Triploidy after in vitro fertilization: cytogenetic analysis of human zygotes and embryos

Common dysmorphic oocytes and embryos in assisted reproductive technology laboratory in association with gene alternations

Amorphic or defected oocytes and embryos are commonly observed in assisted reproductive technology (ART) laboratories. It is believed that a proper gene expression at each stage of embryo development contributes to the possibility of a decent-quality embryo leading to successful implantation. Many studies reported that several defects in embryo morphology are associated with gene expressions during in vitro fertilization (IVF) treatment. There is lacking literature review on summarizing common morphological defects about gene alternations. In this review, we summarized the current literature. We selected 64 genes that have been reported to be involved in embryo morphological abnormalities in animals and humans, 30 of which were identified in humans and might be the causes of embryonic changes. Five papers focusing on associations of multiple gene expressions and embryo abnormalities using RNA transcriptomes were also included during the search. We have also reviewed our time-lapse image database with over 3000 oocytes/embryos to show morphological defects possibly related to gene alternations reported previously in the literature. This holistic review can better understand the associations between gene alternations and morphological changes. It is also beneficial to select important biomarkers with strong evidence in IVF practice and reveal their potential application in embryo selection. Also, identifying genes may help patients with genetic disorders avoid unnecessary treatments by providing preimplantation genetic testing for monogenic/single gene defects (PGT-M), reduce embryo replacements by less potential, and help scientists develop new methods for oocyte/embryo research in the near future.

Parental genomes segregate into distinct blastomeres during multipolar zygotic divisions leading to mixoploid and chimeric blastocysts

Background

During normal zygotic division, two haploid parental genomes replicate, unite and segregate into two biparental diploid blastomeres.

Results

Contrary to this fundamental biological tenet, we demonstrate here that parental genomes can segregate to distinct blastomeres during the zygotic division resulting in haploid or uniparental diploid and polyploid cells, a phenomenon coined heterogoneic division. By mapping the genomic landscape of 82 blastomeres from 25 bovine zygotes, we show that multipolar zygotic division is a tell-tale of whole-genome segregation errors. Based on the haplotypes and live-imaging of zygotic divisions, we demonstrate that various combinations of androgenetic, gynogenetic, diploid, and polyploid blastomeres arise via distinct parental genome segregation errors including the formation of additional paternal, private parental, or tripolar spindles, or by extrusion of paternal genomes. Hence, we provide evidence that private parental spindles, if failing to congress before anaphase, can lead to whole-genome segregation errors. In addition, anuclear blastomeres are common, indicating that cytokinesis can be uncoupled from karyokinesis. Dissociation of blastocyst-stage embryos further demonstrates that whole-genome segregation errors might lead to mixoploid or chimeric development in both human and cow. Yet, following multipolar zygotic division, fewer embryos reach the blastocyst stage and diploidization occurs frequently indicating that alternatively, blastomeres with genome-wide errors resulting from whole-genome segregation errors can be selected against or contribute to embryonic arrest.

Conclusions

Heterogoneic zygotic division provides an overarching paradigm for the development of mixoploid and chimeric individuals and moles and can be an important cause of embryonic and fetal arrest following natural conception or IVF.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13059-022-02763-2.

Histone demethylase KDM4A overexpression improved the efficiency of corrected human tripronuclear zygote development

Human zygotes are difficult to obtain for research because of limited resources and ethical debates. Corrected human tripronuclear (ch3PN) zygotes obtained by removal of the extra pronucleus from abnormally fertilized tripronuclear (3PN) zygotes are considered an alternative resource for basic scientific research. In the present study, eight-cell and blastocyst formation efficiency were significantly lower in both 3PN and ch3PN embryos than in normal fertilized (2PN) embryos, while histone H3 lysine 9 trimethylation (H3K9me3) levels were much higher. It was speculated that the aberrant H3K9me3 level detected in ch3PN embryos may be related to low developmental competence. Microinjection of 1000 ng/µl lysine-specific demethylase 4A (KDM4A) mRNA effectively reduced the H3K9me3 level and significantly increased the developmental competence of ch3PN embryos. The quality of ch3PN zygotes improved as the grading criteria, cell number and pluripotent expression significantly increased in response to KDM4A mRNA injection. Developmental genes related to zygotic genome activation (ZGA) were also upregulated. These results indicate that KDM4A activates the transcription of the ZGA program by enhancing the expression of related genes, promoting epigenetic modifications and regulating the developmental potential of ch3PN embryos. The present study will facilitate future studies of ch3PN embryos and could provide additional options for infertile couples.

Novel mutations in TUBB8 expand the mutational and phenotypic spectrum of patients with zygotes containing multiple pronuclei

After fertilization, parental chromosomes decondense and form pronuclei. During these processes, germ cell genomes merge and give rise to the zygotic genome. Multiple pronuclei (MPN) formation is usually caused by polyspermic fertilization or oocyte-derived meiotic failure, and account for 15-18% of cytogenetically abnormal cases among spontaneous abortions. However, pathogenic gene mutations responsible for human MPN formation still need to be identified. Tubulin β eight class VIII (TUBB8) is the major β-tubulin isotype that assembles the human oocyte spindle. In this study, we identified 3 novel heterozygous missense mutations (c.524 T > C [p.V175A], c.10_12delins CTT [p.I4L], and c.1045 G > A [p.V349I]) in TUBB8 that were associated with a new phenotype: MPN in zygotes after in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI). These mutations were found in 3 independent female patients with infertility, and had experienced 2-3 failed IVF/ICSI attempts due to zygotic developmental arrest. These sites are evolutionarily conserved in primate TUBB8 genes as well as in other human β-tubulin isotypes, suggesting that they have important biochemical functions. This finding reveals previously unreported phenotypes caused by TUBB8 mutations and will be helpful for future genetic counseling of infertile patients with MPN.

