title: Electrical activation and in vitro development of human oocytes that fail to fertilize after intracytoplasmic sperm injection.
abstract: OBJECTIVE
  To determine whether electrically stimulated Ca2+ influx can "rescue" fertilization and early embryogenesis in human oocytes that fail to fertilize after intracytoplasmic sperm injection (ICSI).
  
  
  METHODS
  Prospective, randomized trial of a laboratory procedure.
  
  
  METHODS
  A research laboratory at a university medical center.
  
  
  METHODS
  Discarded oocytes from ICSI-IVF cycles.
  
  
  METHODS
  Oocytes (n = 104) that showed no evidence of fertilization 16-24 hours after ICSI were assigned to three treatment groups: group 1 (one direct current electrical pulse at 1.36-1.50 kV/cm for 40-60 micros), group 2 (three pulses every 15-20 minutes), or group 3 (treated the same as group 2 but with no electrical stimulation).
  
  
  METHODS
  After stimulation, the oocytes were cultured in vitro for 3-5 days. Oocytes that displayed two pronuclei and a second polar body within 16 hours were considered to have fertilized normally. Fertilization and embryo cleavage rates were compared between groups.
  
  
  RESULTS
  Fertilization occurred in 26 (70%) of 37 and 38 (78%) of 49 group 1 and 2 oocytes, respectively, but in only 5 (27%) of 18 group 3 oocytes. Within 3 days, group 2 embryos routinely developed beyond the two-cell to four-cell stage (61% versus 13% in group 1); 11% of these oocytes developed to the morula or early blastocyst stage. Sex chromosome analyses indicated 10 male and 8 female embryos.
  
  
  CONCLUSIONS
  Oocytes that fail to fertilize by 24 hours after ICSI can resume apparently normal fertilization and early embryonic development in response to electrical stimulation. Moreover, the degree of cytoplasmic activation as determined by the number of pulses applied affects fertilization efficiency and early embryonic development.
authors.affiliation: Program for In Vitro Fertilization, Reproductive Surgery and Fertility, New York University School of Medicine, New York, USA.
authors.forename: J
authors.initials: J
authors.lastname: Zhang
authors.forename: C W
authors.initials: CW
authors.lastname: Wang
authors.forename: A
authors.initials: A
authors.lastname: Blaszcyzk
authors.forename: J A
authors.initials: JA
authors.lastname: Grifo
authors.forename: J
authors.initials: J
authors.lastname: Ozil
authors.forename: E
authors.initials: E
authors.lastname: Haberman
authors.forename: A
authors.initials: A
authors.lastname: Adler
authors.forename: L C
authors.initials: LC
authors.lastname: Krey
mesh_terms: D000328:Adult; D002478:Cells, Cultured; D003593:Cytoplasm / Q000502:physiology; D004558:Electric Stimulation; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D017404:In Situ Hybridization, Fluorescence; D008297:Male; D008845:Microinjections; D009865:Oocytes / Q000502:physiology* / Q000648:ultrastructure; D011446:Prospective Studies