Top

Reproductive Biology and Endocrinology

Published in:

01-12-2020 | ICSI | Review

Risk of birth defects in children conceived by artificial oocyte activation and intracytoplasmic sperm injection: a meta-analysis

Authors: Rui Long, Meng Wang, Qi Yu Yang, Shi Qiao Hu, Li Xia Zhu, Lei Jin

Published in: Reproductive Biology and Endocrinology | Issue 1/2020

Abstract

Background

Whether artificial oocyte activation (ICSI-AOA) will increase the risk of birth defects remains controversial. Thus, we performed this study to evaluate the risk of birth defects and further compare the incidence of different birth defects types (chromosomal aberrations and non-chromosomal aberrations) in children conceived by ICSI-AOA and conventional intracytoplasmic sperm injection (ICSI) in an enlarged sample size.

Method

A comprehensive review of the literatures comparing birth defects in children conceived by ICSI-AOA and conventional ICSI by October 2020 was performed in PubMed, Embase, Cochrane Libraries, Web of Science, and Chinese databases including China National Knowledge Infrastructure, China Biology Medicine disc and Wan Fang. Risk ratios (RR) and 95% confidence intervals (CI) were calculated.

Results

Five studies were included in the final analysis. Compared with conventional ICSI, ICSI-AOA did not increase the birth defects rate (RR = 1.27, 95%CI 0.70–2.28) of children. Furthermore, in a subgroup analysis, birth defects were classified into two types (chromosomal aberrations and non-chromosomal aberrations) in four studies and no statistical difference were revealed.

Conclusion

Our analysis indicates that ICSI-AOA represents no significant difference in the prevalence of major birth defects or types of birth defects (chromosomal aberrations and non-chromosomal aberrations) comparing with conventional ICSI. This conclusion may provide clinicians evidence-based support in patient counseling and instruction of the application and safety concern about ICSI-AOA.

Palermo G, Joris H, Devroey P, Van Steirteghem AC. Pregnancies after intracytoplasmic injection of single spermatozoon into an oocyte. Lancet. 1992;340:17–8.CrossRefPubMed

Heindryckx B, Van der Elst J, De Sutter P, Dhont M. Treatment option for sperm- or oocyte-related fertilization failure: assisted oocyte activation following diagnostic heterologous ICSI. Hum Reprod. 2005;20:2237–41.PubMedCrossRef

Esfandiari N, Faved MH, Gotlieb L, Casper RF. Complete failed fertilization after intracytoplasmic sperm injection - analysis of 10 years’ data. Int J Fertil Womens Med. 2005;50:187–92.PubMed

Flaherty SP, Payne D, Matthews CD. Fertilization failures and abnormal fertilization after intracytoplasmic sperm injection. Hum Reprod. 1998;13:155–64.PubMedCrossRef

Swain JE, Pool TB. ART failure: oocyte contributions to unsuccessful fertilization. Hum Reprod Update. 2008;14:431–46.PubMedCrossRef

Miyazaki S, Ito M. Calcium signals for egg activation in mammals. J Pharmacol Sci. 2006;100:545–52.PubMedCrossRef

Ramadan WM, Kashir J, Jones C, Coward K. Oocyte activation and phospholipase C zeta (PLC zeta): diagnostic and therapeutic implications for assisted reproductive technology. Cell Commun Signal. 2012;10:12.PubMedPubMedCentralCrossRef

Liu J, Nagy Z, Joris H, Tournaye H, Devroey P, Van Steirteghem A. Successful fertilization and establishment of pregnancies after intracytoplasmic sperm injection in patients with globozoospermia. Hum Reprod. 1995;10:626–9.PubMedCrossRef

Rawe VY, Olmedo SB, Nodar FN, Doncel GD, Acosta AA, Vitullo AD. Cytoskeletal organization defects and abortive activation in human oocytes after IVF and ICSI failure. Mol Hum Reprod. 2000;6:510–6.PubMedCrossRef

10.

Ebner T, Montag M, Montag M, Van der Ven K, Van der Ven H, Ebner T, Shebl O, Oppelt P, Hirchenhain J, Kruessel J, et al. Live birth after artificial oocyte activation using a ready-to-use ionophore: a prospective multicentre study. Reprod BioMed Online. 2015;30:359–65.PubMedCrossRef

11.

