Journal of Assisted Reproduction and Genetics

, Volume 29, Issue 12, pp 1393–1396 | Cite as

Live birth after SrCl2 oocyte activation in previous repeated failed or low fertilization rates after ICSI of frozen-thawed testicular spermatozoa: case report

  • Jun-Woo Kim
  • Jung-Lim Choi
  • Seong-Ho Yang
  • San-Hyun Yoon
  • Jae-Hoon Jung
  • Jin-Ho Lim



To report a live birth resulting after strontium chloride (SrCl2) oocyte activation in a couple with complete fertilization failure or low fertilization rates following intracytoplasmic sperm injection (ICSI) of frozen-thawed testicular spermatozoa.


The couple underwent ICSI of frozen-thawed testicular spermatozoa. After ICSI, the oocytes were artificially activated by SrCl2 because the results of fertilization were not satisfactory in the previous cycles. The main outcome measures were fertilization, pregnancy, and birth.


In the first and second cycles performed previously at another clinic, fertilization rates were 9.1 % and 0.0 %, respectively. In the third cycle, 31 metaphase II oocytes were retrieved. After sperm injection, all of the oocytes were stimulated using SrCl2 for activation. Sixteen oocytes were fertilized (51.6 %), and a single embryo was transferred into the uterus on Day 3. A healthy girl weighing 2750 g was born at 40 weeks of gestation by caesarean section.


This result suggests that SrCl2 could be useful for oocyte fertilization in case of repeated complete fertilization failure or low fertilization rates following ICSI of frozen-thawed testicular spermatozoa.


Artificial oocyte activation (AOA) Fertilization failure Frozen-thawed testicular spermatozoa ICSI SrCl2 


