Recurrent spontaneous oocyte activation causes female infertility

Serdar Coskun, Sateesh Maddirevula, Khalid Awartani, Meshael Aldeery, Wafa Qubbaj, Junaid Kashir, Fowzan S. Alkuraya

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Purpose: Spontaneous oocyte activation (SOA) is a recently classified phenomenon characterized by the presence of a single pronucleus immediately following oocyte retrieval, without the apparent involvement of sperm. SOA currently remains poorly understood in humans, with no clear genetic or pathological factor(s). Herein, we report two separate cases of recurrent spontaneous oocyte activation, investigating potential avenues to identify causative etiology. Methods: Two patients with several cycles with SOA have undergone further genetic and embryologic investigation to reveal underlying causes for SOA and provide a treatment if possible. Results: One case was a patient with recurrent pregnancy loss and the other was diagnosed as unexplained infertility. In the first case, 61 out of 69 oocytes retrieved exhibited SOA in five cycles while in the second case 44 out of 49 oocytes exhibited SOA in five cycles. Oocytes were injected with sperm; embryo development and presence of paternal contribution were investigated. No pregnancy is ensued following embryo transfer in both patients. Time-lapse imaging of embryogenesis from the second case did not reveal even momentary second pronucleus appearance. We also performed clinical whole exome sequencing for both patients but did not identify any disease-causing variant. Conclusion: Patients with SOA suffer from infertility. Our results indicate that more investigation is required to understand the etiology of SOA in humans concentrating on the molecular mechanisms that underpin regulation of oocyte activation and calcium dynamics need to be investigated to fully understand, and perhaps in the future rectify, recurrent SOA.

Original languageBritish English
Pages (from-to)675-680
Number of pages6
JournalJournal of Assisted Reproduction and Genetics
Issue number3
StatePublished - Mar 2022


  • Genetic analysis
  • Paternal contribution
  • Recurrent pregnancy loss
  • Spontaneous oocyte activation
  • Unexplained infertility


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