1. İstanbul Memorial Hospital ART and Genetics Center Failed fertilization after clinical intracytoplasmic sperm injection Murid Javed, Navid Esfandiari, Robert Casper Toronto Centre for Advanced Reproductive Technology, University of Toronto, Toronto, Canada Presented by: Dr. Khalili

2. İstanbul Memorial Hospital ART and Genetics Center ICSI Indication Male infertility (especially severe cases) Epididymal sperm Testicular sperm Idiopathic infertility Repeated IVF failures Presence of Anti-Sperm Abs

3. İstanbul Memorial Hospital ART and Genetics Center Assisted Fertilization fertilization after ICSI is 70–80% TFF occurs in 5–10% of IVF cycles and 1– 3% of ICSI cycles TFF after ICSI cycles is mostly due to low number of mature oocytes or oocyte activation failure TFF is rare in cases with normal oocytes and sperm TFF with normal sperm & good ovarian response (due: lack of oocyte activation)

4. İstanbul Memorial Hospital ART and Genetics Center Factors involved in fertilization failure Oocyte morphology Oocyte maturity Oocyte activation Poor ovarian response Sperm motility and progression Sperm structural defects Sperm DNA damage Procedural effects of the ICSI

5. İstanbul Memorial Hospital ART and Genetics Center Normal features of a healthy mature oocyte (MII) : 1. presence of a polar body 2. a round even shape 3. light color cytoplasm 4. homogenous granularity 5. small PVS without debris 6. colorless zp