title: Artificial oocyte activation with calcium ionophore A23187 in intracytoplasmic sperm injection cycles using surgically retrieved spermatozoa.
abstract: OBJECTIVE
  To evaluate the effect of artificial oocyte activation (AOA) on intracytoplasmic sperm injection (ICSI) cycles using surgically retrieved sperm.
  
  
  METHODS
  Laboratory study.
  
  
  METHODS
  Fertility/assisted fertilization center.
  
  
  METHODS
  Couples undergoing surgical sperm retrieval for ICSI (n = 204).
  
  
  METHODS
  Application of calcium ionophore A23187 for AOA.
  
  
  METHODS
  Cycles were divided into experimental groups according to the origin of the sperm used for injection and the type of azoospermia: [1] testicular sperm aspiration in nonobstructive-azoospermic patients (TESA-NOA group, n = 58), [2] TESA in obstructive-azoospermic patients (TESA-OA group, n = 48), [3] and percutaneous epididymal sperm aspiration in obstructive-azoospermic patients (PESA-OA, n = 98). For each experimental group, cycles where AOA was applied (subgroup: activation) were compared with cycles in which AOA was not applied (subgroup: control). The fertilization, high-quality embryo, implantation, and pregnancy rates were compared among the subgroups.
  
  
  RESULTS
  For patients undergoing TESA, AOA did not improve ICSI outcomes for either type of azoospermia. However, for cases in which the injected sperm were retrieved from the epididymis, a statistically significantly increased rate of high-quality embryos was observed with AOA.
  
  
  CONCLUSIONS
  Artificial oocyte activation may improve ICSI outcomes in azoospermic patients when epididymal, but not testicular spermatozoa, are injected.
authors.affiliation: Fertility-Assisted Fertilization Center, São Paulo, Brazil; Sapientiae Institute, São Paulo, Brazil; Department of Gynecology and Obstetrics, Botucatu Medical School/UNESP Botucatu, São Paulo, Brazil.
authors.forename: Edson
authors.initials: E
authors.lastname: Borges
authors.forename: Daniela Paes
authors.initials: DP
authors.lastname: de Almeida Ferreira Braga
authors.forename: Tatiana Carvalho
authors.initials: TC
authors.lastname: de Sousa Bonetti
authors.forename: Assumpto
authors.initials: A
authors.lastname: Iaconelli
authors.forename: José Gonçalves
authors.initials: JG
authors.lastname: Franco
mesh_terms: D053713:Azoospermia / Q000453:epidemiology; D001707:Biopsy, Needle / Q000379:methods; D001938:Brazil; D000001:Calcimycin / Q000627:therapeutic use*; D004822:Epididymis; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods; D006801:Humans; D007248:Infertility, Male / Q000453:epidemiology; D007258:Informed Consent; D008297:Male; D054315:Oocyte Retrieval / Q000379:methods; D009865:Oocytes / Q000187:drug effects / Q000502:physiology*; D011247:Pregnancy; D020554:Sperm Injections, Intracytoplasmic / Q000379:methods*; D053625:Sperm Retrieval
chemical_list: D000001:Calcimycin