morphoМорфологические ведомостиMorphological newsletter1812-31712686-8741Private Medical University REAVIZ10.20340/mv-mn.2025.33(4).991morpho-991Research ArticleОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯRESEARCH ARTICLESЭФФЕКТИВНОСТЬ ПРИМЕНЕНИЯ ИСКУССТВЕННОЙ АКТИВАЦИИ ООЦИТОВ ИОНОФОРАМИ КАЛЬЦИЯ В ПРОГРАММАХ ВРТ У ПАЦИЕНТОВ С НЕБЛАГОПРИЯТНЫМ РЕПРОДУКТИВНЫМ АНАМНЕЗОМ: ЭМБРИОЛОГИЧЕСКИЕ И КЛИНИЧЕСКИЕ ИСХОДЫEFFECTIVENESS OF CALCIUM IONOPHORE ARTIFICIAL OOCYTE ACTIVATION IN ART PROGRAMS FOR PATIENTS WITH ADVERSE REPRODUCTIVE HISTORY: EMBRYOLOGICAL AND CLINICAL OUTCOMEShttps://orcid.org/0000-0002-8681-8844ПоповаОльга ОлеговнаPopovaOl'ga O.

аспирант кафедры гистологии и эмбриологии

Postgraduate student of the Department of Histology and Embryology

popovaoo@outlook.comhttps://orcid.org/0000-0002-3903-4350ШурыгинаОксана ВикторовнаShuryginaOksana V.

доктор медицинских наук, профессор кафедры гистологии и эмбриологии и кафедры репродуктивной медицины, клинической эмбриологии и генетики 

Doctor of Medical Sciences, Professor of the Department of Histology and Embryology and the Department of Reproductive Medicine, Clinical Embryology and Genetics

oks-shurygina@yandex.ruЮхимецСергей НиколаевичYukhimetsSergey N.

кандидат медицинских наук, доцент кафедры анатомии Медицинского колледжа 

Candidate of Medical Sciences, Associate Professor of the Department of Anatomy at the Medical College

y_s_n@mail.ruhttps://orcid.org/0000-0003-0222-1803СараеваНаталья ВладимировнаSaraevaNatal'ya V.

кандидат медицинских наук, доцент кафедры репродуктивной медицины, клинической эмбриологии и генетики, Самарского государственного медицинского университета; заведующая отделением Медицинской компании ИДК группы компаний «Мать и дитя», Самара

Candidate of Medical Sciences, Associate Professor of the Department of Reproductive Medicine, Clinical Embryology and Genetics; Head of the Department

kuzichkina@gmail.comПетроваАльбина АнатольевнаPetrovaAl'bina A.

кандидат биологических наук, врач эмбриолог

Candidate of Biological Sciences, Doctor of Embryology

oks-shurygina@yandex.ruМинаеваТатьяна ВасильевнаMinaevaTat'yana V.

врач-эмбриолог

Doctor of Embryology

dr.popovaoo@outlook.comhttps://orcid.org/0000-0003-4920-2511ШурыгинСергей АлександровичShuryginSergey A.

кандидат медицинских наук, ассистент кафедры анатомии и морфологии 

Candidate of Medical Sciences, assistant of the Department of Anatomy and Morphology

oks-shurygina@yandex.ruСамарский государственный медицинский университет, СамараРоссияSamara State Medical University, SamaraRussian FederationУниверситет Святого Иосифа в Танзании, Дар-эс-СаламТанзанияSt. Joseph University in Tanzania, Dar es SalaamUnited Republic of TanzaniaСамарский государственный медицинский университет; Медицинская компания ИДК группа компаний «Мать и дитя», СамараРоссияSamara State Medical University; Medical Company IDK of the «Mother and Child» Group of Companies, SamaraRussian FederationМедицинская компания ИДК группа компаний «Мать и дитя», СамараРоссияMedical Company IDK of the «Mother and Child» Group of Companies, Samara,Russian FederationМедицинская компания ИДК группа компаний «Мать и дитя», СамараРоссияMedical Company IDK of the «Mother and Child» Group of Companies, SamarRussian FederationМедицинский университет «РЕАВИЗ», СамараРоссияMedical University REAVIZ, SamaraRussian Federation202526012026334id-991Copyright © Попова О.О., Шурыгина О.В., Юхимец С.Н., Сараева Н.В., Петрова А.А., Минаева Т.В., Шурыгин С.А., 20262026Попова О.О., Шурыгина О.В., Юхимец С.Н., Сараева Н.В., Петрова А.А., Минаева Т.В., Шурыгин С.А.Popova O.O., Shurygina O.V., Yukhimets S.N., Saraeva N.V., Petrova A.A., Minaeva T.V., Shurygin S.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.morpholetter.com/jour/article/view/991

