Is There Any Role for Calcium Ionophore in ICSI Cycles for Cases of Non Obstructive Azoospermia?

Objectives: Evaluate the effect of artificial oocyte activation (AOA) using calcium ionophore (A23187) on the rate of fertilization and cleavage of embryos in surgically retrieved sperm of patients with non-obstructive azoospermia undergoing intracytoplasmic sperm injection (ICSI). Study design: This study was conducted on 60 infertile couples undergoing ICSI cycles as a randomized controlled parallel group’s experimental study in a private IVF center in Egypt from January 2018 to July 2019. ICSI cycles were divided into two groups: Group A: includes 30 ICSI patients with surgically retrieved sperms of non-obstructive azoospermia treated with calcium ionophore (A23187). Group C/Control: includes 30 ICSI patients with surgically retrieved sperms of non-obstructive azoospermia non-treated with calcium ionophore (A23187). Results: There was no statistical difference between both groups regarding the fertilization rate (p = 0.853). There was no statistical difference between them regarding implantation rate (p = 0.237). The percentage of Class A embryos in the ca ionophore group was 81.7%, while it was 82.8% in the control group. There was insignificant difference between them (p = 0.782). There was no statistical significant difference between the two groups regarding the clinical pregnancy rate, it was (56.7%) in the ca ionophore group while it was (53.3%) in the control group. Conclusion: AOA by Ca2++ ionophore didn’t improve the outcome of ICSI cycle in cases of non obstructive azoospermia in terms of fertilization, implantation and pregnancy rate.