1. Dr.Ehab Darwish Medical Director TopLab Co. for IVF lab consultations and training

2. In VIVO

3. Human embryo development

4. Infertility Inability to conceive after more than one year of intercourse without contraception. 10-15% of population is suffering from infertility

5. Assisted Reproductive Technology (ART) Assisted Reproductive Technology (ART) Assisted reproductive technology Replace source of gametes----Sperm, oocyte or zygote donors Aid in the fertilization process— ICSI, IVF, ZIFT, GIFT. Aid the implantation process — FET Surrogate mothers Pre-implantation genetic screening— PGD, PGS

6. Intra cytoplasmic sperm injection

7. Challenge Some rare cases showed a complete or partial inability of the human oocyte to undergo cleavage after successful fertilization in ICSI cycle. No published papers was conducted before to help these cases.

8. Calcium signaling and oocyte activation.

9. Study question.

10. Calcium ionophore

11. Design Four couples with a history of incomplete ICSI cycles owing to 2PN arrest A23187 Ca2+ ionophore solution (GM508 Cult-ActiveR, Gynemed, Lensahn, Germany) was used for AOA Fertilization rate Cleavage rate Pregnancy rate

12. Results

13. Outcome Use of Ca 2+ ionophore: 1. Overcomes the problem of inadequate signaling events 2. Helps the embryos to reach more advanced stages. 3. Dramatically shifts the fate of ICSI cycles from being cancelled treatment trials, to complete ones. New hope for this category of infertility patients

14. Bigger study

15. Thank You!