Artificial oocyte activation with calcium ionophore does not cause a widespread increase in chromosome segregation errors in the second meiotic division of the oocyte 

Antonio Capalbo, Christian S. Ottolini, Darren K. Griffin, Filippo Maria Ubaldi, Alan H. Handyside, Laura Rienzi

Fertil Steril. 2016 Mar; 105(3):807-814.e2. doi: 10.1016/j.fertnstert.2015.11.017. Epub 2015 Dec 1




To study the effect of artificial oocyte activation (AOA) on chromosome segregation errors in the meiotic divisions.


Prospective cohort study with historical control.


Private/academic IVF centers.


Fifty-six metaphase II oocytes were donated from 12 patients who had undergone IVF between June 2008 and May 2009.


Oocytes were activated by 40 minutes’ exposure to 100 μM calcium-ionophore. The activated oocyte was tubed and analyzed by array comparative genomic hybridization and/or single-nucleotide polymorphism genotyping and maternal haplotyping (meiomapping). A control sample of embryos derived from normally fertilized oocytes was included for comparison.

Main Outcome Measure(s)

Incidence of chromosome segregation errors in artificially activated and normally fertilized oocytes in relation to pronuclear evaluation.


Of 49 oocytes that survived the warming procedure, thirty-nine (79.6%) activated. Most activated normally, resulting in extrusion of the second polar body and formation of a single or no pronucleus (2PB1PN: 30 of 39, 76.9%; or 2PB0PN: 5 of 39, 12.8%). Twenty-seven of these were analyzed, and 16 (59.3%) were euploid, showing no effect of AOA on meiotic segregation. Single-nucleotide polymorphism analysis of normally activated oocytes confirmed normal segregation of maternal chromosomes. No difference in the proportion of meiosis II type errors was observed between artificially activated oocytes (28.6%; 95% confidence interval 3.7%–71.0%) compared with embryos obtained from normally fertilized oocytes (44.4%; 95% confidence interval 13.7%–78.8%). The abnormally activated oocytes, with ≥2PN (4 of 39, 10.3%) were diploid, indicating a failure to coordinate telophase of meiosis II with polar body extrusion.


From this preliminary dataset, there is no evidence that AOA causes a widespread increase in chromosome segregation errors in meiosis II. However, we recommend that it be applied selectively to patients with specific indications.

Key Words

Calcium ionophore; chromosome segregation; fertilization failure; meiosis; oocyte activation