Sfontouris IA, Nastri CO, Lima MLS, Tahmasbpourmarzouni E, Raine-Fenning N, Martins WP. Artificial oocyte activation to improve reproductive outcomes in women with previous fertilization failure: a systematic review and meta-analysis of RCTs. Hum Reprod. 2015;30:1831–41.PubMedCrossRef

12.

Kashir J, Heindryckx B, Jones C, De Sutter P, Parrington J, Coward K. Oocyte activation, phospholipase C zeta and human infertility. Hum Reprod Update. 2010;16:690–703.PubMedCrossRef

13.

Nasr-Esfahani MH, Deemeh MR, Tavalaee M. Artificial oocyte activation and intracytoplasmic sperm injection. Fertil Steril. 2010;94:520–6.PubMedCrossRef

14.

Vanden Meerschaut F, Nikiforaki D, Heindryckx B, De Sutter P. Assisted oocyte activation following ICSI fertilization failure. Reprod BioMed Online. 2014;28:560–71.CrossRef

15.

Miller N, Biron-Shental T, Sukenik-Halevy R, Klement AH, Sharony R, Berkovitz A. Oocyte activation by calcium ionophore and congenital birth defects: a retrospective cohort study. Fertil Steril. 2016;106:590.PubMedCrossRef

16.

Nakajo Y, Shibasaki S, Matsukawa N, Aono N, Toya M, Doshida M, Hashimoto T, Kyono K. Follow-up of children born after new technologies: testicular sperm extraction (TESE), in vitro maturation (IVM), and artificial oocyte activation (AOA). Hum Reprod. 2016;31:109.

17.

Li B, Zhou Y, Yan Z, Li M, Xue S, Cai R, Fu Y, Hong Q, Long H, Yin M, et al. Pregnancy and neonatal outcomes of artificial oocyte activation in patients undergoing frozen-thawed embryo transfer: a 6-year population-based retrospective study. Arch Gynecol Obstet. 2019;300:1083–92.PubMedCrossRef

18.

Deemeh MR, Tavalaee M, Nasr-Esfahani MH. Health of children born through artificial oocyte activation: a pilot study. Reprod Sci. 2015;22:322–8.PubMedCrossRef

19.

Mateizel I, Verheyen G, Van de Velde H, Tournaye H, Belva F. Obstetric and neonatal outcome following ICSI with assisted oocyte activation by calcium ionophore treatment. J Assist Reprod Genet. 2018;35:1005–10.PubMedPubMedCentralCrossRef

20.

Vanden Meerschaut F, D'Haeseleer E, Gysels H, Thienpont Y, Dewitte G, Heindryckx B, Oostra A, Roeyers H, Van Lierde K, De Sutter P. Neonatal and neurodevelopmental outcome of children aged 3-10 years born following assisted oocyte activation. Reprod BioMed Online. 2014;28:54–63.CrossRef

21.

Yoon HJ, Bae IH, Kim HJ, Jang JM, Hur YS, Kim HK, Yoon SH, Lee WD, Lim JH. Analysis of clinical outcomes with respect to spermatozoan origin after artificial oocyte activation with a calcium ionophore. J Assist Reprod Genet. 2013;30:1569–75.PubMedPubMedCentralCrossRef

22.

Li J, Zheng X, Lian Y, Li M, Lin S, Zhuang X, Chen L, Liu P, Qiao J. Artificial oocyte activation improves cycles with prospects of ICSI fertilization failure: a sibling oocyte control study. Reprod BioMed Online. 2019;39:199–204.PubMedCrossRef

23.

Van Steirteghem A, Bonduelle M, Devroey P, Liebaers I. Follow-up of children born after ICSI. Hum Reprod Update. 2002;8:111–6.PubMedCrossRef

24.

Bonduelle M, Van Assche E, Joris H, Keymolen K, Devroey P, Van Steirteghem A, Liebaers I. Prenatal testing in ICSI pregnancies: incidence of chromosomal anomalies in 1586 karyotypes and relation to sperm parameters. Hum Reprod. 2002;17:2600–14.PubMedCrossRef

25.

Terada Y, Hasegawa H, Takahashi A, Ugajin T, Yaegashi N, Okamura K. Successful pregnancy after oocyte activation by a calcium ionophore for a patient with recurrent intracytoplasmic sperm injection failure, with an assessment of oocyte activation and sperm centrosomal function using bovine eggs. Fertil Steril. 2009;91:935.e11–4.

