OBJECTIVE
Intracytoplasmic sperm injection (ICSI) is a technique which involves aspiration of the oocyte membrane after mechanically penetrating the zona pellucida. This process might result in an increase in the internal pressure of the oocyte and a possible degeneration of the oocyte membrane. PIEZO-ICSI is a technique which uses a piezoelectric actuator to maintain the microdrilling of the zona pellucida with the help of a thin-walled microinjection pipette. This technique would reduce the physical pressure with a gentle microinjection. The aim of the current study was to compare the fertilization rates in between PIEZO-ICSI and conventional ICSI in couples with a history of prior low-fertilization rates.
MATERIALS AND METHODS
Data of reproductive age women with a history of fertilization rate ≤ 50% and a history of retrieval of ≥4 oocytes within less than 2 years in between the cycles with normal sperm parameters and whom were performed the PIEZI-ICSI technique were investigated retrospectively (Group 1, Conventional ICSI; Group 2, PIEZO-ICSI). Fertilization, embryo utilization, and pregnancy rates were compared in between the patient’s previous conventional ICSI and PIEZO-ICSI procedures.
RESULTS
A total of 93 women who had opted PIEZO-ICSI technique due to low fertilization rates with conventional ICSI were assessed retrospectively. Mean age of the patients was 35.1 ± 3.9 and median number of IVF trails before was 2 (min-max:1-13). When compared to conventional ICSI, PIEZO-ICSI resulted in a higher number of 2pn embryos (1.6 ± 1.8 % vs. 3.7 ± 3.0 %; p<0.01) and a higher fertilization rate (23.1 ± 15.1 % vs. 52.6 ± 16.9 %; p<0.01). 22 out of 25 patients (88%) who had no fertilized embryos with conventional ICSI had at least one fertilized good quality embryo to be transferred. Only one patient who had a history of fertilization rate ≤ 50% with conventional ICSI had no fertilized embryos after PIEZO-ICSI technique. Embryo transfer could not be performed in 4.3% (4/93) of the patients due to fertilization failure and in 21.5% (20/93) of the patients due to poor embryo quality during cleavage stage or blastulation phase. Pregnancy was achieved in 50.8% (31/61) of the patients after fresh or frozen embryo transfer (8 of the patients are still under frozen thawed embryo transfer preparation protocol).
CONCLUSIONS
PIEZO-ICSI technique significantly increased fertilized embryos and fertilization rates with a decrease in fertilization failure rates. For this reason, PIEZO-ICSI might be an considered as an alternative strategy to conventional ICSI in patients with a history of low fertilization rates.
https://link.springer.com/content/pdf/10.1007/s10815-024-03030-y.pdf
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