Abstract
BACKGROUND: The objective of this study is to evaluate artificial oocyte activation (AOA) with calcium ionophore (CaI) in a subsequent attempt at fertilisation in patients after extremely low or failed fertilisation. We assessed improvements in fertilisation, implantation and pregnancy rates as well as cancellation rates in these patients. Finally, was evaluated the result testing in addition to delivery rate and obstetric outcomes in children born after AOA. MATERIALS AND METHODS: This was a retrospective observational study conducted in an IVF laboratory of an IVI clinic (IVIRMA Valencia, Spain). One group (509 mature oocytes from 66 patients) received a first intracytoplasmic sperm injection (ICSI) without AOA, which resulted in either a failed fertilisation or very low values (<30%). This group was compared with a second group (616 mature oocytes from the same 66 patients) that used AOA. Outcome was compared by McNemar's test and the dependent t tests. RESULTS: AOA plus CaI resulted in enhanced fertilisation (51 vs. 13.1%), ongoing pregnancy (47 vs. 21.7%), and implantation (31.1 vs. 13.1%) rates, and less chances for cancelling the cycle (22.7 vs. 69.3%). There were no observed adverse effects in obstetric and perinatal outcomes after the use of AOA. CONCLUSION: Our findings support the use of AOA for a given population of patients where fertilisation was affected during previous attempts. After AOA, we observed a significant increase in reproductive success due to the increased number of embryos available for embryo selection and, therefore, enhanced chances for success. The use of this artificial technique is comforting after checking non-existence of detrimental effects on the offspring.