Artificial Oocyte Activation (AOA) Following Intracytoplasmic Sperm Injection (ICSI)

- Executive Summary

▪️  IVF facilities could consider offering AOA for patients with previous no or low fertilisation, defined as lower than 30% (conditional recommendation).

▪️  AOA could be considered after proper counselling and well-informing the patients of globozoospermia cases (conditional recommendation).

▪️  IVF facilities should NOT recommend AOA for the general ICSI population (conditional recommendation against).

▪️  IVF facilities should NOT recommend AOA for improving embryo quality (conditional recommendation against).

▪️ IVF facilities should NOT recommend AOA for improving embryo development and blastocyst formation (conditional recommendation against).

▪️  IVF facilities should NOT recommend rescue AOA either hours or on day 1 after ICSI (conditional recommendation against).

▪️  IVF facilities could consider sibling-oocyte-split if AOA is offered for patients of previous low or no fertilisation, given the scarce long-term safety data (good practice statment).

▪️  Except for globozoospermia cases, IVF facilities should NOT recommend AOA for ICSI cycle with male factor infertility and no history of no or low fertilisation (conditional recommendation against).

▪️  Except for the above recommendations, AOA should only be considered within a research context without charging the patients and after proper counselling and written consent (good practice statment).