To observe the fertility rate, cleavage rate and embryo outcome in the second time of intracytoplasmic sperm injection (ICSI) with artificial assisted activation by calcium ionophore A23187 in women who once had low or failed fertilization.

Eleven women with assisted pregnancy in the Reproductive Medicine Center of the Third Affiliated Hospital of Zhengzhou University from January 2015 to December 2015 were selected. All of them were treated by ICSI again due to the failure of fertilization or low fertilization rate (fertilization rate < 30%) of ICSI in the last cycle. The clinical data of all patients were analyzed retrospectively. A total of 122 mature oocytes from 11 patients activated by calcium ion carrier A23187 were used as the activation group, and 108 oocytes from the 11 patients in the previous conventional ICSI operation were used as the control group. The fertilization rate, cleavage rate and general situation of the infants born after the activation of oocytes with calcium ion carrier were observed.

The fertility rate and cleavage rate of the activation group were 36.9%(45/122) and 88.9%(40/45), respectively; and they were 12.5% (21 /108) and 61.9%(13/21), respectively, of the control group, and the difference was statistically significant between the two groups (P<0.05). The number of available embryos and the number of high quality embryos in the activation group were 3.42±2.69 and 1.67±1.24, significantly higher than the 1.51±0.53 and 0.76±0.54 in the control group, and the difference was statistically significant (P< 0.05). In the 11 patients, 5 cases got clinical pregnancy after oocyte activation.

Artificial assisted activation for mature oocytes by the calcium ionophore A23187 can improve the fertility rate, cleavage rate and pregnancy rate of patients once with failed ICSI fertilization or fertilization rate.

Oocytes; Calcium ionophore; Intracytoplasmic sperm injecions; Fertilization failure