Актуальность. Компетентность ооцита является определяющим фактором успешного оплодотворения и развития эмбриона. Низкое качество ооцитов может приводить к отсутствию оплодотворения или остановке развития эмбрионов in vitro. Для преодоления недостаточной активации ооцитов у пациенток с неудачами оплодотворения и неудовлетворительным качеством эмбрионов в анамнезе предлагается проведение искусственной активации ооцитов с помощью ионофоров кальция (АОА). Анализ эффективности использования данной технологии представляет интерес для специалистов фундаментальной медицины, а также клиник вспомогательных репродуктивных техно-логий (ВРТ).Цель исследования: оценить эффективность активации ооцитов ионофором Ca²⁺ на эмбриологическом этапе про-грамм ВРТ у пациентов с предыдущими неудачными попытками лечения бесплодия.Материалы и методы. Проведено ретроспективное когортное сравнительное исследование на базе ЗАО «Клинический госпиталь "Мать и дитя"» (Самара) в период с января по декабрь 2024 года. Группа исследования (n=35): циклы с применением АОА ионофором кальция (A23187, Sigma) после ИКСИ по медицинским показаниям (низкий процент оплодотворения в анамнезе). Контрольная группа (n=61): циклы со стандартной процедурой ИКСИ без применения активации. Критерии включения: возраст 18–43 лет, использование спермы партнёра, наличие полных данных о культивировании до 5-х суток. Для подготовки клеток и проведения ИКСИ использовали среды Vitrolife (Sweden). Клетки получали путём трансвагинальной аспирации фолликулов через 36–37 часов после триггера овуляции. После ИКСИ клетки выдерживали в среде с ионофором Ca²⁺ (концентрация 10 мМ) 8–10 минут при 6% CO₂, 5% O₂ и температуре +37°C. Для оценки качества эмбрионов использовали балльную систему, основанную на критериях Gardner et al. (1999), модифицированную с учётом дополнительных морфологических параметров.Результаты. Основные параметры – частота оплодотворения, частота дробления и частота формирования бластоцист – не имели значимых отличий между группами (p>0,05). Существенное отличие отмечено только по среднему баллу эмбрионов на перенос (2,91±2,09 vs 3,98±1,41, p=0,008). Показатели частоты наступления клинической беременности, подтверждённой УЗИ (36,0% vs 30,4%), и частоты имплантации (27,3% vs 23,8%) оставались сопоставимыми (p>0,05). Выявлен клинически значимый тренд к снижению разницы между показателями беременности, установленной по определению положительного уровня ХГЧ, и частотой клинической беременности (4% vs 10,7% в контроле), что может свидетельствовать о более высокой компетенции эмбрионов в группе АОА и снижении ранних репродуктивных потерь.Заключение. Искусственная активация ооцитов ионофорами кальция не приводит к статистически значимому улучшению основных эмбриологических показателей, но демонстрирует тенденцию к снижению разницы между биохимической и клинической беременностью, что может указывать на повышение качества эмбрионов у пациентов с неблагоприятным репродуктивным анамнезом. Для получения более достоверных выводов требуется накопление информации и проведение мультицентровых рандомизированных исследований с увеличенным объёмом выборки.

Background. Oocyte competence is a determinant of successful fertilization and embryo development. Poor oocyte quality may lead to fertilization failure or in vitro embryo developmental arrest. Artificial oocyte activation (AOA) using calcium ionophores has been proposed to overcome oocyte activation deficiency in patients with fertilization failure and unsatisfactory embryo quality. The effectiveness of this technology is of interest to fundamental medicine specialists and ART clinics.Aim. To evaluate the effectiveness of calcium ionophore-mediated oocyte activation at the embryological stage of assisted reproductive technology (ART) programs in patients with previous unsuccessful infertility treatments.Materials and Methods. A retrospective cohort comparative study was conducted at the Clinical Hospital "Mother and Child" (Samara) from January to December 2024. Study group (n=35): cycles with AOA using calcium ionophore (A23187, Sigma) after ICSI by medical indications (low fertilization rate in history). Control group (n=61): cycles with standard ICSI procedure without activation. Inclusion criteria: age 18–43 years, partner sperm use, complete data on culture up to day 5. Vitrolife media (Sweden) were used for cell preparation and ICSI. Cells were obtained by transvaginal follicular aspiration 36–37 hours after ovulation trigger. After ICSI, cells were in-cubated in medium with Ca²⁺ ionophore (10 mM concentration) for 8–10 minutes at 6% CO₂, 5% O₂, and +37°C. Embryo quality was assessed using a scoring system based on Gardner et al. (1999) criteria, modified with additional morphological parameters.Results. Main parameters–fertilization rate, cleavage rate, and blastocyst formation rate–showed no significant differences between groups (p>0.05). A significant difference was observed only in mean embryo score at trans-fer (2.91±2.09 vs 3.98±1.41, p=0.008). Clinical pregnancy rate confirmed by ultrasound (36.0% vs 30.4%) and implantation rate (27.3% vs 23.8%) remained comparable (p>0.05). A clinically significant trend toward re-duced difference between positive hCG and clinical pregnancy rate (4% vs 10.7% in control) was revealed, sug-gesting higher embryo competence in the AOA group and reduced early reproductive loss.Conclusion. Calcium ionophore artificial oocyte activation does not lead to statistically significant improvement in main embryological parameters but demonstrates a trend toward reducing the gap between biochemical and clinical pregnancy, which may indicate improved embryo quality in patients with adverse reproductive history. Data accumulation and multicenter randomized studies with increased sample size are required for more reliable conclusions.

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The authors declare that there are no conflicts of interest present.