The Use of Artificial Oocyte Activation as an Adjunct in Addressing Fertilisation Failures among Women Undergoing In Vitro Fertilisation Cycles: A University Cohort Study

The current implementation of intracytoplasmic sperm injection (ICSI) has mainly been for male factor, but 1-5% fertilisation failure persists due to poor oocyte activation. Thus, we performed a prospective cohort study at the Advanced Reproductive Centre, Hospital Canselor Tuanku Muhriz, Universiti Kebangsaan Malaysia to assess the role of artificial oocyte activation (AOA) in improving the fertilisation rates via calcium ionophore GM508. Our study included a total of 43 women diagnosed with low fertilisation rate (LFR) or total fertilisation failure (TFF) by comparing their index in vitro fertilisation (IVF) cycles with subsequent IVF-AOA cycles. We found that, most women were older, 38.44 years old, with a majority experiencing primary subfertility, primarily due to male factors. Our findings found an increase in fertilisation rates (FR) with further improvements in cleavage rates, blasturation rates and top embryo quality rates (TQE). Furthermore, TQE was also better in the TFF cohort compared to the LFR cohort. Overall, our findings highlight the potential of AOA to improve FR and embryological outcomes; however, further search with larger and multicenter studies is necessary for broader recommendations.