Homozygous mutations in REC114 cause female infertility characterised by multiple pronuclei formation and early embryonic arrest

BACKGROUND

Abnormal pronuclear formation during fertilisation and subsequent early embryonic arrest results in female infertility. In recent years, with the prevalence of assisted reproductive technology, a few genes have been identified that are involved in female infertility caused by abnormalities in oocyte development, fertilisation and embryonic development. However, the genetic factors responsible for multiple pronuclei formation during fertilisation and early embryonic arrest remain largely unknown.

OBJECTIVE

We aim to identify genetic factors responsible for multiple pronuclei formation during fertilisation or early embryonic arrest.

METHODS

Whole-exome sequencing was performed in a cohort of 580 patients with abnormal fertilisation and early embryonic arrest. Effects of mutations were investigated in HEK293T cells by western blotting and immunoprecipitation, as well as minigene assay.

RESULTS

We identified a novel homozygous missense mutation (c.397T>G, p.C133G) and a novel homozygous donor splice-site mutation (c.546+5G>A) in the meiotic gene REC114. REC114 is involved in the formation of double strand breaks (DSBs), which initiate homologous chromosome recombination. We demonstrated that the splice-site mutation affected the normal alternative splicing of REC114, while the missense mutation reduced the protein level of REC114 in vitro and resulted in the loss of its function to protect its partner protein MEI4 from degradation.

CONCLUSIONS

Our study has identified mutations in REC114 responsible for human multiple pronuclei formation and early embryonic arrest, and these findings expand our knowledge of genetic factors that are responsible for normal human female meiosis and fertility.

Zygotes segregate entire parental genomes in distinct blastomere lineages causing cleavage-stage chimerism and mixoploidy

Dramatic genome dynamics, such as chromosome instability, contribute to the remarkable genomic heterogeneity among the blastomeres comprising a single embryo during human preimplantation development. This heterogeneity, when compatible with life, manifests as constitutional mosaicism, chimerism, and mixoploidy in live-born individuals. Chimerism and mixoploidy are defined by the presence of cell lineages with different parental genomes or different ploidy states in a single individual, respectively. Our knowledge of their mechanistic origin results from indirect observations, often when the cell lineages have been subject to rigorous selective pressure during development. Here, we applied haplarithmisis to infer the haplotypes and the copy number of parental genomes in 116 single blastomeres comprising entire preimplantation bovine embryos (n = 23) following in vitro fertilization. We not only demonstrate that chromosome instability is conserved between bovine and human cleavage embryos, but we also discovered that zygotes can spontaneously segregate entire parental genomes into different cell lineages during the first post-zygotic cleavage division. Parental genome segregation was not exclusively triggered by abnormal fertilizations leading to triploid zygotes, but also normally fertilized zygotes can spontaneously segregate entire parental genomes into different cell lineages during cleavage of the zygote. We coin the term "heterogoneic division" to indicate the events leading to noncanonical zygotic cytokinesis, segregating the parental genomes into distinct cell lineages. Persistence of those cell lines during development is a likely cause of chimerism and mixoploidy in mammals.

Triploid human embryonic stem cells derived from tripronuclear zygotes displayed pluripotency and trophoblast differentiation ability similar to the diploid human embryonic stem cells

Because the diploid human embryonic stem cells (hESCs) can be successfully derived from tripronuclear zygotes thus, they can serve as an alternative source of derivation of normal karyotype hESC lines. The aim of the present study was to compare the pluripotency and trophoblast differentiation ability of hESCs derived from tripronuclear zygotes and diploid hESCs. In the present study, a total of 20 tripronuclear zygotes were cultured; 8 zygotes developed to the blastocyst stage and 1 hESC line was generated. Unlike the previous studies, chromosomal correction of tripronuclear zygotes during derivation of hESCs did not occur. The established line carries 3 sets of chromosomes and showed a numerical aberration. Although the cell line displayed an abnormal chromosome number, it was found the cell line has been shown to be pluripotent with the ability to differentiate into 3 embryonic germ layers both in vitro and in vivo. The expression of X inactive specific transcript (XIST) in mid-passage (passage 42) of undifferentiated triploid hESCs was detected, indicating X chromosome inactivation of the cell line. Moreover, when this cell line was induced to differentiate toward the trophoblast lineage, morphological and functional trophoblast cells were observed, similar to the diploid hESC line.

Pronuclear removal of tripronuclear zygotes can establish heteroparental normal karyotypic human embryonic stem cells

PURPOSE

This study aimed to derive heteroparental normal karyotypic human embryonic stem cells (hESCs) from microsurgically corrected tripronuclear (3PN) zygotes.

METHODS

After sequential culture for 5-6 days, embryos developed from microsurgically corrected 3PN zygotes were analyzed by fluorescence in situ hybridization (FISH) using probes for chromosomes 17, X and Y. Intact 3PN zygotes from clinical in vitro fertilization (IVF) cycles were cultured as the control group. The inner cell mass (ICM) of blastocysts that developed from microsurgically corrected 3PN zygotes was used to derive hESC lines, and the stem cell characteristics of these lines were evaluated. G-banding analysis was adopted to identify the karyotype of the hESC line, and the heteroparental inheritance of the hESC line was analyzed by DNA fingerprinting analysis.

