Objective: To compare the efficacy of piezo-assisted micromanipulation with
conventional micromanipulation for intracytoplasmic sperm injection (ICSI)
into oocytes in patients with impaired semen parameters and no success wit
h in vitro fertilization (IVF). Study Design:A retrospective randomized stu
dy was conducted on 204 cycles for 104 couples with piezo-assisted ICSI and
122 cycles for 96 couples with conventional ICSI. Piezo-assisted ICSI cons
ists of two steps, namely penetration of the zona pellucida alone with a pi
ezo-pulse and then puncturing of the oolemma with a light negative pressure
without piezo, as with conventional ICSI. The tips of injection pipettes w
ere prepared after pulling by breakage with a scalpel under a microscope, s
o that the inner diameter at and near the tip was 5 tm, as for conventional
ICSI. Results: Piezo-assisted ICSI demonstrated significantly more favorab
le results, with a fertilization rate of 90.3% (conventional ICSI: 83.1%, p
< 0.01) and a cleavage rate of 88.1% (conventional ICSI: 84.6%, p < 0.01).
Conclusion: Piezo-assisted ICSI is easy to incorporate a spermatozoa exact
ly into the ooplasm with little deformation of the oocyte during insertion.
Piezo-assisted ICSI can be used effectively for human oocytes to improve t
he fertilization, cleavage rates. Copyright (C) 2001 S. Karger AG, Basel.