Morphologically abnormal oocytes not capable of fertilization despite repeated strategies

Abstract

Objective: To describe a case with repeated total fertilization failure due to oocyte defect.

Design: Case report.

Setting: University hospital.

Patient(s): A patient with repeated total fertilization failure.

Intervention(s): Assisted oocyte activation, intracytoplasmic sperm injection (ICSI) with calcium ionophore oocyte activation, donor semen, and donor oocytes.

Main outcome measure(s): Fertilization, pregnancy, and live birth.

Result(s): Five cycles of IVF/ICSI were performed. In the first IVF cycle, 19 oocytes failed to fertilize. In the second ICSI attempt, 12 oocytes were retrieved and were not fertilized. In the third and fourth natural cycles, donor semen was used for IVF and ICSI, respectively, yet the oocytes could not be fertilized even by assisted activation. Then donor oocytes were used in the fifth cycle by ICSI. All five donated oocytes fertilized normally, and three embryos were transferred on day 3. Clinical pregnancy was confirmed, and a healthy girl weighing 3,200 g was delivered at 39 weeks of gestation by cesarean section.

Conclusion(s): In cases of repeated fertilization failure caused by oocyte defects, oocyte donation seems to be a good choice for patients who wish to become pregnant.