Genetic polymorphisms of serotonin transporter and receptor 1A could influence success during embryo implantation and maintenance of pregnancy

OBJECTIVE

To explore whether serotonin-related gene polymorphisms influence clinical outcomes of IVF treatment in recipients using donated oocytes.

DESIGN

Nested case-control study.

SETTING

University-affiliated infertility clinic.

PATIENT(S)

Two hundred forty-five women undergoing IVF treatment with donated oocytes.

INTERVENTION(S)

None.

MAIN OUTCOME MEASURE(S)

Genotype and haplotype analysis of the serotonin transporter-linked polymorphic region (5-HTTLPR), rs1800532, rs6295, rs6313, and rs3813929, between recipients grouped according to the results of the oocyte donation for IVF treatment.

RESULT(S)

No differences were found between genotype distribution of the tryptophan hydroxylase 1, serotonin receptor 2A, and serotonin receptor 2C polymorphisms. Recipients carrying the LL genotype for 5-HTTLPR had lower clinical pregnancy rates (PR) and higher biochemical pregnancy loss (BPL) events. Lower implantation rates were found in CC carriers for 5-HT1A.rs6295 who also presented higher BPL rates. A lower incidence of clinical pregnancy was observed for LC haplotypes, corresponding to an increase in BPL rates.

CONCLUSION(S)

A strong association was found between early pregnancy loss and recipients carrying the 5-HTTLPR and rs6295 genetic variants. Identifying biological processes involving serotonin and embryo implantation may help to understand the dynamics of the maternal-embryo dialogue.

Concentration of Glutathione and Expression of Glutathione Peroxidases 1 and 4 in Fresh Sperm Provide a Forecast of the Outcome of Cryopreservation of Human Spermatozoa

Oxidative stress imbalance potentially leads to damage of the structure of the cell and macromolecules such as plasma membrane components, proteins, and DNA. The plasma membrane of the sperm cell, which has high levels of polyunsaturated fatty acids, renders it particularly sensitive to free radical-mediated attacks. The freezing and subsequent thawing of sperm is a physically stressful process carried out during routine procedures in assisted reproduction techniques, which results in a highly variable and unpredictable reduction in the number of motile sperm cells. Subsequently, oxidative status can positively or negatively affect the motility, viability, and fertilizing capacity of thawed sperm. These effects are counteracted by various oxidative defense enzymes and anti-oxidants such as glutathione peroxidase isoforms GPx1 and GPx4, glutathione reductase (GR), and cellular glutathione (reduced) (GSH). In this way, oxidative status could represent a predictive marker of sperm quality following the freeze-thaw process. This study was based on 56 human sperm samples. We observed direct positive and negative relationships between the postthaw motile sperm recovery rate and GPx1 and GPx4 expression and activity, on the one hand, and GSH concentrations, on the other. No correlation was found between this recovery rate and GR or basic semen parameters. Predictive values clearly demonstrate that, among the molecules analyzed, the most accurate diagnoses result when analyses are conducted for GPx1 and GPx1 messenger RNA expression, GPx1 and GPx4 enzymatic activity, and GSH concentration. In conclusion, a reserve of glutathione, together with GPx expression, is necessary to eliminate free radicals using GSH or a like structural protein and seems to be essential for a good postthaw recovery. These molecules can be employed as indicators of postthaw sperm quality.

Semen samples showing an increased rate of spermatozoa with imprinting errors have a negligible effect in the outcome of assisted reproduction techniques

The topic of imprinting defects present in the sperm of infertile patients has been addressed by several reports in the last few years. However, whether methylation abnormalities at one or few CpGs within an imprinted locus are pathological is a matter of debate. Moreover, whether imprinting anomalies in sperm could interfere with fertility treatment outcomes is still unknown. In this report we analyze the sperm DNA methylation profile of H19-ICR, KvDMR, SNRPN-ICR, IG-DMR and MEG3-DMR by pyrosequencing in 107 infertile men series and a control population of 30 proven fertile males. DNA methylation was statistically evaluated from two points of view: first, the methylation of each CpG was analyzed in the control population and the mean, standard deviation and range were determined and compared with infertile population data; second, in order to define altered methylation patterns for each region, a hierarchical cluster analysis was performed by which individuals were grouped in different clusters according to the degree of similarity of their methylation pattern. Two pieces of data supported the results obtained in the multi-variate analysis: the classification of the vast majority of control individuals in clusters with normal methylation patterns and the significant differences in methylation levels found between individuals within the normal and abnormal clusters. Individuals included in normal and abnormal methylation clusters were compared according to seminal parameters as well as to the outcome of assisted reproduction.

Cumulative newborn rates increase with the total number of transferred embryos according to an analysis of 15,792 ovum donation cycles

OBJECTIVE

To measure the success of in vitro fertilization (IVF) of donated ova according to cumulative newborn rates (CNBR) per number of embryos required to achieve at least one newborn (EmbR), considering in addition the relevance of age and infertility etiology.

DESIGN

Survival curves and Kaplan-Meier methods were employed to analyze CNBR with respect to the number of EmbR in a retrospective cohort of oocyte donation recipients.

SETTING

University-affiliated infertility center.

PATIENT(S)

Infertile couples undergoing IVF with oocyte donation.

INTERVENTION(S)

None.

MAIN OUTCOME MEASURE(S)

CNBR per EmbR.

RESULT(S)

The CNBR increased radically (up to 64.8%) between 1 and 5 EmbR, moderately (85.2%) between 5 and 15, and slowly thereafter, reaching a plateau at 15 embryos (92.4%) and peaking after 25 EmbR (96.8%), thus demonstrating that the chances of success vary as failed attempts accumulate. Patient age was not a negative factor, and indication for oocyte donation was also irrelevant to the outcome. The data showed an overall mean number of 2.6 embryo transfers and 5.8 transferred embryos per newborn.