RESULTS

The blastocyst formation rate (13.5 %) of the microsurgically corrected 3PN zygotes was significantly higher (P < 0.05) than that of intact 3PN zygotes (8.7 %). The diploid rate of the blastocysts (55.0 %) was significantly higher (P < 0.05) than that of the arrested cleavage-stage embryos (18.4 %) in microsurgically corrected 3PN zygotes. The triploid rate of the microsurgically corrected 3PN zygotes (5.7 %) was significantly lower (P < 0.01) than that of intact 3PN zygotes (19.4 %). Furthermore, we established one heteroparental normal karyotypic hESC line from the microsurgically corrected tripronuclear zygotes.

CONCLUSIONS

Pronuclear removal can effectively remove the surplus chromosome set of 3PN zygotes. A combination of pronuclear removal and blastocyst culture enables the selection of diploidized blastocysts from which heteroparental normal karyotypic hESC lines can be derived.

The parental origin correlates with the karyotype of human embryos developing from tripronuclear zygotes

Objective

It has previously been suggested that embryos developing from intracytoplasmic sperm-injected (ICSI) zygotes with three pronuclei (3PN) are endowed with a mechanism for self-correction of triploidy to diploidy. 3PN are also observed in zygotes after conventional in vitro fertilization (IVF). The parental origin, however, differs between the two fertilization methods. Whereas the vast majority of 3PN IVF zygotes are of dispermic origin and thus more likely to have two centrioles, the 3PN ICSI zygotes are digynic in origin and therefore, more likely to have one centriole. In the present study, we examine whether the parental origin of 3PN embryos correlates with the karyotype.

Methods

The karyotype of each nucleus was estimated using four sequential fluorescence in situ hybridizations-each with two probes-resulting in quantitative information of 8 different chromosomes. The karyotypes were then compared and correlated to the parental origin.

Results

3PN ICSI embryos displayed a significantly larger and more coordinated reduction from the assumed initial 3 sets of chromosomes than 3PN IVF embryos.

Conclusion

The differences in the parental origin-and hence the number of centrioles-between the 3PN IVF and the 3PN ICSI zygotes are likely to be the cause of the differences in karyotypes.

Embryo developmental potential of microsurgically corrected human three-pronuclear zygotes

We explored the embryo development potential of human three-pronuclear (3PN) zygotes reduced to two-pronuclear (2PN) zygotes (3 → 2PN zygotes) by micropuncture. In this study, there were three groups, the 3 → 2PN group (338 zygotes), the non-corrected 3PN group (381 zygotes), and the normal 2PN group (359 zygotes). The first cleavage mode (2-cell cleavage or 3-cell cleavage), 6-8 cell embryogenesis rate, high-quality embryogenesis rate and Day 5/Day 6 blastulation rate were compared between the three groups. The success rate of enucleation was 92.9%. The 2-cell cleavage rate was significantly higher in the 3 → 2PN group (74.3%) than in the 3PN group (36.4%) (P < 0.05), but had no statistical difference compared with the 2PN group (86.0%) (P > 0.05). The 6-8 cell embryogenesis rate was significantly higher in the 3 → 2PN group (91.1%) as compared to the 2PN group (85.6%) (P < 0.05), but had no statistical difference compared with the 3PN group (95.0%) (P > 0.05). Total blastulation rate was significantly higher in the 2PN group (58.8%) as compared to the 3PN group (21.5%) (P < 0.01), and in the 3 → 2PN group as compared to the 3PN group (5.6%) (P < 0.01). Also D5 blastulation rate was significantly higher in the 2PN group (53.7%) as compared to the 3 → 2PN group (8.9%) (P < 0.01), and in the 3 → 2PN group as compared to the 3PN group (1.9%) (P < 0.01). In 3 → 2PN zygotes, the first cleavage mode is mainly 2 cells which is significantly higher than that in 3PN zygotes. Compared with 3PN zygotes, the embryo developmental potential of 3 → 2PN zygotes is improved, but still is lower than that in 2PN zygotes.

Altered cleavage patterns in human tripronuclear embryos and their association to fertilization method: a time-lapse study

PURPOSE

To analyze the cleavage patterns in dipronuclear (2PN) and tripronuclear (3PN) embryos in relation to fertilization method.

METHOD

Time-lapse analysis.

RESULTS

Compared to 2PN, more 3PN IVF embryos displayed early cleavage into 3 cells (p < 0.001), displayed longer duration of the 3-cell stage (p < 0.001), and arrested development from the compaction stage and onwards (p < 0.001). For the IVF embryos, the 2nd and 3rd cleavage cycles were completed within the expected time frame. However, timing of the cell divisions within the cleavage cycles differed between the two groups. In contrast, the completion of the 1st, 2nd, and 3rd cleavage cycle was delayed, but with a similar division pattern for 3PN ICSI compared with the 2PN ICSI embryos. 3PN, more often than 2PN ICSI embryos, displayed early cleavage into 3 cells (p = 0.03) and arrested development from the compaction stage and onwards (p = 0.001). More 3PN IVF than ICSI embryos displayed early cleavage into 3 cells (p < 0.001).

CONCLUSIONS

This study reports differences in cleavage patterns between 2PN and 3PN embryos and for the first time demonstrates differences in the cleavage pattern between 3PN IVF and ICSI embryos.

