Is piezo-ICSI (intracytoplasmic sperm injection) a viable alternative for patients with previous poor fertilisation results? A prospective audit.

Conventional ICSI (intracytoplasmic sperm injection) is generally performed using an injection pipette which pierces the zona pellucida and the oolemma of the oocyte which may cause damage to the fragile oocyte. Piezo is a different method of perforating the zona pellucida and the oolemma, using ultra rapid submicron forward movement delivered by a flat tipped pipette. Published studies have shown a reduced degeneration rate and increased fertilisation rate with piezo-ICSI. Patients will undergo conventional ICSI regardless of their involvement in this study Patient suitability/eligibility for piezo-ICSI: Patients that have a higher than expected degeneration rate (>2 oocytes) or poor fertilisation outcomes (<30% normal fertilisation) on a previous conventional ICSI cycle may be offered piezo-ICSI as a method of fertilisation by their fertility specialist. Performance of piezo-ICSI: The procedure is performed in the Newlife IVF laboratory approximately 3h after oocyte collection as per standard insemination protocol. There is no change to the patient experience as this is a laboratory based technique. Piezo-ICSI is performed in a similar fashion to conventional ICSI with minimal disruption to patients’ gametes outside of a temperature and gas controlled environment. No additional procedures or tests are required for the patient to undertake. Monitoring: All participants undergoing conventional ICSI or piezo-ICSI cycles will be continually monitored for fertilisation rate, oocyte degeneration rate, abnormal fertilisation rates, cleavage and blastulation rate, utilisation rate and pregnancy rate, as is standard practice at Newlife IVF. The study will not involve any additional procedures or follow up outside of a conventional ICSI cycle.