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Artificial egg activation calcium ionophore

Treatment add-on

Artificial egg activation calcium ionophore is rated amber

Artificial egg activation calcium ionophore is rated amber

Amber

What does this traffic light rating mean?

The traffic light rating system consists of three colours that indicate whether the evidence, in the form of high-quality randomised control trials (RCTs), shows that a treatment add-on can safely improve the live birth rate for someone undergoing fertility treatment.

We give an amber symbol for an add-on where there is conflicting evidence to show that an add-on can improve live birth rates, or that the add-on is safe for patients to use. This means that the evidence is not conclusive and further research is required, and the add-on should not be recommended for routine use.

What is egg activation?

When a sperm meets an egg, it triggers a process called ‘egg activation’ which starts off the process of embryo development, while at the same time allowing only one sperm to fertilise the egg. If the egg doesn’t activate, then it won’t develop.

Egg (or oocyte) activation may be stimulated by chemicals called calcium ionophores. These chemicals can be added to the embryo in the lab.

Are there any risks?

In theory, egg activation using calcium ionophores could cause embryos to have abnormal numbers of chromosomes, which would cause the pregnancy to miscarry. Currently, there’s not enough evidence to decide whether these risks are a serious concern.

Given the possible risks, clinics offering this treatment should only do so for selected patients who have had failed fertilisation and should be able to justify their reasons for doing so.

What’s the evidence for egg activation?

At the October 2019 Scientific and Clinical Advances Advisory Committee (SCAAC) meeting the Committee evaluated the evidence base for egg activation. Minutes of this discussion and the evidence used to inform this discussion is available here.

In the few studies done to date, egg activation using calcium ionophores may improve fertilisation rates in ICSI cycles where the egg and sperm have failed to activate in previous treatment cycles. However, there are no RCTs to show that it is effective and there are no follow up studies on the safety of this technique.

What are treatment add-ons?

Treatment add-ons are optional additional treatments that you may be offered on top of your routine fertility treatment, often at an additional cost. Some clinics may refer to treatments add-ons as ‘supplementary’ or ‘embryology treatments’. There are a wide range of treatment add-ons on offer including tests, drugs, equipment, holistic or alternative therapies, and surgical interventions.

However, all treatment add-ons share one common characteristic: they claim to improve the chances of having a baby (live birth rate). Evidence on whether some treatment add-ons are safe or effective is often missing or absent. These claims can attract a lot of attention with many patients opting for a treatment add-on thinking that it may be the best option for them despite there being little or no evidence to prove it is.

Treatment add-ons have varying levels of scientific evidence to support their effectiveness and safety and, at times, this evidence can be contradictory. It is important to keep in mind that for most patients, routine fertility treatment is an effective option on its own.

We aim to publish clear and reliable information about some of the treatment add-ons that lack sufficient evidence to show that they are effective and/or safe. This allows patients to make an informed decision about whether using a treatment add-on as part of their treatment is the best option for them.

To make it easier to understand the scientific evidence for each treatment add-on we have developed the HFEA’s traffic-light rated list of add-ons.

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Review date: 25 August 2022

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