Laser-assisted injection intracytoplasmic sperm

Objective: To improve oocyte survival and fertilization rates after intracy toplasmic sperm injection (ICSI) in patients with inherent oocyte fragility . Design: Pilot feasibility study and case report. Setting: Private hospital. Patient(s): Infertile couple with repeated failures of ICSI caused by oocyt e degeneration. Intervention(s): Laser-assisted drilling of the zona. pellucida followed by ICSL. Main Outcome Measure(s): Oocyte survival, fertilization, and pregnancy. Results: In a couple with four previous ICSI failures because of poor oocyt e survival (33.3%, 0%, 20%, and 18%), a fifth attempt using laser-assisted ICSI resulted in the survival of 8 oocytes out of 13 injected. Normal ferti lization occurred in 5 oocytes, and a clinical pregnancy was established. Conclusion(s): Performing ICSI through a laser-drilled hole in the zona. pe llucida reduces the risk of oocyte damage related to deformation during the initial phase of the microinjection procedure. This modification of ICSI a ppears to be suitable for patients whose oocyte show inherent fragility and high degeneration rates after the standard ICSI procedure. (C) 2001 by Ame rican Society for Reproductive Medicine.