Can Assessment of Total Acrosin Activity Help Predict Failed or Low Fertilization Rate ICSI for Implementation of Artificial Oocyte Activation?

ABSTRACT

Artificial oocyte activation (AOA), post intracytoplasmic sperm injection (ICSI) is considered as the only method to overcome failed fertilization post ICSI. However, there is still no prognostic test to foresee failed fertilization and to implement AOA. Therefore, the aim of this study was evaluation of total acrosin activity and its relation to failed fertilization and implementation of AOA post ICSI. 61 ICSI cycles were grouped to control ICSI (n=41), ICSI/ICSI-AOA (n=8) and ICSI-AOA (n=12) according to availability of sperm with normal morphology at time of ICSI. In the ICSI group all the oocytes were inseminated with sperm with normal morphology, while in the ICSI/ICSI-AOA at least 50% and the ICSI-AOA less than 25% were inseminated with sperm with normal morphology. The mean values of sperm parameters, percentage normal acrosome and acrosin activity were assessed for each group and these parameters were significantly higher in the ICSI group compared to the other groups. Half of the oocytes in the ICSI/ ICSI-AOA group underwent AOA (ICSI/ICSI-AOA+) and the other half were used as internal control (ICSI/ICSI-AOA-). Percentage fertilization rate were compared between the four groups and were significantly different between ICSI/ICSI-AOA+ with ICSI/ICSI-AOA- showing that AOA improves fertilization rate in the sibling oocytes. Unlike the treated oocytes (AOA+), a significant correlation was observed between density and percentage motility and acrosin activity with fertilization rate in the untreated oocytes (AOA-). Therefore, the results of this study indicate that evaluation of acrosin activity, along with morphology may help us to select semen samples with possible low oocyte activation potential for implementation AOA.

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