The effectiveness of intracytoplasmic sperm injection combined with piezoelectric stimulation in infertile couples with total fertilization failure.

OBJECTIVE: To assess the effectiveness of intracytoplasmic sperm injection (ICSI) combined with piezoelectric stimulation in infertile couples with a history of total fertilization failure (TFF). DESIGN: Prospective controlled trial. SETTING: Clinical IVF laboratory. PATIENT(S): Seventy-one couples undergoing ICSI on sibling oocytes having at least one previous ICSI attempt with TFF. INTERVENTION(S): ICSI or ICSI with piezoelectric activation. MAIN OUTCOME MEASURE(S): Fertilization rate. RESULT(S): The patients were allocated to two groups: group I included 21 patients with only one previous TFF and group II included 50 patients with more than one previous TFF. Collectively, a total of 823 metaphase II (MII) oocytes were retrieved in 78 oocyte retrievals. In Group I, combined ICSI with piezoelectric stimulation was applied to 123/211 (58.2%) of MII oocytes (group IA), whereas standard ICSI procedure was applied to 88/211 (41.8%) of MII oocytes (group IB). The fertilization rate was 62% and 12% in group IA and group IB respectively. In group II, piezoelectric activation was applied in all 612 MII oocytes, of which 296 (48.3%) were fertilized. The rates for implantation and pregnancy/embryo transfer were obtained as 30.6% and 44.1%, respectively. CONCLUSION(S): Piezoelectric activation seems to improve IVF outcome in patients with previous TFF history.

Successful application of preimplantation genetic diagnosis for Leigh syndrome.

OBJECTIVE: To perform preimplantation genetic diagnosis (PGD) for a SURF1 gene mutation of the Leigh syndrome to transfer unaffected or carrier embryo/embryos. DESIGN: Case report. SETTING: Clinical IVF laboratory. PATIENT(S): A couple carrying an nt769 G/A mutation that is associated with Leigh syndrome. INTERVENTION(S): Oocytes were fertilized by means of intracytoplasmic sperm injection. The resulting embryos were biopsied 3 days after fertilization. One blastomere was taken and whole-genome amplification was performed. Amplification of the mutation site was achieved by polymerase chain reaction (PCR) and restriction digestion was completed. Gel Imager was used to measure the digests of normal and mutant load. MAIN OUTCOME MEASURE(S): Embryo testing by means of PGD-PCR and pregnancy. Successful preimplantation genetic diagnosis for a SURF1 gene mutation and transfer of healthy or carrier embryos. RESULT(S): Successful singleton pregnancy resulting in the delivery of healthy baby girl. CONCLUSION(S): We report the first case of successful PGD for Leigh syndrome resulting in delivery of a healthy newborn.