Gamete Treatment to Correct Fertilization Failure

The spermatozoa will be prepared in the standard fashion and utilized for injection after
exposure to a membrane permeabilizing agent. The raw sperm specimen may be selected through a
synthetic, sterile, single-use, culture-tested mesh. The specimen will then be placed in a
37°C environment. After 30 minutes, the selected portion is retrieved from the other side of
the mesh. The spermatozoa will be prepared in the standard fashion will be utilized for
injection or intrauterine insemination.

The injected oocytes will be then exposed to the previously mentioned activating agents for
the purpose of inducing embryo development. The successfully fertilized oocytes will be
further kept in culture for up to 5 days as per standard IVF/ICSI. Results in terms of
fertilization and embryo cleavage will be assessed and monitored for the remainder of the
culture period. Developing embryos selected according to standard criteria will be replaced
to the patient or will be cryopreserved.

Because fertilization failure carries such a high emotional and financial toll on our
patients, at the present time, the only method to generate an embryo for these cases is to
perform assisted oocyte activation in conjunction with ICSI. The research intervention -
assisted oocyte activation - is believed to help alleviate the failed fertilization by
obtaining some zygotes for the patient. In these cases of complete failed fertilization,
intracytoplasmic sperm injection (ICSI) will be performed as a routine clinical treatment
even if they are not enrolled in the study. After several failures, their reproductive
physician may recommend the use of donor spermatozoa instead of the male partner's.

Inclusion Criteria:

- Patients with complete fertilization failure with standard IVF or failure with one
prior ICSI treatment cycle

Exclusion Criteria:

- not meeting inclusion criteria

- IVF without ICSI