CONCLUSION(S)

The relationship between CNBR and number of EmbR provides pragmatic and exact information about the probability of success with oocyte donation, which is of obvious relevance to patient counseling.

Female overweight is not associated with a higher embryo euploidy rate in first trimester miscarriages karyotyped by hysteroembryoscopy

Overweight women (body mass index ≥ 25 kg/m(2)) present an embryo euploidy rate in first trimester miscarriages similar to normoweight controls after a selective biopsy and karyotyping of embryo and/or chorion samples taken by hysteroembryoscopy.

Cumulative live-birth rates per total number of embryos needed to reach newborn in consecutive in vitro fertilization (IVF) cycles: a new approach to measuring the likelihood of IVF success

OBJECTIVE

To report the use of cumulative live-birth rates (CLBRs) per ovarian stimulation cycle to measure the success of IVF is proving to be the most accurate method for advising couples who failed to conceive, although the accuracy yielded is relatively low, and cycle outcome is highly dependent on the number of embryos replaced. Our aim with this work is to report the CLBRs of IVF as a function of the number of embryos required to reach a live birth (EmbR), considering age, day of ET, and infertility etiology.

DESIGN

Survival curves and Kaplan-Meier methods to analyze CLBR in a retrospective cohort with respect to the number of EmbR.

SETTING

University-affiliated infertility center.

PATIENT(S)

Infertile couples undergoing IVF using own oocytes.

INTERVENTION(S)

None.

MAIN OUTCOME MEASURE(S)

CLBR per embryo transferred.

RESULT(S)

CLBRs increase rapidly between 1 and 5 EmbR, moderately between 5 and 15, and slowly thereafter. Live-birth rates rise more slowly when embryos are transferred on days 2-3 rather than on days 5-6, with comparable long-term results. Women's age is a negative factor from 35 to 37 years old, with a dramatic decrease in live-birth rates beyond age 40 years. In addition, there are significant worse results in endometriosis patients.

CONCLUSION(S)

The relationship between CLBR and number of EmbR provides realistic and precise information regarding IVF success and can be used to guide couples and practitioners.

Embryo quality, blastocyst and ongoing pregnancy rates in oocyte donation patients whose embryos were monitored by time-lapse imaging

PURPOSE

In the current study, our aim was to demonstrate that EmbryoScope incubation conditions is comparable to standard laboratory incubation circumstances by comparing embryo quality, development and ongoing pregnancy rates between the EmbryoScope (ES) and a standard incubator (SI). We analyzed 478 embryos from 60 couples undergoing oocyte donation were included in the study.

METHODS

All embryos retrieved from a patient were randomly distributed in the ES or SI. We calculated blastocyst development rate, blastocyst viability and ongoing pregnancy rate for embryo transfers from ES, SI and mixed (one embryo from the ES and one from the SI). Statistical analysis was conducted by Chi square tests, considering p < 0.05 significant.

RESULTS

No significant differences were found between the ES and SI from all the parameters evaluated.

CONCLUSIONS

Thus we concluded that time-lapse monitoring in the EmbryoScope does not impair embryo quality while allowing for morphological, spatial and temporal analysis of embryo development.

Force production and spatial arm coordination profile in arm crawl swimming in a fixed position

This study analyzed the relationship between mechanical force production and spatial arm position of the swimming movement for each side of the swimmer. Eight internationally recognized male swimmers performed fix positioned arm only swimming with a dynamometer synchronized with underwater cameras. The upper arm positions (α in side, β in frontal view) and the elbow angles (γ in 3D) were determined at the moment where the force production reached the peak (Fmax) and the maximal values of rate of force development (RFDmax). RFDmax and α values showed significant differences between the sides (P<0.05). To show the motion integration structure of the performance, Multiple Regression Analysis (MRA) was employed separately for both sides. For the criterion variable, the impulse of force (ImpF50%) was calculated. The defined parameters as the mechanical and spatial predictor system were used for the model. The results of the MRA showed that the predictor system yielded the model structure of the variables that explain the criterion variables for ImpF50% by the dominant (P=0.007) and by the nondominant side (P=0.001), respectively. The alternate contribution of the variables to the models can objectively express the performance difference between the two sides of the swimmer.

Differential transcriptomic profile in spermatozoa achieving pregnancy or not via ICSI

Basic sperm analysis is limited as a method of estimating pregnancy. This study’s objective was use of microarray technology to differentiate the gene expressions of spermatozoa that achieved pregnancy in an intracytoplasmic sperm injection (ICSI)cycle in an oocyte donation programme with those that did not achieve pregnancy. A study of nested cases and controls was designed to evaluate fresh and frozen spermatozoa from infertile males undergoing ICSI with donor oocytes. The global genome expression of pooled samples from each group (achieving pregnancy versus those that didn’t, from fresh or frozen spermatozoa)was compared using microarray analysis. The level of expression of some of the transcripts from fresh spermatozoa was shown to differ for those that achieved pregnancy versus those that didn’t. Additionally, exclusively expressed transcripts were identified for both outcome groups. Analysis of frozen spermatozoa didn’t reveal differential expression, but exclusively expressed transcripts were detected. Lists of the transcripts were systematically analysed using different databases in order to provide information about them and their relationship with male fertility. The results revealed profound differences between the expression profiles of spermatozoa that resulted in pregnancy versus those that didn’t. These differences may explain ICSI failure associated with male factor infertility.