospective study involved 114 patients receiving ICSI-AOA in Shanghai First Maternity and Infant Hospital with previous ICSI fertilization failure or poor embryo development. The previous ICSI cycles of the same patients without AOA served as the control group. The fertilization rates, cleavage rates, transferable embryo rates and blastocyst formation rates of the two groups were compared. Additionally, the clinical pregnancy, implantation rate and live birth rates were also compared to assess the efficiency and safety of AOA. Furthermore, two subgroup analyses were performed in this study based on the cause of infertility and the reason for AOA. The fertilization rate, embryonic development potential and clinical outcome were compared among groups.
Among 114 ICSI-AOA cycles, the fertilization rate, top-quality embryo rate, implantation rate, clinical pregnancy per patient and live birth rate per patient were improved significantly compared with previous ICSI cycles (p<0.05 to P< 0.001), and the miscarriage rate in the AOA group was significantly lower than that of the control group (p<0.001). In the AOA subgroups based on the cause of infertility, the fertilization rates of each subgroup were significantly improved compared with previous control cycles except for the mixed factor infertility subgroup (p<0.05 to p<0.001). In the AOA subgroups based on the reason for AOA, the fertilization rates of each subgroup were significantly increased compared with those in their previous ICSI cycle without AOA (p<0.001); however, there was no significant difference in the top-quality embryo rate. No significant improvement was found in the implantation rates and the clinical pregnancy rate in each subgroup except for the poor embryo development subgroup. In the 114 AOA cycles, 35 healthy infants (21 singletons and 7 twins) were delivered without major congenital birth defects or malformations.
This study showed that AOA with the calcium ionophore ionomycin can improve the reproductive outcomes of patients with previous fertilization failure and poor embryo development after ICSI.
钙离子载体（离子霉素）人工卵母细胞激活（AOA）是否能改善因男性因素或其他原因导致的体外受精（ICSI）失败或胚胎发育不良的情况？
本回顾性研究纳入了在上海第一妇婴保健院接受 ICSI-AOA 的 114 名患者，这些患者之前的 ICSI 受精失败或胚胎发育不良。同一患者未接受 AOA 的 ICSI 周期作为对照组。比较两组的受精率、卵裂率、可移植胚胎率和囊胚形成率。此外，还比较了临床妊娠率、种植率和活产率，以评估 AOA 的效率和安全性。此外，本研究还基于不孕原因和 AOA 原因进行了两组亚组分析。比较了各组的受精率、胚胎发育潜能和临床结局。
在 114 个 ICSI-AOA 周期中，与之前的 ICSI 周期相比，受精率、优质胚胎率、种植率、每位患者的临床妊娠率和每位患者的活产率均显著提高（p<0.05 至 P<0.001），且 AOA 组的流产率显著低于对照组（p<0.001）。在基于不孕原因的 AOA 亚组中，除混合因素不孕亚组外，每个亚组的受精率均较之前的对照组周期显著提高（p<0.05 至 p<0.001）。在基于 AOA 原因的 AOA 亚组中，每个亚组的受精率均较之前无 AOA 的 ICSI 周期显著提高（p<0.001）；然而，优质胚胎率无显著差异。除胚胎发育不良亚组外，每个亚组的种植率和临床妊娠率均无显著提高。在 114 个 AOA 周期中，35 名健康婴儿（21 名单胎和 7 名双胞胎）顺利分娩，无重大先天性出生缺陷或畸形。
本研究表明，钙离子载体（离子霉素）人工卵母细胞激活（AOA）可改善因 ICSI 受精失败或胚胎发育不良导致的患者的生殖结局。
