We have selected women for autologous mitochondrial injection based on previous poor embryo development and failed IVF cycles. EggPCs were isolated from ovarian biopsies, counted and if an adequate number were present, the EggPCs are frozen until the patient undergoes another fresh IVF cycle. On the day of oocyte retrieval, the EggPCs are thawed, the membranes disrupted and mitochondria concentrated by differential centrifugation. The EggPC-derived mitochondria are injected at the time of ICSI into the patient’s own oocytes. The autologous mitochondrial injection treatment is based on a wealth of preclinical and clinical data demonstrating that the addition of mitochondria during IVF treatment is safe, increases embryo quality and improves IVF success rates (25-27). Our own clinical experience, as well as that in Dubai (28) and in Turkey (29), has demonstrated improved embryo quality and pregnancy and live births similar to those seen with ooplasm injection previously. So far, more than a dozen healthy live births have been achieved in our clinic following autologous mitochondrial injection in poor prognosis women under the age of 40 years with previous failed cycles or poor embryo development. Unfortunately, our experience in older women suggests that oocyte aneuploidy is a major reason for lack of success with this treatment since there have been no ongoing pregnancies or live births in women over 40 years of age (table 1). Data regarding live births following autologous mitochondrial injection is being collected and entered into a worldwide registry to ultimately confirm the safety of this new procedure. Our data however, suggests that using EggPCs to improve mitochondrial energy production in oocytes and embryos may lead to better reproductive outcomes in cases of poor embryo development and recurrent failure of pregnancy. We believe that this process together with the addition of mitochondrial nutrients, such as coQ10 in order to enhance oocyte energy production before the resumption of meiosis may be a great combination for improving live birth rates difficult IVF patients in the future.