Could Antimullerian Hormone Play a Role in Fertilization Failure in ICSI Application

Aim: Failed fertilization (FF) occurs in approximately 2–3% of ICSI cycles and is mainly due to lack of oocyte activation. The reasons of total fertilization insufficiency in ICSI applications can be listed as mitosis errors, sperm aster formation defects, sperm decondensation defects, PN formation defects and oocyte activation defects. In this study, sperm functions, oocyte morphology, hormone levels and possible effects of gonadotropins used in the treatment were investigated retrospectively. Material and Methods: In this study, semen parameters and sperm functions, oocyte morphology, basal hormone values and treatment processes of 32 fertilization failure cases and 91 fertile controls were compared. Results: It was found that age of female and male, basal FSH value and gonadotropin used in the treatment process were higher in total fertilization failure cases compared to fertile controls (p = 0.004, p = 0.041, p = 0.008, p = 0.004). Basal AMH level, total oocyte count, M2 oocyte count, quality oocyte count and normal ZP percentage were lower in fertilization failure cases (p = 0.002, p = 0.000, p = 0.000, p = 0.008, p = 0.000). There was no statistically significant difference between the two groups in terms of sperm functions. Conclusions: It was understood that high FSH and low AMH levels and high-dose gonadotropin treatment in cases with optimal sperm quality may cause oocyte cytoplasmic and zona pellucida abnormalities, and it should be discussed as a cause of fertilization failure.