  1. 1.
    Sakkas D, Urner F, Bianchi PG, Bizzaro D, Wagner I, Jaquenoud N, et al. Sperm chromatin anomalies can influence decondensation after intracytoplasmic sperm injection. Hum Reprod. 1996;11:837–43.PubMedCrossRefGoogle Scholar
  2. 2.
    Schmiady H, Tandler-Schneider A, Kentenich H. Premature chromosome condensation of the sperm nucleus after intracytoplasmic sperm injection. Hum Reprod. 1996;11:2239–45.PubMedCrossRefGoogle Scholar
  3. 3.
    Nasr-Esfahani MH, Razavi S, Mardani M, Shirazi R, Javanmardi S. Effects of failed oocyte activation and sperm protamine deficiency on fertilization post-ICSI. Reprod Biomed Online. 2007;14:422–9.PubMedCrossRefGoogle Scholar
  4. 4.
    Yanagida K, Katayose H, Yazawa H, Kimura Y, Sato A, Yanagimachi H, et al. Successful fertilization and pregnancy following ICSI and electrical oocyte activation. Hum Reprod. 1999;14:1307–11.PubMedCrossRefGoogle Scholar
  5. 5.
    Zhang J, Wang CW, Blaszcyzk A, Grifo JA, Ozil J, Haberman E, et al. Electrical activation and in vitro development of human oocytes that fail to fertilize after intracytoplasmic sperm injection. Fertil Steril. 1999;72:509–12.PubMedCrossRefGoogle Scholar
  6. 6.
    Tesarik J, Sousa M. More than 90 % fertilization rates after intracytoplasmic sperm injection and artificial oocyte activation with calcium ionophore. Fertil Steril. 1995;63:343–9.PubMedGoogle Scholar
  7. 7.
    Battaglia DE, Koehler JK, Klein NA, Tucker MJ. Failure of oocyte activation after intracytoplasmic sperm injection using round-headed sperm. Fertil Steril. 1997;68:118–22.PubMedCrossRefGoogle Scholar
  8. 8.
    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.PubMedCrossRefGoogle Scholar
  9. 9.
    Kim ST, Cha YB, Park JM, Gye MC. Successful pregnancy and delivery from frozen-thawed embryos after intracytoplasmic sperm injection using patient with mosaic Down syndrome. Fertil Steril. 2001;75:445–7.PubMedCrossRefGoogle Scholar
  10. 10.
    Eldar-Geva T, Brooks B, Margalioth EJ, Zylber-Haran E, Gal M, Silber SJ. Successful pregnancy and delivery after calcium ionophore oocyte activation in a normozoospermic patient with previous repeated failed fertilization after intracytoplasmic sperm injection. Fertil Steril. 2003;79:1656–8.PubMedCrossRefGoogle Scholar
  11. 11.
    Chi HJ, Koo JJ, Song SJ, Lee JY, Chang SS. Successful fertilization and pregnancy after intracytoplasmic sperm injection and oocyte activation with calcium ionophore in a normozoospermic patient with extremely low fertilization rates in intracytoplasmic sperm injection cycles. Fertil Steril. 2004;82:475–7.PubMedCrossRefGoogle Scholar
  12. 12.
    Moaz MN, Khattab S, Foutouh IA, Mohsen EA. Chemical activation of oocytes in different types of sperm abnormalities in cases of low or failed fertilization after ICSI: a prospective pilot study. RBM Online. 2006;13:791–4.PubMedGoogle Scholar
  13. 13.
    Kyono K, Nakajo Y, Nishinaka C, Hattori H, Kyoya T, Ishikawa T, et al. A birth from the transfer of a single vitrified-warmed blastocyst using intracytoplasmic sperm injection with calcium ionophore oocyte activation in a globozoospermic patient. Fertil Steril. 2008;91:931.e7–11.CrossRefGoogle Scholar
  14. 14.
    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 bovien eggs. Fertil Steril. 2008;91:935.e11–4.CrossRefGoogle Scholar
  15. 15.
    Nakagawa K, Yamano S, Moride N, Yamashita M, Yoshizawa M, Aono T. Effect of activation with Ca ionophore A23187 and puromycin on the development of human oocytes that failed to fertilize after intracytoplasmic sperm injection. Fertil Steril. 2001;76:148–52.PubMedCrossRefGoogle Scholar
  16. 16.
    Murase Y, Araki Y, Mizuno S, Kawaguchi C, Naito M, Yoshizawa M, et al. Pregnancy following chemical activation of oocytes in a couple with repeated failure of fertilization using ICSI: case report. Hum Reprod. 2004;19:1604–7.PubMedCrossRefGoogle Scholar
  17. 17.
    Yanagida K, Morozumi K, Katayose H, Hayashi S, Sato A. Successful pregnancy after ICSI with strontium oocyte activation in low rates of fertilization. RBM Online. 2006;13:801–6.PubMedGoogle Scholar
  18. 18.
    Kyono K, Kumagai S, Nishinaka C, Nakajo Y, Uto H, Toya M, et al. Birth and follow-up of babies born following ICSI using SrCl2 oocyte activation. RBM Online. 2008;17:53–8.PubMedGoogle Scholar
  19. 19.
    Chen J, Qian Y, Tan Y, Mima H. Successful pregnancy following oocyte activation by strontium in normozoospermic patients of unexplained infertility with fertilisation failures during previous intracytoplasmic sperm injection treatment. Reprod Fertil Dev. 2010;22:852–5.PubMedCrossRefGoogle Scholar
  20. 20.
    Son WY, Chung JT, Gidoni Y, Holzer H, Levin D, Chian RC, et al. Comparison of survival rate of cleavage stage embryos produced from in vitro maturation cycles after slow freezing and after vitrification. Fertil Steril. 2009;92:956–8.PubMedCrossRefGoogle Scholar
  21. 21.
    Bagchi A, Woods EJ, Critser JK. Cryopreservation and vitrification: recent advances in fertility preservation technologies. Expert Rev Med Devices. 2008;5:359–70.PubMedCrossRefGoogle Scholar
  22. 22.
    Vernaeve V, Tournaye H, Osmanagaoglu K, Verheyen G, Van Steirteghem A, Devroey P. Intracytoplasmc sperm injection with testicular spermatozoa is less successful in men with nonobstructive azoospermia than in men with obstructive azoospermia. Fertil Steil. 2003;79:529–33.CrossRefGoogle Scholar
  23. 23.
    Park YS, Lee SH, Song SJ, Jun JH, Koong MK, Seo JT. Influence of motility on the outcome of in vitro fertilization/intracytoplasmc sperm injection with fresh vs. frozen testicular sperm from men with obstructive azoospermia. Fertil Steil. 2003;80:526–30.CrossRefGoogle Scholar
  24. 24.
    Nasr-Esfahani MH, Deemeh MR, Tavalaee M. Artificial oocyte activation and intracytoplasmic sperm injection. Fertil Steril. 2010;94:520–6.PubMedCrossRefGoogle Scholar
  25. 25.
    Swann K, Ozil JP. Dynamics of the calcium signal that triggers mammalian egg activation. Int Rev Cytol. 1994;152:183–222.PubMedCrossRefGoogle Scholar
  26. 26.
    Tesarik J, Mendoza C, Greco E. The activity (calcium oscillator?) responsible for human oocyte activation after injection with round spermatids is associated with spermatid nuclei. Fertil Steril. 2000;74:1245–7.PubMedCrossRefGoogle Scholar
  27. 27.
    Hoshi K, Yanagida K, Yazawa H, Katayose H, Sato A. Intracytoplasmic sperm injection using immobilized or motile human spermatozoon. Fertil Steril. 1995;63:1241–5.PubMedGoogle Scholar
  28. 28.
    Borges Jr E. de Almeida Ferreira Braga DP, de Sousa Bonetti TC, Iaconelli A Jr, Franco JG Jr. Artificial oocyte activation with calcium ionophore A23187 in intracytoplasmic sperm injection cycles using surgically retrieved spermatozoa. Fertil Steril. 2009;92:131–6.PubMedCrossRefGoogle Scholar
  29. 29.
    Ahmady A, Michael E. Successful pregnancy and delivery following intracytoplasmic injection of frozen-thawed nonviable testicular sperm and oocyte activation with calcium ionophore. J Androl. 2007;28:13–4.PubMedCrossRefGoogle Scholar
  30. 30.
    Stecher A, Bach M, Neyer A, Vanderzwalmen P, Zintz M, Zech NH. Case report: live birth following ICSI with non-vital frozen-thawed testicular sperm and oocyte activation with calcium ionophore. J Assist Reprod Genet. 2011;28:411–4.PubMedCrossRefGoogle Scholar
  31. 31.
    Suganuma R, Walden CM, Butters TD, Platt FM, Dwek RA, Yanagimachi R, et al. Alkylated imino sugars, reversible male infertility-inducing agents, do not affect the genetic integrity of male mouse germ cells during short-term treatment despite induction of sperm deformities. Biol Reprod. 2005;72:805–13.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2012

Authors and Affiliations

  • Jun-Woo Kim
    • 1
  • Jung-Lim Choi
    • 1
  • Seong-Ho Yang
    • 1
  • San-Hyun Yoon
    • 1
  • Jae-Hoon Jung
    • 1
  • Jin-Ho Lim
    • 1
  1. 1.In Vitro Fertilization CenterMaria Fertility HospitalSeoulKorea

Personalised recommendations