Improved fertilization, degeneration and embryo quality rates with PIEZO-ICSI compared with conventional ICSI – A sibling oocyte split multi-center trial.

To investigate whether PIEZO-ICSI increases the fertilization rate, decreases the degeneration rate, and increases utilization rate per oocyte injected compared with conventional ICSI.Sibling oocyte split multi-centre trial.Fertility clinics PATIENT(S): Women with a diagnosis of infertility utilizing ICSI as their method of insemination who have ≥ 6 mature oocytes for injection.Participants had their mature oocyte cohort divided, where half were injected using conventional ICSI and the other half were injected using PIEZO-ICSI. For patients with an uneven oocyte number the extra oocyte was injected using conventional ICSI. The injection technique utilized first was also randomized to ensure there was no bias due to order of injection.The primary outcome measure was fertilization rate post injection.A total of 108 patients underwent a sibling split use of conventional ICSI and PIEZO-ICSI. The fertilization rate was 71.6% for PIEZO-ICSI, which was significantly increased compared with conventional ICSI 65.6% (p=0.028). In addition, oocyte degeneration rate was decreased in PIEZO-ICSI versus conventional ICSI (6.3% vs 12.1% respectively, p=0.002), and blastocyst quality was increased, as measured by the number of grade A and B quality blastocysts present on day 5 of development (33.3% vs 27.5% p=0.019). There were no significant differences found in aneuploidy rate, utilization rate, clinical pregnancy, or live birth outcome after single embryo transfer between the two injection techniques.This trial supports the possibility that PIEZO-ICSI increases fertilization, decreases oocyte degeneration rates and increases blastocyst quality compared with conventional ICSI, however, does not appear to influence the clinical pregnancy nor live birth rate per transfer.