Objective: To evaluate whether PIEZO-ICSI provides improved outcomes in embryonic development compared to conventional ICSI.

Methods: This experimental study analyzed 181 oocytes retrieved from 21 patients at the Mexican Institute of Infertility between March and April of the current year. Oocytes were inseminated either by conventional ICSI or PIEZO-ICSI. Embryo quality was assessed using Scott’s criteria for zygotes, ASEBIR classification for cleavage-stage embryos, and Gardner’s criteria for blastocysts. Statistical analyses were performed using JASP software, applying Chisquare tests for associations and ANOVA for group differences.In the second phase of the study, 235 fresh oocytes obtained between January and August 2025 from 39 patients were analyzed in the same manner.

Results: The mean patient age in the first phase was 37.2 ± 6.14 years. No statistically significant differences were observed between techniques in fertilization rate (p = 0.48), degeneration rate (p = 0.432), cleavage-stage embryo quality (p = 0.347), blastocyst formation rate (p = 0.827), or proportion of good-quality blastocysts (p = 1.000). However, subgroup analysis revealed a higher proportion of zygotes classified as Z1 with PIEZO-ICSI (p = 0.006), indicating superior pronuclear quality. Conversely, conventional ICSI yielded a higher frequency of cleavage-stage embryos graded as A (p < 0.001). In the second phase, with a mean patient age of 38.13 ± 3.4 years, the only significant difference was a lower frequency of D-quality cleavage-stage embryos in the PIEZO-ICSI group (p = 0.004).

Conclusions: PIEZO-ICSI results in superior pronuclear quality compared to conventional ICSI and produces fewer poor-quality cleavage-stage embryos in fresh cycles. Nonetheless, conventional ICSI was associated with a higher proportion of A-grade embryos at the cleavage stage when looking into all types of eggs origin. Blastocyst formation outcomes did not differ between techniques. Although results remain inconclusive, we believe that the adoption of the less invasive PIEZO.

To be Updated