26.

Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gotzsche PC, Ioannidis JPA, Clarke M, Devereaux PJ, Kleijnen J, Moher D. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. J Clin Epidemiol. 2009;62:e1–34.CrossRefPubMed

27.

Wells GA, Shea B, O'Connell D, Peterson J, Welch V, Losos M, Tugwell M. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. 2015. http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp. Accessed 13 Oct 2020.

28.

Kobayashi M, Yoshida A, Tanigiwa S, Seida K, Suzuki H, Tanaka M. Clinical outcome following ICSI with assisted oocyte activation (ionomycin or electroporation). Hum Reprod. 2013;28:100.

29.

Bernardini L, Gianaroli L, Fortini D, Conte N, Magli C, Cavani S, Gaggero G, Tindiglia C, Ragni N, Venturini PL. Frequency of hyper-, hypohaploidy and diploidy in ejaculate, epididymal and testicular germ cells of infertile patients. Hum Reprod. 2000;15:2165–72.PubMedCrossRef

30.

Kissin DM, Jamieson DJ, Barfield WD. Monitoring health outcomes of assisted reproductive technology. N Engl J Med. 2014;371:91–3.PubMedPubMedCentralCrossRef

31.

Rybouchkin AV, Van der Straeten F, Quatacker J, De Sutter P, Dhont M. Fertilization and pregnancy after assisted oocyte activation and intracytoplasmic sperm injection in a case of round-headed sperm associated with deficient oocyte activation capacity. Fertil Steril. 1997;68:1144–7.PubMedCrossRef

32.

Heindryckx B, De Gheselle S, Gerris J, Dhont M, De Sutter P. Efficiency of assisted oocyte activation as a solution for failed intracytoplasmic sperm injection. Reprod BioMed Online. 2008;17:662–8.PubMedCrossRef

33.

Fawzy M, Emad M, Mahran A, Sabry M, Fetih AN, Abdelghafar H, Rasheed S. Artificial oocyte activation with SrCl2 or calcimycin after ICSI improves clinical and embryological outcomes compared with ICSI alone: results of a randomized clinical trial. Hum Reprod. 2018;33:1636–44.PubMedCrossRef

34.

Murugesu S, Saso S, Jones BP, Bracewell-Milnes T, Athanasiou T, Mania A, Serhal P, Ben-Nagi J. Does the use of calcium ionophore during artificial oocyte activation demonstrate an effect on pregnancy rate? A meta-analysis. Fertil Steril. 2017;108:468–482.e463.PubMedCrossRef

35.

Heytens E, Soleimani R, Lierman S, De Meester S, Gerris J, Dhont M, Van der Elst J, De Sutter P. Effect of ionomycin on oocyte activation and embryo development in mouse. Reprod BioMed Online. 2008;17:764–71.PubMedCrossRef

36.

Vanden Meerschaut F, Nikiforaki D, De Roo C, Lierman S, Qian C, Schmitt-John T, De Sutter P, Heindryckx B. Comparison of pre- and post-implantation development following the application of three artificial activating stimuli in a mouse model with round-headed sperm cells deficient for oocyte activation. Hum Reprod. 2013;28:1190–8.CrossRef

37.

Montag M, Koster M, van der Ven K, Bohlen U, van der Ven H. The benefit of artificial oocyte activation is dependent on the fertilization rate in a previous treatment cycle. Reprod BioMed Online. 2012;24:521–6.PubMedCrossRef

38.

Ebner T, Oppelt P, Wober M, Staples P, Mayer RB, Sonnleitner U, Bulfon-Vogl S, Gruber I, Haid AE, Shebl O. Treatment with Ca2+ ionophore improves embryo development and outcome in cases with previous developmental problems: a prospective multicenter study. Hum Reprod. 2015;30:97–102.PubMedCrossRef

39.

Mansour R, Fahmy I, Tawab NA, Kamal A, El-Demery Y, Aboulghar M, Serour G. Electrical activation of oocytes after intracytoplasmic sperm injection: a controlled randomized study. Fertil Steril. 2009;91:133–9.PubMedCrossRef

40.

