İstanbul Memorial Hospital ART and Genetics Centerİstanbul Memorial Hospital ART and Genetics Center

Failed fertilization after clinical intracytoplasmic

sperm injection

Murid Javed , Navid Esfandiari , Robert Casper

Toronto Centre for Advanced Reproductive Technology , University of Toronto, Toronto,

Canada

Presented by: Dr. Khalili

İstanbul Memorial Hospital ART and Genetics Centerİstanbul Memorial Hospital ART and Genetics Center

ICSI IndicationICSI Indication

• Male infertility (especially severe cases)

• Epididymal sperm • Testicular sperm • Idiopathic infertility• Repeated IVF failures• Presence of Anti-Sperm Abs

İstanbul Memorial Hospital ART and Genetics Centerİstanbul Memorial Hospital ART and Genetics Center

Assisted Fertilization Assisted Fertilization • fertilization after ICSI is 70–80%• TFF occurs in 5–10% of IVF cycles

and 1–3% of ICSI cycles• TFF after ICSI cycles is mostly due to

low number of mature oocytes or oocyte activation failure

• TFF is rare in cases with normal oocytes and sperm

• TFF with normal sperm & good ovarian response (due: lack of oocyte activation)

İstanbul Memorial Hospital ART and Genetics Centerİstanbul Memorial Hospital ART and Genetics Center

Factors involved in fertilization failure

Oocyte morphologyOocyte maturityOocyte activationPoor ovarian responseSperm motility and progressionSperm structural defects

Sperm DNA damage

Procedural effects of the ICSI

İstanbul Memorial Hospital ART and Genetics Centerİstanbul Memorial Hospital ART and Genetics Center

Normal features of ahealthy mature oocyte

(MII) :

1. presence of a polar body 2. a round even shape 3. light color cytoplasm 4. homogenous granularity 5. small PVS without debris 6. colorless zp