Insights into The Outcomes of Artificial Oocyte Activation: A Retrospecive Analysis of 1,300 Couples Undergoing Intracytoplasmic Sperm Injection.

OBJECTIVE: Oocyte activation deficiency remains a significant obstacle in assisted reproductive technologies. Intracytoplasmic sperm injection combined with artificial oocyte activation (ICSI-AOA) has been introduced as a promising strategy to enhance fertilization efficiency and clinical outcomes. This study aimed to provide a comprehensive analysis of clinical results from 1,300 ICSI-AOA cycles and to assess the health status of the resulting offspring. MATERIALS AND METHODS: This retrospective study analyzed 1,300 ICSI-AOA cycles performed between 2018 and 2020. Follow-up assessments were conducted after live birth to evaluate child health. Fertilization outcomes, embryo development parameters, pregnancy results, and offspring health status were examined using imaging, molecular, and biochemical approaches to ensure a comprehensive evaluation. RESULTS: Across the 1,300 ICSI-AOA cycles, the failed fertilization rate was 4.54% and 20.16% of cycles were cancelled, while 91.06% proceeded to embryo transfer. Of 14,522 retrieved cumulus-oocyte complexes, 85.38% reached maturation. Mature oocytes showed a fertilization rate of 59.69% and a cleavage rate of 96.93%, producing 7,180 day-three embryos. Fresh transfers (n=571) resulted in chemical and clinical pregnancy rates of 24.6% and 20.82%. In addition, 3,270 embryos were cryopreserved, and thawed transfers achieved chemical and clinical pregnancy rates of 22.55% and 21.61%. Among 3,018 non-frozen embryos, 447 formed blastocysts, and 44 fresh blastocyst transfers yielded pregnancy rates of 21.87% (chemical) and 9.38% (clinical). Thawed blastocyst transfers achieved chemical and clinical pregnancy rates of 23.67% and 22.11%. Overall, 266 live births were obtained from 1,317 transfers, corresponding to a 14.19% implantation rate and a 20.20% per-cycle live birth rate, with anomalies detected in 1.5% of offspring. CONCLUSION: ICSI-AOA provides favorable fertilization, pregnancy, and live birth outcomes, and no major health concerns were observed in the resulting children, consistent with previous ICSI reports.