Human oocyte morphometry before and after cryopreservation: A prospective cohort study

Segmentation of mature human oocytes provides interpretable and improved blastocyst outcome predictions by a machine learning model

Within the medical field of human assisted reproductive technology, a method for interpretable, non-invasive, and objective oocyte evaluation is lacking. To address this clinical gap, a workflow utilizing machine learning techniques has been developed involving automatic multi-class segmentation of two-dimensional images, morphometric analysis, and prediction of developmental outcomes of mature denuded oocytes based on feature extraction and clinical variables. Two separate models have been developed for this purpose-a model to perform multiclass segmentation, and a classifier model to classify oocytes as likely or unlikely to develop into a blastocyst (Day 5-7 embryo). The segmentation model is highly accurate at segmenting the oocyte, ensuring high-quality segmented images (masks) are utilized as inputs for the classifier model (mask model). The mask model displayed an area under the curve (AUC) of 0.63, a sensitivity of 0.51, and a specificity of 0.66 on the test set. The AUC underwent a reduction to 0.57 when features extracted from the ooplasm were removed, suggesting the ooplasm holds the information most pertinent to oocyte developmental competence. The mask model was further compared to a deep learning model, which also utilized the segmented images as inputs. The performance of both models combined in an ensemble model was evaluated, showing an improvement (AUC 0.67) compared to either model alone. The results of this study indicate that direct assessments of the oocyte are warranted, providing the first objective insights into key features for developmental competence, a step above the current standard of care-solely utilizing oocyte age as a proxy for quality.

Ultra-Fast Vitrification: Minimizing the Toxicity of Cryoprotective Agents and Osmotic Stress in Mouse Oocyte Cryopreservation

Globally, women have been adopting oocyte cryopreservation (OC) for fertility preservation for various reasons, such as inevitable gonadotoxic treatment for specific pathologic states and social preferences. While conventional vitrification (C-VIT) has improved the success rate of OC, challenges of possible toxicities of high-concentration cryoprotective agents and osmotic stress persist. To overcome these challenges, we evaluated the ultra-fast vitrification (UF-VIT) method, which reduces the equilibration solution stage exposure time compared to C-VIT by observing mouse oocyte intracellular organelles and embryonic development. Consequently, compared to fresh mouse oocytes, UF-VIT presented significant differences only in endoplasmic reticulum (ER) intensity and mitochondrial (MT) distribution. Meanwhile, C-VIT showed substantial differences in the survival rate, key ER and MT parameters, and embryonic development rate. UF-VIT exhibited considerably fewer negative effects on key MT parameters and resulted in a notably higher blastocyst formation rate than C-VIT. Meiotic spindle (spindle and chromosomes) morphology showed no significant changes between the groups during vitrification/warming (VW), suggesting that VW did not negatively affect the meiotic spindle of the oocytes. In conclusion, UF-VIT seems more effective in OC owing to efficient cytoplasmic water molecule extraction, osmotic stress reduction, and minimization of cell contraction and expansion amplitude, thus compensating for the drawbacks of C-VIT.

Blastocyst Transplantation Strategies in Women of Different Ages

(1) Background: Single blastocyst transfers (SBT) and double blastocyst transfers (DBT) are widely used in clinical practice. The objective of this study was to investigate the application of these two strategies in women of different ages. (2) Methods: Analysis was carried out on 5477 frozen embryo transfer cycles of women in different ages. All the cycles were divided into three groups according to the age of the included women: <35, 35-39, and >39. The live birth rate (LBR) and multiple birth rate (MBR) between the SBT and DBT among these groups, respectively, were compared. (3) Results: In the women < 35 group, the LBR was similar in SBT and DBT, but the MBR was higher in DBT than SBT. In women 35-39, with >10 oocytes retrieved, the MBR in DBT was significantly higher than SBT, but there was no significant difference in LBR between the two groups; with ≤10 oocytes retrieved, the LBR in DBT were significantly higher than SBT, but the MBT was not significantly different between the two groups. In women > 39, the LBR and MBR were lower in the SBT than DBT, but the differences were not statistically significant. (4) Conclusions: Selective SET is appropriate for most young women, whereas older women are advised to make individualized choices based on the number of oocytes retrieved and blastocyst quality.

Effect of melatonin on the clinical outcome of patients with repeated cycles after failed cycles of in vitro fertilization and intracytoplasmic sperm injection

To explore whether embryo culture with melatonin (MT) can improve the embryonic development and clinical outcome of patients with repeated cycles after in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) failure, immature oocytes from controlled ovarian superovulation cycles were collected for in vitro maturation (IVM) and ICSI. The obtained embryos were cultured in 0, 10–11, 10–9, 10–7 and 10–5 M MT medium respectively, and 10–9 M was screened out as the optimal concentration. Subsequently, 140 patients who underwent failed IVF/ICSI cycles received 140 cycles of embryo culture in vitro with a medium containing 10–9 M MT, these 140 MT culture cycles were designated as the experimental group (10–9 M group), and the control group was the previous failed cycles of patients (0 M group). The results showed that the fertilization, cleavage, high-quality embryo, blastocyst, and high-quality blastocyst rates of the 10–9 M group were significantly higher than those of the 0 M group (P < 0.01; P < 0.01; P < 0.0001; P < 0.0001; P < 0.0001). To date, in total, 50 vitrified-warmed cycle transfers have been performed in the 10–9 M group and the implantation rate, biochemical pregnancy rate and clinical pregnancy rate were significantly higher than those in the 0 M group (all P < 0.0001). Two healthy infants were delivered successfully and the other 18 women who achieved clinical pregnancy also had good examination indexes. Therefore the application of 10–9 M MT to embryo cultures in vitro improved embryonic development in patients with repeated cycles after failed IVF/ICSI cycles and had good clinical outcomes.

