Comparison of piezo-assisted micromanipulation with conventional micromanipulation for intracytoplasmic sperm injection into human oocytes

Objective: To compare the efficacy of piezo-assisted micromanipulation with conventional micromanipulation for intracytoplasmic sperm injection (ICSI) into oocytes in patients with impaired semen parameters and no success wit h in vitro fertilization (IVF). Study Design:A retrospective randomized stu dy was conducted on 204 cycles for 104 couples with piezo-assisted ICSI and 122 cycles for 96 couples with conventional ICSI. Piezo-assisted ICSI cons ists of two steps, namely penetration of the zona pellucida alone with a pi ezo-pulse and then puncturing of the oolemma with a light negative pressure without piezo, as with conventional ICSI. The tips of injection pipettes w ere prepared after pulling by breakage with a scalpel under a microscope, s o that the inner diameter at and near the tip was 5 tm, as for conventional ICSI. Results: Piezo-assisted ICSI demonstrated significantly more favorab le results, with a fertilization rate of 90.3% (conventional ICSI: 83.1%, p < 0.01) and a cleavage rate of 88.1% (conventional ICSI: 84.6%, p < 0.01). Conclusion: Piezo-assisted ICSI is easy to incorporate a spermatozoa exact ly into the ooplasm with little deformation of the oocyte during insertion. Piezo-assisted ICSI can be used effectively for human oocytes to improve t he fertilization, cleavage rates. Copyright (C) 2001 S. Karger AG, Basel.