Journal of Reproduction & Infertility

Journal of Reproduction & Infertility

Intracytoplasmic sperm injection (ICSI) of one and two day(s)-old oocytes after complete in vitro fertilization (IVF) failure

Authors
Mohammad Mehdi Akhondi 1
Maerefat Ghaffari 2
Mahnaz Ashrafi 3
Ensieh Sh.Tehrani 3
Ashraf Moeini 3
Tahereh Madani 3
Mohammad Reza Sadeghi 2
Leila Karimiyan 3
1 Reproductive Biotechnology Research Center, Avicenna Research Institute, ACECR, Tehran, Iran; Infertility team of Royan Research Center, Tehran, Iran
2 Reproductive Biotechnology Research Center, Avicenna Research Institute, ACECR, Tehran, Iran
3 Royan Research Center, Endocrinology & Infertility Department, Tehran, Iran
Abstract
The objective of this study was to evaluate the outcome of late (one and two days) Intracytoplasmic sperm injection (ICSI) after total fertilization failure in IVF. 35 IVF cycles that were part of our regular IVF program and showed no evidence of fertilization 16-46 hours after insemination (oocytes were observed at 16-18 hours and again 42-44 hours after the IVF procedures), were assigned to two treatment groups. Assisted fertilization with ICSI was carried out at 24 and 48 hours after oocyte retrieval. Group I (injected-day 1),consisted of 21 patients with 72 failed-fertilized metaphase II oocytes injected 1 day after ovum pick-up; and group II (injected-day 2), included 14 patients with 45 failed-fertilized metaphase II oocytes injected 2 days after ovum pick-up. A single spermatozoon from the patient's husband (same as that used for insemination in IVF program) was injected into the cytoplasm of each of these oocytes. Resultant embryos were transferred 72 and 96 hours after oocyte retrieval in group I and II, respectively. Fertilization was achieved with ICSI in most patients with fertilization failure. In group I, (80.5%) oocytes fertilized, whereas in group II, 46.6% of oocytes fertilized. Cleavage rate was 79.3% of injected oocytes in group I, and 42.8% in group II. Finally, in group one 19 of 21 (94%) embryos well transferred. The transfer rate for group two was 11 of 14 (78%). These results indicate significant differences between fertilization and cleavage rates in both groups. One of the singleton pregnancies resulted from transfer of the embryos in group II, and none in group I. This is the first known pregnancy achieved from late (two days) ICSI and late transferred embryos, after failed IVF. In conclusion, late (24 and 48 hours) ICSI after complete failed fertilization in IVF, can give good fertilization and good cleavage rates. This method can be used as an ideal protocol in IVF programs, to increase chance of pregnancy in infertile couples using the advantages of two main assisted reproductive treatments including IVF and ICSI.
Keywords
Failed IVF
Fertilization failure
Late ICSI
Reinsemination
Kruger TF, Coetzee K. The role of sperm morphology in assisted reproduction. Hum Reprod Update. 1999 5(2):172-8.
Trounson A, Webb J. Fertilization of human oocytes following reinsemination in vitro.Fertil Steril. 1984,41(6):816-9.
Pampiglione JS, Mills C, Campbell S, et al. The clinical outcome of reinsemination of human oocytes fertilized in vitro. Fertil Steril. 1990, 53(2):306-10.
Malter H, Talansky B, Gordon J, et al. Cohen J. Monospermy and polyspermy after partial zona dissection of reinseminated human oocytes. Gamete Res. 1989, 23(4):377-86.
Imocdcmbc DAG, Ligue AB. The influence of subzonal microinsemination of oocytes failing to fertilize in scheduled routine in vitro fertilization cycles. Hum Reprod 1994, 51:139-48.
Tsirigotis M, Nicholson N, Taranissi M, et al. Late intracytoplasmic sperm injection in unexpected failed fertilization in vitro: diagnostic or therapeutic? Fertil Steril. 1995, 63(4):816-9.
Yuzpe AA, Liu Z, Fluker MR, et al. Rescue intracytoplasmic sperm injection (ICSI)-salvaging in vitro fertilization (IVF) cycles after total or near-total fertilization failure. Fertil Steril. 2000, 73(6):1115-9.
Morton PC, Yoder CS, Tucker MJ, et al. Reinsemination by intracytoplasmic sperm injection of 1-day-old oocytes after complete conventional fertilization failure. Fertil Steril. 1997, 68(3):488-91.
Boldt J, Howe AM, Butler WJ, et al. The value of oocyte reinsemination in human in vitro fertilization. Fertil Steril. 1987,48(4):617-23.
Nagy ZP, Staessen C, Liu J, et al. Prospective, auto-controlled study on reinsemination of failed-fertilized oocytes by intracytoplasmic sperm injection. Fertil Steril. 1995, 64(6):1130-5.
Sjogren A, Lundin K, Hamberger L, et al. Itracytoplasmic sperm injection of 1- day- old oocytes after fertilization failure (letter). Hum Reprod. 1995,10:947.
Lundin K, Sjogren A, Hamberger L, et al. Reinsemination of one-day-old oocytes by use of intracytoplasmic sperm injection. Fertil Steril. 1996, 66(1):118-21.
Bongso A,Fong CY, Ng SC, et al. Fertilization, cleavage, and cytogenetics of 48-hour zona-intact and zona-free human unfertilized oocytes reinseminated with donor sperm. Fertil Steril. 1992, 57(1):129-33.
Van Steirteghem A, Nagy Z, Liu J, et al. Verheyen G,Smitz J, Tournaye H, Liebaers I, Devroey P. Intracytoplasmic sperm injection (Review). Ba Clin Obstet Gynecol. 1994, 8(1):85-93.
Nagy ZP, Joris H, Liu J, et al. Intracytoplasmic single sperm injection of 1-day-old unfertilized human oocytes. Hum Reprod. 1993, 8(12):2180-4.
Plachot M, de Grouchy J, Junca AM, et al. Chromosome analysis of human oocytes and embryos: does delayed fertilization increase chromosome imbalance? Hum Reprod. 1988, 3(1):125-7.
Van Steirteghem AC, Nagy Z, Joris H, et al. High fertilization and implantation rates after intracytoplasmic sperm injection. Hum Reprod. 1993, 8(7):1061-6.
Tabibzadeh S,Babaknia A. The signals and molecular pathways involved in implantation, a symbiotic interaction between blastocyst and endometrium involving adhesion and tissue invasion (Review). Hum Reprod. 1995, 10(6):1579-602.
Benadiva CA, Nulsen J, Siano L, et al. Intracytoplasmic sperm injection overcomes previous fertilization failure with conventional in vitro fertilization. Fertil Steril. 1999, 72(6): 1041-4.
World Health Organization. Laboratory manual for the examination of human semen and sperm -cervical mucus interaction,third edition.New York Cambridge University Press. 1992, 3-15, 27-8.
Journal of Reproduction & Infertility
Volume 1, Issue 3
Summer 2000
Pages 23-29