Temporal and developmental-stage variation in the occurrence of mitotic errors in tripronuclear human preimplantation embryos

Mitotic errors during early development of human preimplantation embryos are common, rendering a large proportion of embryos chromosomally mosaic. It is also known that the percentage of diploid cells in human diploid-aneuploid mosaic embryos is higher at the blastocyst than at the cleavage stage. In this study, we examined whether there is temporal and/or developmental-stage variation in the occurrence of mitotic errors in human preimplantation embryos from the first day of development onward using mitotically stable digynic tripronuclear human embryos as a model system. All the cells of the 114 digynic tripronuclear human preimplantation embryos included were analyzed by fluorescence in situ hybridization for chromosomes 1, 13, 16, 17, 18, 21, X, and Y. Embryos were grouped according to day of development (1-6) and developmental stage (2-cell to blastocyst stage). The possibility of a mitotic error was highest in the first and second mitotic divisions. The percentage of cells with mitotic errors increased during preimplantation development and was highest at the 9-16 cell stage (76%, P = 0.027). Thereafter, the percentage of cells with mitotic errors decreased to 64% at the morula and 56% at the blastocyst stage. The pattern found correlates with the activation of the embryonic genome at the 8-16 cell stage. A better insight in the timing of occurrence of mitotic errors in human preimplantation embryos could help in understanding and prevention of these errors and is relevant in the context of PGS.

Effects of cumulus cells removal after 6 h co-incubation of gametes on the outcomes of human IVF

PURPOSE

To investigate the effects of cumulus cells removal after 6 h co-incubation of gametes on the fertilization, polyspermy, multinucleation and clinical pregnancy rates in human IVF.

METHODS

A total of 1,200 IVF-ET cycles undergoing 6 h co-incubation of gametes in 2009 were included in this study. Inclusion criteria were: female age <38 years, first IVF treatment, with bi-ovary and normal ovarian response, e.g., 4 ~ 20 oocytes could be obtained. A 6 h period of co-incubation was applied in all IVF cycles. According to the history of infertility, cumulus cells were mechanically removed either 6 h post-insemination or 20 h post-insemination. For couples with primary infertility, or unexplained infertility, or mild oligospermia or asthenospermia, the cumulus cells were removed at 6 h of insemination for the polar body observation (6 h group, n = 565). Of these, 80 cycles received early rescue ICSI due to fertilization failure or low fertilization rate at 6 h of insemination. For couples with secondary infertility and normal semen analysis, the cumulus cells were removed at 20 h of insemination as routine (20 h group, n = 635). Of these, three cycles received late rescue ICSI due to fertilization failure at 20 h of insemination. Normal fertilization, polyspermy (≥3PN), multinucleation and clinical pregnancy rates were compared between the two groups (rescue ICSI cycles were not included in the comparison in both groups).

RESULTS

Significant difference (P < 0.05) was observed between the groups regarding polyspermy rates (7.48% in 6 h group and 9.22% in 20 h group). No difference was observed between the groups regarding normal fertilization rates (2PN rate) (64.89% in 6 h group and 65.74% in 20 h group). No difference was observed between the groups regarding multinucleation and clinical pregnancy rates (11.01% and 65.15% in 6 h group, 10.75% and 66.93% in 20 h group, respectively). The clinical pregnancy rate was 51.43% in cycles receiving early rescue ICSI, while no clinical pregnancy was obtained in cycles receiving late rescue ICSI.

CONCLUSION

The present results indicate that cumulus cells removal at 6 h of insemination is a relatively safe operation, which yielded comparable normal fertilization rate, multinucleation and clinical pregnancy rates compared with 20 h group. This protocol may be beneficial for early obsevation of fertilization failure and make early rescue ICSI possible.

Tri-pronucleated zygotes may occur less frequently in luteinizing hormone activity-added cycles

OBJECTIVE

This study was performed to evaluate the association between adding luteinizing hormone (LH) activity and the incidence of tripronuclear (3PN) zygotes occurrence.

METHODS

The incidence of 3PN and cycle outcomes was compared between recombinant follicle stimulating hormone (rFSH)-only and rFSH with exogenous LH activity groups. These comparisons were performed in gonadotropin releasing hormone (GnRHa, n = 196) and gonadotropin releasing hormone antagonist (GnRHant, n = 182) subgroups, and in in vitro fertilisation (IVF) (n = 243) and intracytoplasmic sperm injection (ICSI) (n = 135) cycles, respectively.

RESULTS

The percentage of 3PN was significantly lower in LH activity-added group compared to rFSH-only group (3.6% vs. 5.6%, p = 0.029). Both in GnRHa and GnRHant subgroups, this incidence tended to be lower in LH-supplemented group, although these differences did not reach statistical significance. In IVF cycles, LH activity-added group showed a lower 3PN rate versus rFSH-only group (4.0% vs. 6.7%, p = 0.018). No difference of 3PN rate was found in ICSI cycles.

CONCLUSIONS

Supplementation of exogenous LH activity to ovarian stimulation may be associated with lower prevalence of 3PN zygotes in IVF cycles, but not in ICSI cycles.

Increased responsiveness may be associated with tripronuclear embryos in both conventional in vitro fertilization and intracytoplasmic sperm injection cycles using gonadotropin-releasing hormone agonist long protocols: a self-matched observational study

AIMS

In this self-matched observational study, the factors associated with the presence of tripronuclear (3PN) embryos, in conventional in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) cycles using gonadotropin-releasing hormone agonist long protocols, were investigated.

