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Total or near-total fertilization failure after intracytoplasmic sperm injection (ICSI) is a rare event,but it occurs repeatedly because of sperm defects in activating oocyte.The case presents a successful pregnancy and live birth after calcium ionophore A23187 (A23187) activation on one-day-old unfertilized oocytes in a patient whose husband suffered oligoasthenoteratozoospermia,and who had experienced repeated near-total fertilization failure after ICSI.In the second ICSI cycle,only one oocyte was fertilized while nine were unfertilized.Oocyte activation with A23187 were performed on the one-day-old unfertilized oocytes after ICSI and resulted in fertilization and embryo transfer.A clinical pregnancy was achieved and a healthy baby was born.To our knowledge,this is the first reported case of a healthy birth after oocyte activation on the one-day-old unfertilized oocyte.This indicates that “rescue oocyte activation” on one-day-old unfertilized oocytes after ICSI may be helpful for preventing total or near-total fertilization failure after ICSI.