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ASSISTED OOCYTE ACTIVATION (AOA)
• Potential indication
• When prior cycle with failed or low fertilization after ICSI • For low fertilization, at what threshold?
• Approach
• Biological basis
• Variety of methods:
• Mechanical • Physical
• Chemical
• Split ICSI-AOA cycle
Phospholipase C- PLC-
Ca2+ oscillations Ca2+ response machinery
Activation
Ca2+ ionophore, other artificial activation methods
AOA
THE EVIDENCE
• From case reports and case series to prospective trials
• Meta-analysis of RCTs in women with prior fertilization failure (Sfontouris et al., 2015)
• Insufficient evidence on efficacy and safety • Limitations to date
• Prospective studies since 2015
• Multicenter analysis (n=101 cycles with history of <50%
fertilization rate and without identification of defect)
• Ready-to-use calcium ionophore
• Improved outcomes
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PRECONGRESS COURSE 03 I GENEVA, SWITZERLAND – 2 JULY 2017 71
