Assisted Oocyte Activation with Calcimycin and Ionomycin After Modified ICSI Technique: A Potential Treatment for Previous Fertilization Failure Cases

Background & Objective: Intracytoplasmic sperm injection (ICSI), a technique that involves an injection of a spermatozoon into the oocyte cytoplasm, has allowed the achievement of fertilization for a wide range of couples suffering from infertility. The study assesses the influence of modified ICSI followed by chemically induced activation by calcimycin and Ionomycin in couples with a history of Total fertilization failure (TFF) or Low fertilization rate (LFR).Materials & Methods: A prospective analysis study was conducted with sibling oocytes to compare the application of calcimycin and Ionomycin after the M-ICSI technique. The study was conducted in a private IVF centre in Cairo, Egypt. A case with a TFF history assessed their fertilization rates, cleavage, and good-quality embryos on day three after ICSI.Results: Twenty one cycles comprised 134 oocytes treated with calcimycin and 125 oocytes treated with Ionomycin. Calcimycin-treated oocytes showed a fertilization rate of 39.5 %, a degeneration rate of 3.7 %, an arrest rate of 3.6 %, a cleavage rate of 45.5 %, and a good quality embryo rate of 37.1 %. On the other hand, ionomycin-treated oocytes showed a fertilization rate of 68.0 %, a degeneration rate of 6.0 %, an arrest rate of 3.7 %, a cleavage rate of 74.3 %, and a good quality embryo rate of 31.5 %. Ionomycin-treated oocytes had a significantly higher t-value of fertilization and cleavage rates than calcimycin-treated (p-value < 0.05).Conclusion: M-ICSI followed by Ionomycin or ready-to-use calcimycin may treat TFF patients. Calcium increase could be achieved directly by mechanical activation and last longer by Assisted oocyte activation (AOA) treatment.