Can calcium ionophore use in patients with diminished ovarian reserve increase fertilization and pregnancy rates A randomized controlled study

Capsule:
Routine usage of Calcium ionophore solution to increase fertilization rate, pregnancy rate, and ongoing pregnancy rate is not appropriate for patients who have diminished ovarian reserve.

Authors:
Pinar Caglar Aytac, M.D., Esra Bulgan Kilicdag, M.D., Bulent Haydardedeoglu, M.D., Erhan Simsek, M.D., Tayfun Cok, M.D., Huriye Ayse Parlakgumus, M.D.

Volume 104, Issue 5, Pages 1168-1174

Abstract:

Objective:
To determine whether calcium ionophore solution can improve the fertilization rate in patients with diminished ovarian reserve whose partners have normal sperm parameters.

Design:
Between January 2014 and August 2014, patients with diminished ovarian reserve were randomized to make artificial oocyte activation with calcium ionophore solution.

Setting:
University hospital.

Patient(s):
A total of 296 patients who had diminished ovarian reserve and partners with normal sperm parameters were included in the study.

Intervention(s):
Metaphase 2 oocytes were treated with calcium ionophore solution (GM508 Cult-Active) for 15 minutes just after intracytoplasmic sperm injection.

Main Outcome Measure(s):
Fertilization rate, implantation rate, clinical pregnancy rate, ongoing pregnancy rate.

Result(s):
Fertilization, implantation, pregnancy, and ongoing pregnancy rates for the calcium ionophore and control groups were 60.7% and 55.4%, 12.8% and 10.7%, 21% and 12.8%, and 10.9% and 6.1%, respectively.

Conclusion(s):
This is the first prospective, randomized, controlled study to analyze the effect of calcium ionophore solution on fertilization rate in patients with diminished ovarian reserve. We did not observe any differences in fertilization, clinical pregnancy, or ongoing pregnancy rates between the groups. We propose that fertilization ratios could not be increased by artificial oocyte activation via application of calcium ionophore solution in patients with diminished ovarian reserve.

Clinical Trial Registration Number:
NCT02045914.

  • Jason M. Franasiak

    A very interesting RCT. Were there any noted cases of globozoospermia? This group has been the only patients who have reliably benefited from calcium ionophore use in our experience. It would be interesting to know if any were included here and what their outcomes were.

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