Case reports to suggest an algorithm for management of total fertilisation failure prior to use of donor gametes

Journal of Assisted Reproduction and Genetics
James D M NicopoullosH Abdalla

Abstract

Total fertilisation failure (TFF), even with intracytoplasmic sperm injection (ICSI), occurs in approximately 3 % of cycles, can be recurrent and the exact cause is difficult to elucidate. Differentiation between oocyte and sperm-related cause of TFF is possible using mouse oocyte-activation techniques, but is not an option within most clinical settings. Therefore, the management of these couples is clinically driven, and the endpoint, if recurrent, is often the use of donor gametes. However, with the invariable lack of a definitive cause of TFF, any decision between the use of donor sperm or oocytes remains an emotive one. We present two case reports demonstrating the importance of appropriate investigation, activation techniques (mechanical and chemical) and clinical management options to develop a clinical algorithm prior to the use of donor gametes. This study is composed of two case reports of assisted reproduction investigation and treatment within an assisted conception unit for couples with recurrent total fertilisation failure. Using appropriate investigation (endocrine, urological and embryological) and treatments (ICSI, IMSI, oocyte-activation techniques), a fertilisation rate of 48 % was achieved in two cycles in co...Continue Reading

References

Mar 1, 1994·Human Reproduction·J TesarikJ Testart
Sep 26, 2006·Developmental Biology·Jean-Pierre OzilRichard M Schultz
Aug 21, 2013·Reproductive Biomedicine Online·Amanda Souza SettiEdson Borges
Dec 3, 2013·Cell Calcium·Queenie V NeriGianpiero D Palermo
Oct 16, 2014·Human Reproduction·S ArmstrongC Farquhar

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