Conjoined oocytes are characterized by a follicle containing two oocytes surrounded by a single zona pellucida or their fusion in a zonal region. Gonadotropin stimulation, coupled with PCOS, predisposes to the occurrence of conjoined oocytes. Although a result of developmental accident, conjoined oocytes have the potential to develop into genetically normal embryos and babies. In this paper, the authors describe the aspiration of multiple conjoined oocytes in a single IVF cycle, leading to normal fertilization after selective intracytoplasmic sperm injection (ICSI). Development to blastocyst stage allowed trophectoderm biopsy resulting to a euploid embryo that was eventually transferred, and resulted to a live term birth.

Key words: conjoined oocytes, in vitro fertilization (IVF), intracytoplasmic sperm injection(ICSI)

In Vitro Fertilization (IVF) is an established treatment approach for infertility based on the developments the past quarter century. However, there are still a number of reasons which prevent both doctors and patients from embarking on this available treatment option. The current indication for IVF (including endometriosis, tubal pathology, anovulation, male factor infertility-and unexplained infertility) are reviewed considering prognosis for pregnancy using IVF as compared to no/more conventional treatment. Evidence-based data are presented. Also, maternal age as a factor for success in IVF treatment is reviewed. Local setting situations which contribute to delays in treatment are also tackled.
FERTILIZATION IN VITRO

No abstract available.
Fertilization in Vitro* ; Fertilization*

No abstract available.
Fertilization in Vitro* ; Fertilization* ; Humans*

OBJECTIVE: This study is to evaluate the efficacy of Intracytoplasmic Sperm Injection(ICSI) for previous fertilization failure with conventional in vitro fertilization(IVF), compared with ICSI for male factor. METHOD: The author analyzed the 3 years of clinical experience with ICSI retrospectively, between the conventional IVF failure group (IVF failure) and male factor group (male factor). Surgically retrieved epididymal or testicular spermatozoa for ICSI were excluded. The IVF failure group was 13 cycles of 6 patients and male factor group was 30 cycles of 15 patients. RESULTS: The fertilization rates of the IVF failure group and male factor group were 63% and 66% respectively (p=0.635). The clinical pregnancy rates of the both group were 23.1% and 26.7% (p=0.804), and that of live birth rates were 15.4% and 13.3% (p=0.858). There were no significant difference between the two groups. CONCLUSION: The author concluded that ICSI can overcome previous fertilization failure, with the same fertilization and clinical pregnancy rates seen in patients with male factor.
Fertilization in Vitro* ; Fertilization* ; Humans ; Live Birth ; Male ; Pregnancy Rate ; Retrospective Studies ; Sperm Injections, Intracytoplasmic* ; Spermatozoa

OBJECTIVETo discuss the applied value of rescue intracytoplasmic sperm injection(ICSI) after complete fertilization failure during in vitro fertilization (IVF) cycles.

METHODSAfter 16-18 h co-culture with sperm, all the unfertilized oocytes with the first polar body were re-fertilized by ICSI.

RESULTSAfter rescue ICSI, the abnormal fertilization rate was 17.9% and the normal fertilization rate was 42.7%. Twenty-four hours later, the normal cleavage rate of the normal fertilized oocytes was 79.6%. On the day of embryo transfer, the good-quality rate of embryos was 29.7% (22/74). A mean number of 3.4 (54/16) embryos were transferred to the patient during each cycle. Clinical pregnancy was found in 3 cases out of the 16 (18.8%).

CONCLUSIONThe applied value of rescue ICSI may be correlated with the number and maturity of oocytes on the retrieval day.

OBJECTIVETo evaluate whether or not intracytoplasmic sperm injection (ICSI) can improve previous fertilization limitation on conventional in vitro fertilization (IVF).

METHODSOne hundred and thirty-six completed cycles in 113 patients with ICSI treatment were grouped. Group 1 was 106 cycles perform ICSI because of male factor, and group 2 was other 30 cycles with the history of fertilization failure and fertilization rate < 20% on conventional IVF, also assembling the cycles in group 2 according to the fertilization rate.

RESULTSThere was no significant difference between two groups in the rates of normal fertilization(70.49% vs 72.02%), good quality embryos (38.28% vs 38.81%), and clinical pregnancy (40.57% vs 40.00%) (P > 0.05). The fertilization rate of a majority of cycles (70.00%, 21/30) in group 2 was higher than 50%, and the mean of fertilization rates was 79.79%.

CONCLUSIONICSI can improve the fertilization limitation following IVF during previous cycles, and the fertilization rates was similar to those treated ICSI because of male factor.

OBJECTIVE: This study aimed to compare the clinical outcomes between in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) in sibling oocytes. Additionally, we evaluated whether the implementation of split insemination contributed to an increase in the number of ICSI procedures. METHODS: A total of 571 cycles in 555 couples undergoing split insemination cycles were included in this study. Among them, 512 cycles (89.7%) were a couple's first IVF cycle. The patients were under 40 years of age and at least 10 oocytes were retrieved in all cycles. Sibling oocytes were randomly allocated to IVF or ICSI. RESULTS: Total fertilization failure was significantly more common in IVF cycles than in ICSI cycles (4.0% vs. 1.4%, p<0.05), but the low fertilization rate among retrieved oocytes (as defined by fertilization rates greater than 0% but <30%) was significantly higher in ICSI cycles than in IVF cycles (17.2% vs. 11.4%, p<0.05). The fertilization rate of ICSI among injected oocytes was significantly higher than for IVF (72.3%±24.3% vs. 59.2%±25.9%, p<0.001), but the fertilization rate among retrieved oocytes was significantly higher in IVF than in ICSI (59.2%±25.9% vs. 52.1%±22.5%, p<0.001). Embryo quality before embryo transfer was not different between IVF and ICSI. Although the sperm parameters were not different between the first cycle and the second cycle, split insemination or ICSI was performed in 18 of the 95 cycles in which a second IVF cycle was performed. CONCLUSION: The clinical outcomes did not differ between IVF and ICSI in split insemination cycles. Split insemination can decrease the risk of total fertilization failure. However, unnecessary ICSI is carried out in most split insemination cycles and the use of split insemination might make ICSI more common.
Embryo Transfer ; Embryonic Structures ; Family Characteristics ; Fertilization ; Fertilization in Vitro* ; Humans ; In Vitro Techniques* ; Insemination* ; Oocytes ; Siblings ; Sperm Injections, Intracytoplasmic* ; Spermatozoa

No abstract available.
Estradiol* ; Fertilization in Vitro*

No abstract available.
Fertilization in Vitro* ; Superovulation*