Abdelrehman Saber Khalil - Center of Genetic Engineering, Al-Azhar University, Nasr City, Cairo, Egypt
Mohammed Faris - Department of Obstetrics and Gynecology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
Sayed Bakry - Center of Genetic Engineering, Al-Azhar University, Nasr City, Cairo, Egypt

Background & Objective: Intracytoplasmic sperm injection (ICSI), a technique that involves an injection of a spermatozoon into the oocyte cytoplasm, has allowed the achievement of fertilization for a wide range of couples suffering from infertility. The study assesses the influence of modified ICSI followed by chemically induced activation by calcimycin and Ionomycin in couples with a history of Total fertilization failure (TFF) or Low fertilization rate (LFR).Materials & Methods: A prospective analysis study was conducted with sibling oocytes to compare the application of calcimycin and Ionomycin after the M-ICSI technique. The study was conducted in a private IVF centre in Cairo, Egypt. A case with a TFF history assessed their fertilization rates, cleavage, and good-quality embryos on day three after ICSI.Results: Twenty one cycles comprised ۱۳۴ oocytes treated with calcimycin and ۱۲۵ oocytes treated with Ionomycin. Calcimycin-treated oocytes showed a fertilization rate of ۳۹.۵ %, a degeneration rate of ۳.۷ %, an arrest rate of ۳.۶ %, a cleavage rate of ۴۵.۵ %, and a good quality embryo rate of ۳۷.۱ %. On the other hand, ionomycin-treated oocytes showed a fertilization rate of ۶۸.۰ %, a degeneration rate of ۶.۰ %, an arrest rate of ۳.۷ %, a cleavage rate of ۷۴.۳ %, and a good quality embryo rate of ۳۱.۵ %. Ionomycin-treated oocytes had a significantly higher t-value of fertilization and cleavage rates than calcimycin-treated (p-value < ۰.۰۵).Conclusion: M-ICSI followed by Ionomycin or ready-to-use calcimycin may treat TFF patients. Calcium increase could be achieved directly by mechanical activation and last longer by Assisted oocyte activation (AOA) treatment.

Calcimycin, Calcium Ionophore, ICSI, Ionomycin