Effect of Artificial Oocyte Activation on Intracytoplasmic Sperm Injection Outcomes in Patients With Lower Percentage of Sperm Containing Phospholipase Cζ: A Randomized Clinical Trial

Background: artificial oocyte activation (aoa) is a specialized method in assisted reproductive technique (art). according to increasing concern about using aoa, it is necessary to evaluate sperm-borne oocyte activating factors (soafs) including phospholipase c zeta (plcζ). in this study, plcζ before aoa was evaluated first and then the impact of aoa on pre-implantation embryo development was investigated. methods: this prospective clinical trial enrolled couples subjected to icsi. by evaluating plcζ, semen samples were categorized into two groups; i (control) and ii (plcζ deficient). retrieved oocytes from partners were put into three categories: control group (injected with sperm from group i, n=113), group without aoa (injected with sperm from group ii and no exposure to aoa, n=106), and group aoa (injected with sperm from group ii and exposure to aoa, n=114). finally, fertilization results were compared via kruskal-wallis followed by dunn’s multiple comparison test. the p<0.05 was considered statistically significant. results: fertilization rate was significantly lower in the group without aoa compared to control group (41.9±6.3 vs. 78.1±4.7, p<0.001). aoa improved fertilization rate in group aoa compared to the group without aoa (69.5±3.9 vs. 41.9±6.3, p< 0.01); however, cleavage (91.7±2.8, 90.9±4.6, and 95.2±3.4, respectively) and embryo quality (2.5±0.1, 2.3±0.2, and 2.4±0.2, respectively) scores were not substantially different between groups of control, with and without aoa. conclusion: we showed that plcζ can be considered as a good biomarker in evaluation of oocyte activation capability. further studies are required to establish the best use of plcζ as a biomarker in clinics.