Ebner T, Koster M, Shebl O, Moser M, Van der Ven H, Tews G, Montag M. Application of a ready-to-use calcium ionophore increases rates of fertilization and pregnancy in severe male factor infertility. Fertil Steril. 2012;98:1432–7.PubMedCrossRef

41.

Belva F, De Schrijver F, Tournaye H, Liebaers I, Devroey P, Haentjens P, Bonduelle M. Neonatal outcome of 724 children born after ICSI using non-ejaculated sperm. Hum Reprod. 2011;26:1752–8.PubMedCrossRef

42.

Wen J, Jiang J, Ding C, Dai J, Liu Y, Xia Y, Liu J, Hu Z. Birth defects in children conceived by in vitro fertilization and intracytoplasmic sperm injection: a meta-analysis. Fertil Steril. 2012;97:1331–7.PubMedCrossRef

43.

Sutcliffe AG, Taylor B, Saunders K, Thornton S, Lieberman BA, Grudzinskas JG. Outcome in the second year of life after in-vitro fertilisation by intracytoplasmic sperm injection: a UK case-control study. Lancet. 2001;357:2080–4.PubMedCrossRef

44.

Kent-First MG, Kol S, Muallem A, Ofir R, Manor D, Blazer S, First N, Itskovitz-Eldor J. The incidence and possible relevance of Y-linked microdeletions in babies born after intracytoplasmic sperm injection and their infertile fathers. Mol Hum Reprod. 1996;2:943–50.PubMedCrossRef

45.

Stuppia L, Gatta V, Calabrese G, Guanciali Franchi P, Morizio E, Bombieri C, Mingarelli R, Sforza V, Frajese G, Tenaglia R, Palka G. A quarter of men with idiopathic oligo-azoospermia display chromosomal abnormalities and microdeletions of different types in interval 6 of Yq11. Hum Genet. 1998;102:566–70.PubMedCrossRef

46.

Goldberg MF, Edmonds LD, Oakley GP. Reducing birth defect risk in advanced maternal age. JAMA. 1979;242:2292–4.PubMedCrossRef

47.

Lambert RD. Safety issues in assisted reproductive technology: aetiology of health problems in singleton ART babies. Hum Reprod. 2003;18:1987–91.PubMedCrossRef

48.

Dawson AL, Tinker SC, Jamieson DJ, Hobbs CA, Berry RJ, Rasmussen SA, Anderka M, Keppler-Noreuil KM, Lin AE, Reefhuis J. Twinning and major birth defects, National Birth Defects Prevention Study, 1997-2007. J Epidemiol Community Health. 2016;70:1114–21.PubMedCrossRef

49.

Chauhan SP, Scardo JA, Hayes E, Abuhamad AZ, Berghella V. Twins: prevalence, problems, and preterm births. Am J Obstet Gynecol. 2010;203:305–15.PubMedCrossRef

Title: Risk of birth defects in children conceived by artificial oocyte activation and intracytoplasmic sperm injection: a meta-analysis
Authors: Rui Long
Meng Wang
Qi Yu Yang
Shi Qiao Hu
Li Xia Zhu
Lei Jin
Publication date: 01-12-2020
Publisher: BioMed Central
Keyword: ICSI
Published in: Reproductive Biology and Endocrinology / Issue 1/2020
Electronic ISSN: 1477-7827
DOI: https://doi.org/10.1186/s12958-020-00680-2

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Risk of birth defects in children conceived by artificial oocyte activation and intracytoplasmic sperm injection: a meta-analysis

Abstract

Background

Method

Results

Conclusion

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Method

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 1/2020

Growth hormone activates PI3K/Akt signaling and inhibits ROS accumulation and apoptosis in granulosa cells of patients with polycystic ovary syndrome

Effectiveness and safety of follitropin alfa (Ovaleap®) for ovarian stimulation using a GnRH antagonist protocol in real-world clinical practice: a multicenter, prospective, open, non-interventional assisted reproductive technology study

Sphingosine 1-phosphate protects against radiation-induced ovarian injury in female rats—impact on mitochondrial-related genes

Sperm impairing microbial factor: potential candidate for male contraception

Status of racial disparities between black and white women undergoing assisted reproductive technology in the US

The significance of FMR1 CGG repeats in Chinese women with premature ovarian insufficiency and diminished ovarian reserve