Assisted oocyte activation significantly increases fertilization and pregnancy outcome in patients with low and total failed fertilization after intracytoplasmic sperm injection: a 17-year retrospective study
Assisted oocyte activation significantly increases fertilization and pregnancy outcome in patients with low and total failed fertilization after intracytoplasmic sperm injection: a 17-year retrospective study
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DOI：
10.1016/j.fertnstert.2019.04.006
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发表时间：
2019-08-01
影响因子：
6.7
通讯作者：
Heindryckx, Bjorn
中科院分区：
文献类型：
--
作者：
Bonte, Davina;Ferrer-Buitrago, Minerva;Heindryckx, Bjorn
目的：调查辅助卵母细胞激活 (AOA) 在多大程度上改善诊断为卵母细胞激活缺陷 (OAD) 的患者的临床结果。 设计：回顾性队列研究，比较 AOA 周期和 ICSI 后受精率低或完全失败的夫妇之前的胞浆内单精子注射 (ICSI) 周期。重要的是，在 AOA 之前，使用小鼠卵母细胞激活测试 (MOAT) 对所有患者的精子相关卵母细胞激活能力进行了检查。地点：一所大学医院的不孕不育中心。患者：总共 122 对有 ICSI 后受精率低或完全失败史的夫妇。干预措施：ICSI、MOAT、AOA 和胚胎移植。主要结果指标：受精、妊娠和胚胎移植。活产率。结果：MOAT 显示 19 名患者患有精子相关的 OAD（MOAT 组 1），56 名患者患有精子相关的卵母细胞激活能力减弱（MOAT 组 2），47 名患者患有疑似卵母细胞相关的 OAD（MOAT 组 3）。与之前的 ICSI 尝试（243 个周期）相比，AOA（191 个周期）显着提高了所有 MOAT 组的受精率、妊娠率和活产率。 AOA 后的受精率在 MOAT 组 1 (70.1%)、2 (63.0%) 和 3 (57.3%) 之间存在显着差异。 MOAT 第 1 组和第 3 组之间，妊娠率（49.0% vs. 29.4%）和活产率（41.2% vs. 22.1%）存在显着差异。总共 225 例胚胎移植在 AOA 后产生了 60 例健康活产。结论：在 AOA 之前接受诊断测试的患者与之前的周期相比，临床结果有显着改善。我们的研究结果强调，AOA 应该保留给具有明确 OAD 的患者。 （(C) 2019 年，美国生殖医学会。）
Objective: To investigate the extent to which assisted oocyte activation (AOA) improves clinical outcomes in patients diagnosed with oocyte activation deficiencies (OADs).Design: Retrospective cohort study comparing AOA cycles and previous intracytoplasmic sperm injection (ICSI) cycles in couples experiencing low or total failed fertilization after ICSI. Importantly, the sperm-related oocyte-activating capacity was examined in all patients before AOA with the use of the mouse oocyte activation test (MOAT).Setting: Infertility center at a university hospital.Patient(s): A total of 122 couples with a history of low or total failed fertilization after ICSI.Intervention(s): ICSI, MOAT, AOA, and embryo transfer.Main Outcome Measure(s): Fertilization, pregnancy, and live birth rates.Result(s): MOAT revealed 19 patients with a sperm-related OAD (MOAT group 1), 56 patients with a diminished sperm-related oocyte-activating capacity (MOAT group 2), and 47 patients with a suspected oocyte-related OAD (MOAT group 3). AOA (191 cycles) significantly improved fertilization, pregnancy, and live birth rates in all MOAT groups compared with previous ICSI attempts (243 cycles). Fertilization rates after AOA were significantly different among MOAT groups 1 (70.1%), 2 (63.0%), and 3 (57.3%). Between MOAT group 1 and 3, significant differences in pregnancy (49.0% vs. 29.4%) and live birth (41.2% vs. 22.1%) rates were observed. In total, 225 embryo transfers resulted in 60 healthy live births following AOA.Conclusion(s): Patients undergoing diagnostic testing before AOA show a significant improvement in clinical outcomes compared with previous cycles. Our findings highlight that AOA should be reserved for patients with clear OADs. ((C) 2019 by American Society for Reproductive Medicine.)