Live Births Following Zona Pellucida-Binding Sperm Selection in Recurrent Implantation Failure: Two Case Reports

Recurrent implantation failure (RIF) poses a significant challenge in assisted reproductive technologies (ART). Intracytoplasmic sperm injection (ICSI), while effective for male factor infertility, bypasses natural sperm selection, potentially reducing implantation success. Recently, our group has reported the application of a zona-binding sperm selection technique to improve the outcome of ART following ICSI. This report describes two couples with RIF who achieved live births following ICSI with zona pellucida (ZP)-bound sperm selection using sibling immature oocytes. Both couples, with histories of multiple failed in vitro fertilization (IVF)/ICSI cycles, underwent ZP-binding sperm selection, resulting in high-quality embryos and successful pregnancies. These cases highlight the potential of ZP-bound sperm selection to decrease rates of RIF in patients undergoing IVF/ICSI and warrant further investigation.