MATERIAL & METHODS

Clinical parameters were analyzed in 202 consecutive IVF-IVF or ICSI-ICSI matched cycles. The differences between the former and latter cycles were evaluated and compared according to the presence of 3PN embryos: group A [3PN (-) followed by 3PN (-)]; group B [3PN (-) followed by 3PN (+)]; group C [3PN (+) followed by 3PN (-)]; group D [3PN (+) followed by 3PN (+)].

RESULTS

For the IVF-IVF cycles, the E(2) on human chorionic gonadotropin injection day and the number of retrieved oocytes were increased in the 3PN (+) cycles compared to the 3PN (-) cycles of Groups B (2165.2 ± 1423.3 pg/mL vs 1468.2 ± 796.2 pg/mL, P=0.016; 10.4 ± 9.1 vs 7.2 ± 5.7, P=0.010) and C (2382.7 ± 1214.5 pg/mL vs 1553.0 ± 1119.6 pg/mL, P = 0.004; 13.1 ± 9.1 vs 9.1 ± 7.0, P < 0.001), while these outcome variables did not differ when the former and latter cycles in Groups A and D were compared. These trends were observed in the ICSI-ICSI cycles.

CONCLUSIONS

An increased responsiveness, based on the higher E(2) and greater number of retrieved oocytes, may be associated with the presence of 3PN in both conventional IVF and ICSI cycles.

Analysis of the first mitotic spindles in human in vitro fertilized tripronuclear zygotes after pronuclear removal

Tripronuclear zygotes (3PN) occur in about 5% of cases in human IVF programmes. Human 3PN zygotes derived from a conventional IVF programme may contain not only the extra male pronucleus but also a supplementary centriole. Researchers have tried to restore diploidy by removing the extra male pronucleus of the tripronuclear zygote. However, it is still unknown whether the procedure can remove the supernumerary centriole. The objective of this study was to evaluate the safety of this manipulation by analysing the first mitotic spindles of 3PN zygotes that have undergone extra pronuclear removal. A controlled trial was conducted using human 3PN zygotes from conventional IVF treatment. In the experimental group, the assumed extra male pronuclei in the 3PN zygotes were removed. The first cleavage patterns and in vitro development were observed in both groups; polarized light microscopy and immunocytochemistry were used to analyse the first mitotic spindles. The blastocyst formation rate was significantly higher (P = 0.007) in the pronuclear-removed group (16.0%) than in the control group (4.5%). No significant differences were found between the groups in the first cleavage patterns and the distributions of the first mitotic spindle structure. This study suggests that, after extra pronuclei are removed, the developmental potential of human 3PN zygotes is improved. However, the abnormal patterns in the first mitosis are not corrected by this removal.

Mechanisms giving rise to triploid zygotes during assisted reproduction

OBJECTIVE

To review information on the origin of triploid zygotes as gathered from assisted reproduction techniques.

DESIGN

Identification of relevant literature by a MEDLINE search and own experience on the basis of cytogenetic studies of abnormally fertilized oocytes.

SETTING

None.

PATIENT(S)

None.

INTERVENTION(S)

None.

MAIN OUTCOME MEASURE(S)

None.

RESULT(S)

Penetration of two haploid spermatozoa or of a single diploid spermatozoon into the oocyte causes diandric triploidy. The first case can be discerned by formation of a total of three pronuclei, whereas the second process will remain undetected, because it involves a female and a single but diploid male pronucleus. Digynic triploidy after intracytoplasmic sperm injection is characterized by nonextrusion of the second polar body and formation of three pronuclei. Digyny can also result from the fertilization of diploid giant oocytes. Depending on how maturation of these gametes proceeds, three or only two pronuclei will be observed. Thus, the size of the pronuclear stage must be considered for a successful identification of the abnormality. Endoreduplication within the female pronucleus is not detectable and may represent another, albeit rare, origin of digynic triploidy.

CONCLUSION(S)

Routine inspection of the number of pronuclei is not an absolutely reliable tool for excluding the development of triploid embryos. Observations during assisted reproduction may yield valuable information on the origin of triploidy.

Can 'abnormally' fertilized zygotes give rise to viable embryos?

Conventional practice in in vitro fertilization or intracytoplasmic sperm injection is to select the best quality embryos based on their morphology and cleavage status from a cohort of fertilized oocytes in which two pronuclei were observed at the time they were checked for fertilization. However, in a small proportion of cycles, the selection is limited to embryos that appeared to be either unfertilized (displaying zero pronuclei) or abnormally fertilized (displaying one or three pronuclei) at the time they were checked for fertilization. There is a lack of consensus on whether such embryos should be transferred to the uterus. Cytogenetic analysis of embryos from oocytes with one pronucleus has shown a proportion is diploid. Transfer of such embryos has resulted in healthy births. Limited cytogenetic analysis of oocytes that divide despite the absence of pronuclei at fertilization check indicates that a proportion also have a normal cytogenetic constitution. Cytogenetic analysis of embryos from oocytes with three pronuclei has shown high rates of triploidy and chaotic cell divisions. Subsequent foetuses have extremely unfavourable outcomes. Here, we review the published literature on the cytogenetic analysis of 'unfertilized' and 'abnormally fertilized' embryos and discuss possible pathways which lead to their formation. The limited evidence indicates that oocytes with one pronucleus and oocytes that show normal onward division despite the absence of pronuclei may be considered for replacement in certain circumstances.

Origin and outcome of pregnancies affected by androgenetic/biparental chimerism

BACKGROUND

Androgenetic diploid cells confined to the placenta have recently been reported in several cases of normally developed fetuses in association with placental mesenchymal dysplasia (PMD).

