Artificial egg activation – approach with caution

This study investigated whether artificial activation of the female egg during intracytoplasmic sperm injection treatment improves fertilization and pregnancy rates. 

Intracytoplasmic sperm injection (ICSI) is a method of fertilization often performed as part of in-vitro fertilization (IVF). ICSI includes injection of treated sperm (from the male) directly into the egg (from the female). ICSI has been found to increase the success rate of IVF.

While ICSI treatment usually leads to high fertilization rates of up to 70-80%, some people do experience failed or low fertilization rates. Low fertilization rates are sometimes due to the inability of the male sperm to activate the female egg. In these cases, artificial activation of the egg, combined with ICSI has been successful in increasing fertilization rates. 

This study involved 101 female patients who were diagnosed with fertilization abnormalities (e.g. less than 50% fertilized eggs) in a previous ICSI cycle. Female eggs were treated for 15 minutes immediately after ICSI with a medication (called A23187), which artificially activates the egg by increasing calcium movement. Fertilization, pregnancy, and live birth rates after activation were compared to the previous failed ICSI cycle.

The authors found that the fertilization rate was significantly higher at 48% in the activation cycle compared to 25% in the previous failed cycle. Additionally, fewer patients had their embryo transfer cancelled with this treatment (1 out of 101 cancelled compared to 15 out of 101 in the previous non-activated cycle). Finally, treatment resulted in a 28% live birth rate (35 babies). Of note, one child was born with a major defect following the activation cycle (anal atresia – anus not present or in the wrong place).

The authors conclude that artificial egg activation using A23187 results in significantly better fertilization rates and less embryo transfer cancellation during ICSI. 

This treatment should be approached with caution. Further studies are needed to investigate the risk of anal atresia in babies following A23187 treatment. 

If you have questions about artificial egg activation as part of ICSI treatment, please discuss these with your doctor.