Effect of reduced oocyte aging on the outcome of rescue intracytoplasmic sperm injection.
OBJECTIVE
To evaluate the results of a novel protocol that allows to rescue IVF unfertilized oocytes by intracytoplasmic sperm injection (ICSI).


METHODS
Prospective clinical trial.


METHODS
Private reproductive medical center.


METHODS
Thirty patients undergoing IVF.


METHODS
Controlled ovarian stimulation (COS), conventional IVF, rescue ICSI, embryo culture, and embryo transfer.


METHODS
Identification of unfertilized IVF oocytes 6 hours after insemination and fertilization, and developmental rates of those oocytes after rescue microinjection, as well implantation and pregnancy rates (PR).


RESULTS
All oocytes (392) from 30 patients were inseminated with standard IVF 3 hours after ovum pick-up. Polar body (PB) status was checked at decumulation and rechecked 3 hours later. Eighty-two oocytes were fertilized after IVF alone and 184 nonactivated oocytes (failed fertilization) were rescue microinjected and 166 of them fertilized (20 patients). Cleavage stage on day 2 was significantly more advanced and embryo grade was higher after standard IVF fertilization than after rescue ICSI. Eight of the 30 embryos transferred were implanted in the IVF-only patients (27%) and 8 of 68 embryos in the rescue ICSI patients (12%).


CONCLUSIONS
Rescue ICSI of unfertilized IVF oocytes 6 hours after insemination (9 hours after egg retrieval) can provide normal fertilization, embryo development, and pregnancy; however, corresponding outcome parameters tend to be impaired in comparison to the standard IVF fertilization results.
Nagy
Zsolt P
ZP
Reproductive Biology Associates, Atlanta, Georgia 30342, USA. nagy.zsolt.peter@iol.it
Rienzi
Laura F
LF
Ubaldi
Filippo M
FM
Greco
Ermanno
E
Massey
Joe B
JB
Kort
Hilton I
HI
D000328:Adult; D016922:Cellular Senescence / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D009865:Oocytes / Q000502:physiology*; D011247:Pregnancy; D018873:Pregnancy Rate; D011446:Prospective Studies; D013076:Sperm Count; D020554:Sperm Injections, Intracytoplasmic / Q000379:methods