Voros Charalampos, Mavrogianni Despoina, Athanasiou Diamantis, Sapantzoglou Ioakeim, Bananis Kyriakos, Athanasiou Antonia, Athanasiou Aikaterini, Papadimas Georgios, Tsimpoukelis Charalampos, Papapanagiotou Ioannis, Vaitsis Dimitrios, Koulakmanidis Aristotelis-Marios, Daskalaki Maria Anastasia, Topalis Vasileios, Thomakos Nikolaos, Theodora Marianna, Antsaklis Panagiotis, Chatzinikolaou Fotios, Loutradis Dimitrios, Daskalakis Georgios
Department of Obstetrics and Gynecology, 'Alexandra' General Hospital, National and Kapodistrian University of Athens, 80 Vasilissis Sofias Avenue, 11528 Athens, Greece.
IVF Athens Reproduction Center, 15123 Maroussi, Greece.
Biomedicines. 2025 Aug 18;13(8):2007. doi: 10.3390/biomedicines13082007.
Fertilisation failure following intracytoplasmic sperm injection (ICSI) is a significant challenge in assisted reproductive technology (ART), particularly in the absence of an identifiable cause. Artificial oocyte activation (AOA), typically with calcium ionophores, has emerged as a potential solution in scenarios characterised by a deficiency of phospholipase C zeta (PLCζ). This narrative review consolidates the latest clinical and experimental data regarding the application of calcium ionophores for oocyte activation, the significance of PLCζ testing in instances of unexplained fertilisation failure, and the impact of AOA on the morphokinetics and developmental potential of embryos. AOA has demonstrated an enhancement in fertilisation, cleavage, and pregnancy outcomes in specific patient populations, including individuals with diminished ovarian reserve or those who have previously attempted conception unsuccessfully. Although AOA appears to have no impact on embryo morphokinetics, certain studies indicate slight alterations in early cleavage features. The available statistics indicate that there are no significant safety concerns about outcomes for babies. This finding underscores the significance of tailored ART methodologies that incorporate molecular diagnostics and targeted AOA therapies. It emphasises the necessity for additional prospective trials to enhance patient selection and long-term safety surveillance.
卵胞浆内单精子注射（ICSI）后受精失败是辅助生殖技术（ART）中的一项重大挑战，尤其是在没有可识别原因的情况下。人工卵母细胞激活（AOA），通常使用钙离子载体，已成为在以磷脂酶Cζ（PLCζ）缺乏为特征的情况下的一种潜在解决方案。这篇叙述性综述整合了有关钙离子载体用于卵母细胞激活的最新临床和实验数据、PLCζ检测在不明原因受精失败情况下的意义，以及AOA对胚胎形态动力学和发育潜力的影响。AOA在特定患者群体中已显示出受精、卵裂和妊娠结局的改善，包括卵巢储备功能减退的个体或之前尝试受孕未成功的个体。虽然AOA似乎对胚胎形态动力学没有影响，但某些研究表明早期卵裂特征有轻微改变。现有统计数据表明，婴儿结局没有重大安全问题。这一发现强调了结合分子诊断和靶向AOA疗法的个性化ART方法的重要性。它强调了进行更多前瞻性试验以改善患者选择和长期安全监测的必要性。