METHODS AND RESULTS

We investigated two singleton, mildly growth-restricted, female pregnancies ascertained on the basis of PMD. One case had liver hemangiomas and both infants had multiple skin hemangiomas. Post-natal development was normal. Molecular marker analysis confirmed the diagnosis of androgenetic and normal mixed cell populations in the placenta. Both cases derived from a single maternal genome (M1) and two distinct paternal genomes (P1 and P2). In one case, the androgenetic cell population contained both paternal genomes (P1P2), with one shared in common with the biparental (M1P1) population. In the second case, the androgenetic lineage showed complete homozygosity (P2P2) for a paternal genome not common to the biparental cell population.

CONCLUSION

These new PMD cases help to define the range of possible clinical presentations of androgenetic/biparental mosaicism or chimerism. Placentas with androgenetic/biparental chimeric cell populations may derive from a single tri-pronuclear (3PN) zygote in which one or more parental genomes are not equally apportioned to the daughter cells in the first cell division.

Distinction Between Paternal and Maternal Contributions to the Tripronucleus in Human Zygotes Obtained after In Vitro Fertilization

OBJECTIVE

The aim of this study was to determine the genetic composition of tripronuclear (3PN) zygotes. Fluorescence in situ hybridization (FISH) was used to quantify the sperm tails in human 3PN zygotes.

MATERIALS AND METHODS

Ovarian hyperstimulation was performed using a standard long protocol consisting of gonadotropin-releasing hormone agonist (GnRHa) with human menopausal gonadotropins (HMG) and/or recombinant follicle stimulating hormone (rFSH). Human chorionic gonadotropin (hCG) was administered when at least two leading follicles reached 18 mm in mean diameter. Oocytes were retrieved from the follicles transvaginally under ultrasound guidance 34-36 hours after administration of hCG. The oocytes were examined 16-18 hours after fertilization for the presence and number of pronuclei. The 3PN zygotes were then fixed and extracted in buffer at 37 degrees C for 60 minutes. After washing in a blocking solution, the 3PN zygotes were prepared for indirect immunofluorescence using monoclonal antibody and Hoechst dye 33342 to visualize the number of pronuclei.

RESULTS

Twenty-one 3PN zygotes were randomly collected for evaluation. The number of 3PN zygotes containing one, two or four sperm tails were two (10%), 18 (85%) and one (5%), respectively.

CONCLUSION

Based on our observations, additional pronuclei are mainly of paternal origin.

Chimera and other fertilization errors

The finding of a mixture of 46,XX and 46,XY cells in an individual has been rarely reported in literature. It usually results in individuals with ambiguous genitalia. Approximately 10% of true human hermaphrodites show this type of karyotype. However, the underlying mechanisms are poorly understood. It may be the result of mosaicism or chimerism. By definition, a chimera is produced by the fusion of two different zygotes in a single embryo, while a mosaic contains genetically different cells issued from a single zygote. Several mechanisms are involved in the production of chimera. Stricto sensu, chimerism occurs from the post-zygotic fusion of two distinct embryos leading to a tetragametic chimera. In addition, there are other entities, which are also referred to as chimera: parthenogenetic chimera and chimera resulting from fertilization of the second polar body. Furthermore, a particular type of chimera called 'androgenetic chimera' recently described in fetuses with placental mesenchymal dysplasia and in rare patients with Beckwith-Wiedemann syndrome is discussed. Strategies to study mechanisms leading to the production of chimera and mosaics are also proposed.

Ultrarapid detection of sex chromosomes with the use of fluorescence in situ hybridization with direct label DNA probes in single human blastomeres, spermatozoa, amniocytes, and lymphocytes

OBJECTIVE

To assess the ultrarapid fluorescence in situ hybridization (FISH) procedure with a 1-minute hybridization time for gender determination.

DESIGN

Fluorescence in situ hybridization with direct label fluorescence DNA probes for chromosomes X and Y were tested with the use of different hybridization times and different cell types.

SETTING

Hospital-based IVF program.

INTERVENTION(S)

The efficiency of the FISH procedure with different hybridization times was compared with the use of male lymphocytes. The same FISH procedure, but with only 1-minute hybridization, was carried out in human blastomeres, spermatozoa, uncultured amniocytes, male lymphocytes, and female lymphocytes.

MAIN OUTCOME MEASURE(S)

Percentages of nuclei with positive signals.

RESULT(S)

The percentages of nuclei with positive signals in lymphocytes with hybridization times of 1, 3, 4, 10, 30, and 45 minutes were 97%, 97%, 98%, 98%, 98%, and 98%, respectively. The percentages of nuclei with positive signals after FISH with a 1-minute hybridization time in single blastomeres, spermatozoa, amniocytes, male lymphocytes, and female lymphocytes were 94%, 96%, 96%, 98%, and 97%, respectively.

CONCLUSION(S)

Chromosomes X and Y of human blastomeres. spermatozoa, uncultured amniocytes, and lymphocytes can be detected rapidly with the use of this ultrarapid FISH procedure with a 1-minute hybridization time.

Clinical application of a new stain to detect acrosome-reacted sperm for predicting polyspermic fertilization in IVF-ET

The aim of this study was to evaluate the efficacy of Blutstan staining of human spermatozoa for predicting the spermatozoa capacity of fertilization in human IVF. Blutstan, a prestained glass slide coated with dyes, is able to identify activated sperm quickly and easily. Acrosomal reactivity of spermatozoa was evaluated with this slide glass at the insemination of IVF of 30 couples. There was significant correlation between the Blutstan reactivity and the fertilization rate (r = .52, p < .01). Furthermore, spermatozoa with high Blutstan reactivity were fertilized oocytes polyspermy. This method was rapid, simple, and useful for detecting activated sperm and predicting for the polyspermic fertilization in clinical setting.

