title: Oolemma rupture inside the intracytoplasmic sperm injection needle significantly improves the fertilization rate and reduces oocyte damage.
abstract: OBJECTIVE
  To compare the effect on fertilization, oocyte damage, embryo freezing, and pregnancy rates of two different techniques for rupturing the oolemma during intracytoplasmic sperm injection (ICSI).
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  Fertility Center, Alliant Health System Hospital.
  
  
  METHODS
  Seventy-nine consecutive IVF-ICSI cases.
  
  
  METHODS
  Patients in group I had ICSI performed by pushing the needle into the oocyte until the oolemma was observed to break outside the needle. In group II the oolemma was aspirated into the needle until it ruptured inside the needle.
  
  
  METHODS
  In group II ICSI resulted in significantly higher fertilization and lower oocyte damage rates (66% and 13%) than in group 1 (39% and 29%). There were no statistically significant differences in embryo cleavage rates or pregnancy rates per retrieval between the two groups. A greater number of cases had embryos cryopreserved in group II than in group I.
  
  
  RESULTS
  Rupturing the oolemma by aspirating it into the ICSI needle (group II) improved laboratory outcomes compared with the more traditional technique of breaking this membrane by the stabbing action of the needle (group I). This modification of the ICSI technique also increased the number of patients with cryopreserved embryos and therefore could increase the pregnancy rate per patient.
  
  
  CONCLUSIONS
  The site and technique used to rupture the oolemma during ICSI has a significant effect on the fertilization and damage rates.
authors.affiliation: Department of Obstetrics and Gynecology, University of Louisville School of Medicine, Kentucky, USA. ajcarr01@ulkyvm.louisville.edu
authors.forename: A J
authors.initials: AJ
authors.lastname: Carrillo
authors.forename: S H
authors.initials: SH
authors.lastname: Atiee
authors.forename: B
authors.initials: B
authors.lastname: Lane
authors.forename: D D
authors.initials: DD
authors.lastname: Pridham
authors.forename: P
authors.initials: P
authors.lastname: Risch
authors.forename: I H
authors.initials: IH
authors.lastname: Silverman
authors.forename: C L
authors.initials: CL
authors.lastname: Cook
mesh_terms: D000328:Adult; D003593:Cytoplasm; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D008845:Microinjections / Q000295:instrumentation; D009339:Needles; D009865:Oocytes / Q000473:pathology*; D011247:Pregnancy; D012189:Retrospective Studies; D012421:Rupture; D016896:Treatment Outcome; D015044:Zona Pellucida / Q000473:pathology*