Artificial oocyte activation - any experiences!?

[Dia12]

Hello everyone

I’m currently in my 2nd ICSI cycle with MFI. The first cycle resulted in 9 mature eggs but only 3 fertilised and then only 1 made it to a 5 day blast graded 5BC but unfortunately didn’t stick.

This time around I’ve been on a different drug protocol and have 2 add-ons : AOA (artificial oocyte activation) and embryoGen (enhanced culture media).

I was wondering if anyone had any experiences with these? Any thoughts?

[CritterTamer]

Hey @Dia12!

I’ve never heard of AOA and am fascinated - what is it?

My clinic uses embryo glue as standard - it’s hydraluaronic acid (might be spelled wrong!) which is known to be present in the uterus in high amounts at the time of implantation. They soak the embryos in it prior to transfer to attempt to encourage implantation by simulating the natural womb environment.

In my experience my first round failed so it didnt help but those embryos were 4AB quality. This time we had 2 5AAs put back so if the embryo glue gives them a bit of additional help then great!

Good luck for your transfer xxx

[Dia12]

Hey crittertamer, yes, completely agree, at this stage you’d just rather take all the options that could potentially help. EmbryoGen and Blastgen culture media sounds very similar to embryo glue and as such if you chose to have them, you don’t need to have embryo glue.

AOA has been classified as amber by hfea which means the results are promising but more evidence is required.
It’s basically an addition of calcium ions to the media to help with the fertilisation/ activation of the embryo. This does come with slightly higher risks of mc from the studies so far but not enough to put us off.
I’ve included some blurb about it below.

Both of these add-ons were highly recommended by the consultant as we had 30% fertilisation rate last time.
—————
Artificial egg activation calcium ionophore - Amber

What is egg activation?

When a sperm meets an egg, it triggers a process called ‘egg activation’ which starts off the process of embryo development, while at the same time allowing only one sperm to fertilise the egg. If the egg doesn’t activate, then it won’t develop.
Egg (or oocyte) activation may be stimulated by chemicals called calcium ionophores. These chemicals can be added to the embryo in the lab.

Are there any risks?

In theory, egg activation using calcium ionophores could cause embryos to have abnormal numbers of chromosomes, which would cause the pregnancy to miscarry. As yet there’s not enough evidence to decide whether these risks are a serious concern.

Given the possible risks, clinics offering this treatment are expected to do so only in selected patients who have had failed fertilisation and to justify their reasons for doing so.

What’s the evidence for egg activation?

In the few studies done to date, egg activation using calcium ionophores may improve fertilisation rates in ICSI cycles where the egg and sperm have failed to activate in previous treatment cycles. However, there are no RCTs to show that it is effective or follow up studies on the safety of this technique.

[CritterTamer]

Thanks @Dia12 - that’s really interesting, I’d never heard of it before. We have good fertilisation rates (6/6 first round and 11/12 second round) so I guess it’s not something the clinic would have needed to bring up. Getting the embryos to implant seems to be my problem so we have gone for the endometrial scratch this time to see if it helps.

I hope these new things make the difference for you xxx

[sarahthewiganer]

We were advised to use this by the head of embryology at the knutsford clinic, but then our fertility doctor said we shouldn't because there wasn't enough tests on it. However i don't think they would use it unless they were confident. I hope they work!

fyi - our first round had zero fertilisation, so we did another round but only got one embryo, which was frozen and then fet. that was a chemical. We did another fresh cycle and this is when we got recommended this - but because we got 4 fertilised on the last go they told us not to use AOA.

[Csparkles]

@Dia12 Hi, hope your well. Did AOA work for you in the end?