Trial registration: ChiCTR2100045552.

Applications of Melatonin in Female Reproduction in the Context of Oxidative Stress

Oxidative stress has been recognized as one of the causal mediators of female infertility by affecting the oocyte quality and early embryo development. Improving oxidative stress is essential for reproductive health. Melatonin, a self-secreted antioxidant, has a wide range of effects by improving mitochondrial function and reducing the damage of reactive oxygen species (ROS). This minireview illustrates the applications of melatonin in reproduction from four aspects: physiological ovarian aging, vitrification freezing, in vitro maturation (IVM), and oxidative stress homeostasis imbalance associated with polycystic ovary syndrome (PCOS), emphasising the role of melatonin in improving the quality of oocytes in assisted reproduction and other adverse conditions.

Cystic fibrosis transmembrane conductance regulator in follicular fluid and cumulus cells and its relationship with age

Oocyte quality deteriorates with female age and numerous indicators of oocyte quality exist. In the present study, the levels of cystic fibrosis transmembrane conductance regulator (CFTR) in the follicular fluid (FF) and cumulus cells (CCs) of infertile females in 3 different age groups were assessed to determine the relationship between CFTR and female age. The general features of the 3 groups, including age, body mass index, infertility duration, basal hormone levels and the number of retrieved oocytes were compared. The FF CFTR levels of the 3 groups were also compared and multiple age-related indicators of oocyte quality were analyzed, including the estradiol levels on the human chorionic gonadotropin injection day, the morphologically normal oocyte rate and the available or high-quality embryo rate. Immunofluorescence and PCR analyses were performed to examine CFTR expression in CCs around oocytes. The results indicated differences in general features and several indicators of oocyte quality among the 3 groups and significant differences in CFTR. The FF CFTR level was positively correlated with age, which was confirmed by immunofluorescence and PCR. Collectively, these results indicated that CFTR expression in FF and CCs may be associated with oocyte quality based on the age of individuals undergoing the assisted reproduction technique.

Lipidomic changes in mouse oocytes vitrified in PEG 8000-supplemented vitrification solutions

Cryopreserved oocytes are inevitably exposed to cold stress, which negatively affects the cellular aspects of the oocytes. Lipidomic analysis of the oocytes reveals quantitative changes in lipid classes under conditions of cold stress, leading to potential freezing-vulnerability. We had previously shown that specific phospholipids are significantly downregulated in vitrified-warmed mouse oocytes compared to those in fresh oocytes. In this study, we examined whether supplementation of polyethylene glycol 8000 (PEG 8000) during vitrification influences the lipidome of the oocytes. We used liquid chromatography with tandem mass spectrometry (LC-MS/MS) to study the alteration in the lipidome in three groups of mouse oocytes: fresh, vitrified-warmed, and vitrified with PEG 8000-warmed during vitrification. In these groups, we targeted to analyze 21 lipid classes. We profiled 132 lipid species in the oocytes and statistical analyses revealed lipid classes that were up- or downregulated in these groups. Overall, our data revealed that several classes of lipids were affected during vitrification, and that oocytes vitrified with PEG 8000 to some extent alleviated the levels of changes in phospholipid and sphingolipid contents during vitrification. These results suggest that phospholipids and sphingolipids are influenced by PEG 8000 during vitrification and that PEG 8000 can be considered as a potential candidate for preserving membrane integrity during oocyte cryopreservation.

The frequency of collapse as a predictor of feline blastocyst quality

Domestic cats are frequently used as a research model for felid species that are threatened with extinction. Until now, the development of feline embryos has been evaluated using both classical observation methods and time-lapse monitoring (TLM). Blastocyst collapse observed using time-lapse cinematography is used as a predictor of blastocyst quality and is closely related to implantation potential. The aim of this study was to determine the relationship between the quality of domestic cat blastocysts obtained after in vitro fertilization and the frequency and duration of collapse, and of hatching. There was a significant difference in the average number of collapses and weak contractions between good and poor quality blastocysts. There was no significant difference between hatching and non-hatching blastocysts in terms of blastocyst cavity formation time or average number and duration of collapse. These results showed that the time of cavity formation was not related to blastocyst quality. The number of collapses and the occurrence of hatching were positively related to blastocyst quality, and poor quality blastocysts have, as a consequence, a reduced potential for implantation. TLM plays a significant role in cat embryo evaluation.

Does human oocyte cryopreservation affect equally on embryo chromosome aneuploidy?

Oocytes cryopreservation as an important part of assisted reproductive technologies, which should ensure after warming not only intact oocyte morphological characteristics, but also their genetic apparatus stability. However, the meiotic spindle is very sensitive to the temperature fluctuations that can lead to unequal chromosome segregation during meiosis and as a consequence can cause embryo aneuploidy after oocyte fertilization. The aim of the study was to estimate the oocytes cryopreservation impact on human embryo chromosome aneuploidy. It has been shown that fertilization rate of the cryopreserved oocytes did not differ from fresh ones (83.1% vs 84% respectively). The number of blastocysts obtained from cryopreserved oocytes was less than that obtained from fresh oocytes, however, their morphological characteristics were better if compared the fresh oocytes. Our results showed different cryopreservation impact on aneuploidy rates of certain chromosomes in embryos obtained from cryopreserved oocytes. They had an increased aneuploidy of chromosome 13 and a decreased nondisjunction of chromosome 18 and sex chromosomes.