Investigation of effects of pregnant mare serum gonadotropin (PMSG) on the chromosomal complement of CD-1 mouse embryos

PURPOSE

The objective of this study was to examine the effect of superovulatory doses of gonadotropins on the frequency of chromosomal abnormalities of mouse embryos.

METHODS

Chromosome analysis of 8- to 16-cell stage mouse embryos and zygotes was performed by a cytogenetic method.

RESULTS

There was no significant effect of the pregnant mare serum gonadotropin (PMSG) dose on the level of aneuploidy and structural abnormalities from 8- to 16-cell-stage embryos among superovulated groups. However, a simple dose-response relationship between the PMSG dose and the incidence of polyploidy was observed, with the level of polyploidy rising from 2.9% with 10 i.u. PMSG to 10.5% with 15 i.u. PMSG. In zygote stage, the proportion of polyploid embryos also increased as the dose increased, from 1.9% in 5 i.u. to 6.7% in 15 i.u. PMSG. It was observed that the extra chromosomal set in polyploidy embryos originated by both fertilization of a diploid oocyte and dispermy.

CONCLUSIONS

These results indicate a dose-response relationship between the PMSG dose and the incidence of polyploidy in the CD-1 mouse. Both a disturbance at maturation division and an error at fertilization were the cause of polyploidy.

Chromosome 18 analysis by fluorescence in situ hybridization (FISH) in human blastomeres of abnormal embryos after in vitro fertilization (IVF) attempt

We performed fluorescence in situ hybridization (FISH) with a chromosome 18-specific probe on human abnormal cleaved embryos, fertilized either by two spermatozoa and exhibiting three pronuclei (3 PN) or normally fertilized and exhibiting two pronuclei (2 PN) with subsequent severe fragmentation and/or blocking. The aim of the study was to evaluate the incidence of chromosome 18 anomalies among these embryos in order to evaluate the FISH efficiency on such material and to obtain more precise and complete data than those obtained with classical cytogenetic analysis. For the 3 PN cleaved embryos, FISH confirmed the frequent regulation towards diploidy (25 per cent) and the high frequency of mosaics (53 per cent). For the 2 PN blocked or damaged embryos, FISH permitted chromosome evaluation, which was otherwise impossible with classical cytogenetic techniques: we also found a high mosaic frequency (45 per cent) with these embryos. If this frequency were the same for normally developing embryos, it would be a major obstacle to the reliability of either chromosomal or genetic preimplantation diagnosis.

Cytogenetics of human spermatozoa: what about the reproductive relevance of structural chromosome aberrations?

PURPOSE

The purpose was to review and appreciate data on structural sperm chromosome abnormalities obtained after fusion of human spermatozoa with zona-free hamster eggs.

RESULTS

Breaks and fragments are the predominant sperm chromosome aberrations. In contrast to stable alterations, e.g., translocations, inversions, and deletions that will be transmitted unchanged into following cell generations, breaks, fragments, and some rearrangements have a reduced stability. In proliferating cell systems they will soon be eliminated through formation of lagging chromatin and micronuclei. Their relevance lies in a loss of genetic material or disturbance of cell division that may cause cell death. It is reasonable to assume a responsibility of such aberrations for early unrecognized conception loss. However, this interpretation is subject to criticism because an artifactual origin of sperm chromosome breakage cannot be ruled out.

CONCLUSIONS

The incidence and relevance of structural sperm chromosome abnormalities will remain at issue unless additional and complementary information is provided. For this purpose, new strategies must be developed because further studies employing hamster eggs according to existing protocols will not help resolve the dilemma.

Rescue of human embryos by micromanipulation

This chapter evaluates clinical micromanipulation techniques aimed at rescuing abnormally developing zygotes and cleaved embryos. First, the possibility of reversing dispermic zygotes to a normal biparental diploid state was evaluated by extracting the distal pronucleus (that furthest from the polar body). The ratio of X:Y was determined in both groups of embryos by assessing a minimum of two blastomeres using duplex PCR or multiple colour FISH. The ratio of embryos containing only an X chromosome and those with X as well as Y chromosomes in the intact dispermic zygotes was 1.0:2.6, which is similar to the theoretical ratio of 1:3. This ratio was 1.0:1.5 in dispermic zygotes from which the distal pronuclei were removed. Although the ratio of X:Y was altered following removal of distal pronuclei, suggesting frequent targeting of male pronuclei, accidental removal of the female pronucleus could not be excluded. In a second set of mouse experiments, it was shown that the hatching process of embryos that develop with excessive amounts of degenerate material is adversely affected. It was shown that removal of such extracellular material by micromanipulation potentially reverted the hatching process. It was also indicated that immediate removal of the degenerate tissue was more beneficial than that following prolonged co-culture. Assisted hatching is probably the most frequently applied clinical embryo micromanipulation procedure. The outcome of assisted hatching is dependent largely on the mode by which the zona pellucida is breached, the size of the artificial gap and the thickness of the zona pellucida. Embryos with zonae thicker than 17 microns rarely implant. Zona drilling could be detrimental in embryos with thin zonae (< 12 microns). Superficial zona thinning has not enhanced implantation. These observations led to a routine procedure called selective assisted hatching, which involves measuring the zonae before zona drilling and replacement on day 3 of development. This appears to be most successful in older women and those with elevated basal FSH levels. Selective assisted hatching is routinely applied in consenting patients whose embryos have thick zonae, slow development or excessive fragmentation (> 20%). Zona drilling of all embryos, regardless of zona thickness, is being performed in patients aged over 40 years and in those with repeated failures or elevated basal FSH levels. Results in the first group of more than 900 patients indicate that nearly one-quarter of human embryos have the ability to implant.

