In vitro fertilization (IVF) was initially implemented to overcome the tubal blockage. Subsequently, IVF treatment was extended for the treatment of female infertility to individuals with moderate male infertility. Afterward, with the advent of intracytoplasmic sperm injection (ICSI) into the field of infertility, treatment of male infertility was superseded.

In severe male infertility, when fertilization fails following routine ICSI or in couples with globozoospermic, severe teratozoospermic sperm or cases with testicular sperm extraction (TESE), ICSI can be further complemented by a procedure called " assisted or artificial oocyte activation" (AOA) to improve fertilization rate. There are various artificial methods for oocyte activation such as mechanical, chemical, electrical, and the use of recombinant PLCz, as the main factor involved in oocyte activation. In humans, oocyte activation is mostly accomplished through chemical stimuli like calcium Ionophores or strontium chloride. AOA can on one hand increased fertilization and pregnancy in these couples, on the other hand, has led to increased concerns regarding the future health of these children. Despite this concern, gene expression analysis in mice has shown that the transcriptomics of ICSI-AOA is more similar to IVF than conventional ICSI, indicating further research should be accomplished to evaluate whether ICSI-AOA should replace conventional ICSI. In this regard, recent studies showed that ICSI-AOA improves ICSI outcomes in couples with previous failed ICSI cycles.

Animal knockout studies have shown that the main sperm born factor accounting for oocyte activation is proved to be phospholipase C-zeta (PLCζ) but other factors are believed to complement this molecule. This factor induces intracellular calcium oscillation and based on these properties, calcium Ionophores or strontium chloride have been used to induce calcium oscillation to overcome failed fertilization in the severe male factor or in couples with a pronuclear arrest or retarded embryo development. Genetic mutation and polymorphisms have been shown to account for total or severely failed fertilization cases.

Topics for artificial oocyte activation:

1. Mechanism of mammalian oocyte activation.

2. Effects of artificial oocyte activation on ICSI outcomes in couples with failed fertilization.

3. Effects of artificial oocyte activation on ICSI outcomes in couples with teratozoospermia and globozoospermia.

4. Effects of artificial oocyte activation on ICSI outcomes following testicular sperm extraction (TESE).

5. Effects of artificial oocyte activation on ICSI outcomes in couples with previous failed ICSI cycle.

6. Effects of artificial oocyte activation on ICSI outcomes in couples with retarded embryo development.

7. Failed fertilization related to female oocyte factors.

8. Assessment of markers and tools for the prediction of oocyte activation potential.

9. Meta-analysis on clinical outcomes of artificial oocyte activation following ICSI.

10. Health status of children born through artificial oocyte activation.

11. Gene expression analysis in embryos derived from artificial oocyte activation.

12. Tracking research trends and hotspots in artificial oocyte activation for couples with male infertility: a sciento-metric analysis

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