P-111 Artificial Oocyte Activation (AOA) through piezoelectric stimulation post-Intracytoplasmic Sperm Injection (ICSI) for teratozoospermia patients
Authors: Huseynli R , Tulumbaci O 
Published: July 2024

Abstract

Study question
Does employing piezoelectric stimulation on oocytes post-ICSI in teratozoospermia cases affect early embryonic development rates?

Summary answer
In a retrospective study, piezoelectric stimulation after ICSI showed increased fertilization rates and improved embryo quality in teratozoospermia cases.

What is known already
Fertilization can fail due to various factors. One of the causes of fertilization failure after ICSI is the inability to achieve oocyte activation, a process initiated by sperm-induced events.
Piezoelectric stimulation, a method of artificial oocyte activation, involves applying specific electric currents post-ICSI, elevating Ca+2 levels. Studies suggest its efficacy in enhancing fertilization rates and improving embryo quality, particularly in cases of total fertilization failure and severe sperm abnormalities.
However, available literature on the efficiency of electrical stimulation in cases of sperm abnormalities is limited.

Study design, size, duration
In this retrospective study conducted at our reproductive center between January 2023 and October 2023, we enrolled 122 patients diagnosed with male factor infertility. These patients were divided into two groups: the control group (n = 61) where piezoelectric stimulation was not employed post-ICSI, and the AOA group (n = 61) where piezoelectric stimulation was utilized after the ICSI procedure.

Participants/materials, setting, methods
The study assessed 2122 oocytes, with 1031 in the control and 1091 in the AOA group. Piezoelectric stimulation was administered oocytes approximately 20-30 minutes after ICSI. The quality of sperm samples was assessed based on Kruger’s strict criteria. Following ICSI, statistical analysis utilized Student’s t-test and chi-squared tests to assess the impact of piezoelectric stimulation on fertilization and embryo quality, considering p &lt; 0.05 as significant and p &lt; 0.001 as highly significant.

Main results and the role of chance
Clinical outcomes were compared between two groups. No significant differences were observed between the control group and AOA group regarding female age (29.93±4.9 vs. 29.93±5.11, p = 0.988) and male age (34.25±3.45 vs. 33.93±3.64, p = 0.628), the number of retrieved oocytes (16.90±11.04 vs. 17.89±9.3, p = 0.344), the number of metaphase II (11.02±6.8 vs.12.46±6.6, p = 0.162).
However, a highly significant difference was noted in the distribution of fertilization rate (59.08% [397/672] vs. 66.84% [508/760], p = 0.002), high-quality embryos rate (day 3) (44.08% [175/397] vs. 54.33% [276/508], p = 0.002), blastocyst rate (40.05% [159/397] vs. 50% [254/508], p = 0.003) and the good blastocyst development rate (14.11% [56/397] vs. 24.41% [124/508], p = 0.0001).
Cleavage rate was significantly higher in the AOA group (85.24% [433/508]) than control group (79.09% [314/397]), p = 0.01.

Limitations, reasons for caution
Constraints include the study’s retrospective, single-center design, and a limited sample size.

Wider implications of the findings
Piezoelectric stimulation demonstrates effectiveness in improving fertilization rates and embryo quality in teratozoospermia cases after ICSI.

Trial registration number
not applicable