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.