With PIEZO into the future of ICSI
2020年度 年次大会-講演抄録 | Piezo-ICSI は新時代の顕微授精法となり得るか
学会講師 : Csaba Pribenszky
A recent meta-analysis has summarised the data from 9 studies and compared the laboratory results of ICSI with or without piezo. The data of 17584 fertilisations showed a significant increase of 2PN and blastocyst rates and a decrease in oocyte degeneration if piezo-ICSI was used for fertilisation. Nevertheless, the studies are mainly retrospective ones so proper randomised trials are needed to support these findings. The major teaching of the studies however is that the piezo technique lays the foundations of standardising the ICSI procedure by significantly simplifying the movements and by eliminating the need for oolemma aspiration.
The preparations for piezo-ICSI include the backfilling of an operation liquid into the injecting microcapillary. The application of the operating liquid is fundamentally important as it ensures the safe and effective piercing procedure and minimizes oocyte degeneration. It stabilizes the lateral vibrations of the pipette tip, intensifies axial vibrations and generates a slight vacuum inside of the capillary. First mercury then fluorocarbons and fluoroethers (from the Fluorinert and Novec families by 3M, USA) have been used for piezoICSI. They contain a mixture of fully fluorinated compounds together with a fraction of underfluorinated impurities. The unidentified constituents of Fluorinert and Novec and the impurities coming essentially from their manufacturing process poses a risk for the safe operation as these substances are severely cytotoxic and is an obstacle for the safe use, further registration and widespread of the technique.
A new operating liquid have been developed that is completely free of toxic impurities and constituents. The studies show zero cytotoxicity and an improved efficacy in the piezo ICSI procedure. The standardised piezo-ICSI procedure together with the use of the medical operating liquid ensures a significant leap in the ICSI technique benefiting both patients and clinics.