Laser-assisted intracytoplasmic sperm injection.
OBJECTIVE
To improve oocyte survival and fertilization rates after intracytoplasmic sperm injection (ICSI) in patients with inherent oocyte fragility.


METHODS
Pilot feasibility study and case report.


METHODS
Private hospital.


METHODS
Infertile couple with repeated failures of ICSI caused by oocyte degeneration.


METHODS
Laser-assisted drilling of the zona pellucida followed by ICSI.


METHODS
Oocyte survival, fertilization, and pregnancy.


RESULTS
In a couple with four previous ICSI failures because of poor oocyte survival (33.3%, 0%, 20%, and 18%), a fifth attempt using laser-assisted ICSI resulted in the survival of 8 oocytes out of 13 injected. Normal fertilization occurred in 5 oocytes, and a clinical pregnancy was established.


CONCLUSIONS
Performing ICSI through a laser-drilled hole in the zona pellucida reduces the risk of oocyte damage related to deformation during the initial phase of the microinjection procedure. This modification of ICSI appears to be suitable for patients whose oocyte show inherent fragility and high degeneration rates after the standard ICSI procedure.
Rienzi
L
L
Center for Reproductive Medicine, European Hospital, Rome, Italy. md4756@mclink.it
Greco
E
E
Ubaldi
F
F
Iacobelli
M
M
Martinez
F
F
Tesarik
J
J
D000328:Adult; D002470:Cell Survival; D005240:Feasibility Studies; D005260:Female; D005306:Fertilization; D006801:Humans; D007834:Lasers; D008297:Male; D008875:Middle Aged; D009865:Oocytes / Q000502:physiology; D010865:Pilot Projects; D011247:Pregnancy; D020554:Sperm Injections, Intracytoplasmic / Q000379:methods*; D015044:Zona Pellucida / Q000528:radiation effects