الفهرس 
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Abstract
Oocyte degeneration happens even when ICSI is performed with the greatest caution, especially when the oocytes have extracytoplasmic dysmorphism (thick zona or large perivitelline spaces) or cytoplasmic dysmorphism (granular or vacuoles). Laser-assisted intracytoplasmic sperm injection (LA-ICSI), sometimes referred to as micro-opening or zona pellucida (ZP) thinning, may be able to mitigating mechanical degeneration to the oocyte prior to ICSI.
The purpose of this study
This study aimed to evaluate the effectiveness of a 1480 nm Diode Laser in improving human oocyte dysmorphisms and survival rates.
Study preparation and Description
• A moveable Saturn 5 active laser, ablation laser has 1480 nm wavelength, 400 mw power solid state diode laser and maximum pulse length 2.0 μs.
• Inverted microscope at x400 magnification using a Hoffman Modulation Contrast System.
The oocytes dysmorphisms were classified as follows:
1- Extra-cytoplasmic dysmorphism: alterations of the thick zona pellucida and large or wide perivittelline space.
2- Cytoplasmic dysmorphism: the presence of cytoplasmic granularity and vacuoles.
A total of 160 human oocytes with different dysmorphism were dividing into four groups.
• First group include thick zona oocytes .20 oocytes as control and 20 oocytes treated with laser.
• Second group include large or wide pervittelline space oocytes .20 oocytes as control and 20 oocytes treated with laser.
• Third group include cytoplasmic granularity oocytes .20 oocytes as control and 20 oocytes treated with laser.
• Fourth group include vacuolated cytoplasm oocytes .20 oocytes as control and 20 oocytes treated with laser.
Development of Oocytes, assessment of fertilization and Survival rate
Pronuclei and polar bodies were present 24 hours after microinjection, indicating normal fertilization. The number of blastomeres, division grade A or B, blastocyst quality and percentage of survival rate were all recorded for each embryo on the day of embryo cleavage, which occurred 48–72 hours after ICSI. This assessment of embryo quality, or embryo morphology, was carried out for each embryo.
Results of this study showed that:
A- As regarding the Thick Zona:
• The oocytes of (LA -ICSI) group had a significantly higher fertilization rate than oocytes (C-ICSI) group (100.0%) vs (60.0%) at (P, 0.005).
• The highest proportion (88.9%) of oocytes with grade (A) (LA -ICSI) vs (46.7%) (C-ICSI) group after 48 hour with a significant difference at (P, 0.006) was obtained.
• Blastocyst quality (AA) was (22.2%) for (LA -ICSI) vs (13.3%) for (C-ICSI) group.
• Blastocyst quality (AB) was (38.9%) for (LA -ICSI) vs (26.7%) for (C-ICSI) group.
• Survival rates of injected oocytes were higher in the LA-ICSI group (61.1%) compared with C-ICSI group (40.0%) although, these differences did not reach statistical significance LA-ICSI can assist oocytes with thick zona more than C-ICSI.
B- As regarding the wide pervitilline space (PVS):
• There was no significant difference in fertilization rate after 24h between the two techniques.
• After 48and 72h, (78.6%) were divided to grade (A) for (LA-ICSI) vs (47.1%) for (C- ICSI).
• Blastocyst formation with quality of (AA) was (57.1%) vs. (20.0%) for (LA- ICSI) and (C- ICSI).
• Survival rate (50.0%) for LA -ICSI C- ICSI vs (29.4%) for (C- ICSI) with no significant difference was observed.
C- As regarding the Granular Cytoplasm:
• Fertilization rate was (83.3%) for (LA- ICSI) vs (78.6%) for (C- ICSI).
• Blastocyst formation with quality of (AA) was (90.0%) vs (80.0%) for (LA- ICSI) and (C- ICSI).
• Survival rate (83.3%) for LA -ICSI C- ICSI vs (71.4%) for (C- ICSI) with no significant difference was observed.
D- As regarding the vacuolated cytoplasm.
• Degeneration and fertilization rates of oocyte was the same for two groups (20.0%) and (75.0%) respectively.
• After 72h, division grade (A) for (LA-ICSI) was higher (50.0%) than that (C- ICSI) (37.5%).
• Blastocyst formation quality (AA) appeared to be higher (75.0%) vs (50.0%) for (LA-ICSI) than that (C- ICSI).
• Survival rate was similar between two groups (75.0%).