The parental origin of the distal pronucleus in dispermic human zygotes

The purpose of this investigation was to determine the parental origin of the pronucleus furthest from the second polar body (the distal pronucleus) in dispermic human zygotes. Intact dispermic embryos (n = 53) and those from which the distal pronucleus (n = 50) was removed at the zygote stage were biopsied after cleavage. Blastomeres were sexed using either coamplification of X and Y probes using a duplex polymerase chain reaction (PCR), or simultaneous fluorescence in situ hybridisation (FISH) with directly fluorochrome-labelled probes for chromosomes X, Y and 18. The ratio X/Y was determined in both groups of embryos by assessing a minimum of two blastomeres. If the pronuclei in dispermic zygotes are topographically in a fixed position, the X/Y ratio should change from 1:3 in dispermic embryos to 1:1 in enucleated ones. The ratio of embryos containing only an X chromosome and those with X as well as Y chromosomes in the intact dispermic zygotes was 1.0:2.3 which is similar to the theoretical ratio of 1:3. This ratio was 1.0:1.3 in dispermic zygotes from which the distal pronuclei were removed. This ratio is not significantly different from the 1:1 ratio based on a statistical analysis with a sample size of 50. These sex ratios would have been considered different if more than 200 enucleations had been performed. Although the ratio X/Y was altered following removal of distal pronuclei, suggesting frequent targeting of male pronuclei, accidental removal of the female pronucleus could not be excluded. This indicates that enucleation of dispermic zygotes could produce high yields of gynogenetic and androgenetic embryos for research purposes. Clinical application aimed at producing biparental zygotes may be hazardous, since mosaicism was common among enucleated embryos.

Parental origin of triploidy in human fetuses: evidence for genomic imprinting

Two distinct phenotypes of triploid fetuses have been previously described and a correlation with parental origin of the triploidy has been suggested. We have studied the parental origin of the extra haploid set of chromosomes in nine triploid fetuses using analysis of DNA polymorphisms at a variety of loci. Maternal origin of the triploidy (digyny) was demonstrated in six fetuses with type II phenotype, paternal origin (diandry) in two cases with type I phenotype, and nonpaternity in one case. The predominance of digynic triploids in our study contrasts with the results reported in previous studies in which, through analysis of cytogenetic polymorphisms, paternal origin was found to account for the majority of triploid conceptuses. This difference may be accounted for by a combination of factors--the different methods of parental assignment used and analysis of a different subset of triploid conceptuses. The correlation between the observed phenotypes and the parental origin of triploidy may represent another example of imprinting in human development.

Cytogenetic analysis of the oocyte and embryo after removal of the zona pellucida following failed fertilization

Cytogenetic analysis of the oocyte and embryo after removal of the zona pellucida provides a simple screening method for examining the oocyte and embryo and considering the morphological abnormalities of the zona and adjacent formations, cytoplasm and nucleus. Seventy-one unfertilized oocytes and 27 embryos with poor morphology or cleavage arrest were studied after fixation, staining and mechanical removal of the zona. Fixation was done with a glutaraldehyde solution (1%). The oocytes and embryos were then stained, causing weakening of the zona. A slight pressure on the cover slide led to rupture of the zona and the exposure of the oolema. The oocytes and embryos were analyzed for sperm attachment to and penetration through the zona, appearance of the polar bodies, differentiation of blastomeres from cytoplasmic fragments, nuclear status--pyknotic non-analyzable form, chromosomes or different degenerative appearances of DNA. Peeling of the zona is an easy and reliable screening technique needing only an ordinary light microscope. It provides the advantage of observing the whole structure of the oocyte-embryo, not just the chromosomes as in classical cytogenetic methods.

Chromosomal constitution of mouse blastocysts derived from oocytes inseminated by multiple sperm insertion into the perivitelline space

PURPOSE

Our purpose was to evaluate the rate of chromosomal aberrations in mouse blastocysts obtained after microinjection of multiple spermatozoa under the zona pellucida of mature oocytes. Without detecting the appearance of pronuclei, the microinjected mouse oocytes containing two polar bodies were cultivated to the blastocyst stage and then analyzed cytogenetically.

RESULTS

A chromosome study was carried out in a total of 109 blastocysts derived after microinjection of motile spermatozoa into the perivitelline space. Fifty-five blastocysts (50.5%) exhibited normal diploid chromosome complements, 30 (27.5%) showed different forms of mosaicism, and 24 (22%) exhibited haploidy caused by parthenogenetic activation. Compared to in vivo and in vitro control groups there was a significant increase in the parthenogenesis and mosaic forms of embryos produced by micromanipulation (P < 0.001). A total of 360 well-spread metaphases of 103 blastocysts was analyzed to determine whether the micromanipulation procedure increased the chance of aneuploidy. Aneuploid numbers of chromosomes were absent in all the metaphases analyzed.

CONCLUSION

Mosaicism and parthenogenesis appear to be increased significantly following microinjection of multiple spermatozoa under the zona pellucida of mouse oocytes, and there was no evidence of aneuploidy.