Calcium Ionophore – A New Technique in Assisted Reproduction

or ART, to help increase fertility and solve problems of infertility, heightening the possibilities of having children, for those struggling with such issues. For this particular technique, Samitivej Sukhumvit Hospital in Bangkok, Thailand has conducted extensive research and has joined in the development of the technology for this type of treatment, resulting in the possibility for it to be used to help solve issues of infertility. Samitivej Hospital first used this technology on July 12, 2010, and has continued to use it to this day.

Current treatments for issues of infertility employ the use of ART in solving the problem. For some groups of patients – such as cases where the male has a very low sperm count, weak sperm health, or severe abnormalities, or if the female’s eggs have hard or thick shells, making it difficult for the sperm to penetrate normally and thus rendering it unable to fertilize the eggs – treatment is carried out with a procedure in which a single sperm is injected directly into an egg.

After incubation, eggs that are successfully fertilized become embryos, at which time the embryo transfer procedure is then used to physically place the embryo in the woman’s uterus, where, if the treatment works, pregnancy will occur and the embryo will grow into a baby. We call this method Intracytoplasmic Sperm Injection (ICSI). We have found that within groups treated using ICSI, only about three to five percent of patients experienced either fertilization failure or a less than 50% fertilization rate, whereby the main cause of failure stemmed from sperm abnormalities.

Once the sperm has been injected into the egg, the sperm must signal to the egg (the sperm factor) that it has arrived and should allow their nuclei to be fused together, after which the male sperm nucleus then fuses with the female nucleus. If, however, the sperm has abnormalities, (i.e., problems with sperm morphology – (the size and shape of the sperm) or sperm motility (the ability to move forward normally), will be unable to signal the egg properly, and the egg pronucleus is unable to form and its genetic material is unable to arrange itself in order to fuse and combine with the pronucleus of the sperm. When it comes time for fertilization to occur, therefore, only the nucleus of the sperm will be present, but not that of the egg, and the fertilization is unable to occur. This is why we have introduced this new technique, Calcium Ionophore, as a means to help solve the problem.

The basic principle of the technique is as follows: We take the egg that has been injected with the sperm and we transfer it to a medium containing Calcium Ionophore produced by Bangkok’s Samitivej Sukhumvit Hospital and allow it to incubate for about 15 minutes. The medium then enters the egg and acts as a signaler to the egg that the sperm has arrived. The egg is then activated for pronucleus formation and can begin the process of fertilization. Finally, both the eggs and sperm, having begun the process of fertilization, are cultivated and matured according to the standard procedure.

This technique will be used when:

• Low fertilization after undergoing ICSI (< 50%)
• Very low sperm quality including low sperm count, weak sperm health, or severe abnormalities, etc.
• Sperm morphology or abnormal sperm size and shape
• Sperm motility (the ability to move forward normally)

In solving problems of infertility using ART, we must consider carefully what kind of method is appropriate for each individual case. If an examination finds that the male’s sperm is abnormally shaped, that is, the sperm heads are very large, or in cases where ICSI has already been performed and was unsuccessful, we will then immediately employ the use of the Calcium Ionophore technique in treatment. Although cases such as these may be uncommon, Bangkok’s Samitivej Sukhumvit Hospital is committed to providing comprehensive solutions to the problems of infertility and to meeting the needs of couples facing this difficult issue in whatever way possible. To this end, we have worked to develop this backup treatment technique using Calcium Ionophore whenever needed.

Treatment techniques using Calcium Ionophore are yet another aspect of which we are very proud. It allows us to meet treatment needs for infertility issues in a much more complete and all-inclusive manner. We are very pleased to be able to help find solutions and relieve the distress that every couple battling infertility faces, allowing them to finally be free of anxiety and concern over this difficult issue.  

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