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Nguyen Thanh T, Nguyen DM, Dinh Le T, Ngoc Do L, Tien Nguyen S, Nguyen Minh P, Nguyen Van P, Minh Bui T, Thi Bui TT, Nguyen Dao H, Trung Nguyen K. The Relationship Between Smooth Endoplasmic Reticulum Clusters in Metaphase II Oocytes and Embryological and Birth Outcomes in Infertile Couples. Int J Gen Med 2024; 17:3269-3277. [PMID: 39070228 PMCID: PMC11283835 DOI: 10.2147/ijgm.s469626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2024] [Accepted: 07/16/2024] [Indexed: 07/30/2024] Open
Abstract
Background To assess the relationship between oocytes with smooth endoplasmic reticulum cluster (SERc) and embryological and birth outcomes in infertile couples. Methods This was a descriptive study that included 231 infertile patients undergoing in vitro fertilization (IVF) with a total of 2447 mature oocytes (MII), of which 279 oocytes with SERc(+) from 100 patients, the remaining 2168 oocytes with SERc(-). Oocytes were evaluated for the presence or absence of the SERc simultaneously with intracytoplasmic sperm injection at 200x magnification using inverted microscopy - Observe D1. Results The mean age of patients was 32.05 ± 5.56 years. One hundred patients had at least one SERc(+) oocyte (with 279 SERc(+) and 956 SERc(-) oocytes). One hundred and thirty-one patients had 1212 SERc(-) oocytes. Fertilization outcomes and the rates of good-quality embryos on day 2 and day 5 did not differ between the SERc(+) and the SERc(-) groups. In the first frozen embryo transfer cycles, the clinical pregnancy rate in the group of patients with SERc(+) was not different with the SERc(-) group (61.1% vs 48.78%, p = 0.074, respectively). The live birth rate in the SERc(+) group was statistically significantly higher than the SERc(-) group (57.7% vs 43.9%, p = 0.045, respectively). Conclusion The fertilization rate, the quality of embryos on days 2 and 5 from oocytes with SERc(+) are similar to those with SERc(-). The live birth rate in the patients with SERc(+) group is statistically significantly higher than the SERc(-) group. There is no difference in clinical pregnancy rate between patients with and without SERc. Therefore, the exclusion of oocytes with SERc should not be recommended.
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Affiliation(s)
- Tung Nguyen Thanh
- Military Institute of Clinical Embryology and Histology, Vietnam Military Medical University, Hanoi, 10000, Vietnam
| | - Duc Minh Nguyen
- Andrology and Fertility Hospital of Hanoi, Hanoi, 10000, Vietnam
| | - Tuan Dinh Le
- Department of Rheumatology and Endocrinology, Military Hospital 103, Vietnam Military Medical University, Hanoi, 10000, Vietnam
| | - Lan Ngoc Do
- Military Institute of Clinical Embryology and Histology, Vietnam Military Medical University, Hanoi, 10000, Vietnam
| | - Son Tien Nguyen
- Department of Rheumatology and Endocrinology, Military Hospital 103, Vietnam Military Medical University, Hanoi, 10000, Vietnam
| | - Phuong Nguyen Minh
- Military Institute of Clinical Embryology and Histology, Vietnam Military Medical University, Hanoi, 10000, Vietnam
| | - Phong Nguyen Van
- Department of Biology and Medical Genetics, Vietnam Military Medical University, Hanoi, 10000, Vietnam
| | - Tien Minh Bui
- Department of Obstetrics and Gynecology, Thai Binh University of Medicine and Pharmacy, Thai Binh, 410000, Vietnam
| | - Tuyen Thanh Thi Bui
- Department of Obstetrics and Gynecology, Thai Binh University of Medicine and Pharmacy, Thai Binh, 410000, Vietnam
| | - Hung Nguyen Dao
- Department of Obstetrics and Gynecology, Military Hospital 103, Vietnam Military Medical University, Hanoi, Vietnam
| | - Kien Trung Nguyen
- Department of Obstetrics and Gynecology, Thai Binh University of Medicine and Pharmacy, Thai Binh, 410000, Vietnam
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Shioya M, Okabe-Kinoshita M, Kobayashi T, Fujita M, Takahashi K. Human metaphase II oocytes with narrow perivitelline space have poor fertilization, developmental, and pregnancy potentials. J Assist Reprod Genet 2024; 41:1449-1458. [PMID: 38499932 PMCID: PMC11143139 DOI: 10.1007/s10815-024-03084-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 03/04/2024] [Indexed: 03/20/2024] Open
Abstract
PURPOSE To analyze the fertilization, developmental, and pregnancy potentials in oocytes with narrow perivitelline space. METHODS Perivitelline space (PVS) of oocytes was evaluated at the time of ICSI, and those without sufficient PVS were judged as oocytes with narrow PVS (NPVS oocytes), and those with sufficient PVS formation were judged as oocytes with non-narrow PVS (non-NPVS oocytes). The analysis included 634 NPVS oocytes from 278 cycles and 12,121 non-NPVS oocytes from 1698 cycles. The fertilization and developmental potentials of NPVS and non-NPVS oocytes were compared by calculating odds ratios using a mixed-effects logistic regression model. We also compared the embryo transfer outcomes of those used for single vitrified-warmed blastocyst transfer after developing into the blastocyst stage. RESULTS NPVS oocytes had higher odds ratios for degeneration (adjusted odds ratio [aOR], 1.555; 95% confidence interval [CI], 1.096-2.206; p = 0.0133) and 0PN (aOR, 1.387; 95% CI, 1.083-1.775; p = 0.0095), resulting in a lower 2PN rate (aOR, 0.761; 95% CI, 0.623-0.929; p = 0.0072). Even embryos with confirmed 2PN had lower odds ratios for cleavage (aOR, 0.501; 95% CI, 0.294-0.853; p = 0.0109) and blastocyst development (Gardner criteria; CC-AA) rates (aOR, 0.612; 95% CI, 0.476-0.788; p = 0.0001). Blastocysts developed from NPVS oocytes had significantly lower odds ratios for clinical pregnancy (aOR, 0.435; 95% CI, 0.222-0.854; p = 0.0156) than those developed from non-NPVS oocytes. CONCLUSIONS Oocytes with NPVS have low fertilization and developmental potential, as well as low likelihood of pregnancy.
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Affiliation(s)
- Masashi Shioya
- Takahashi Women's Clinic, 18-14-6F Shinmachi, Chuo-ku, Chiba, 260-0028, Japan.
- Department of Reproductive Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan.
| | | | - Tatsuya Kobayashi
- Department of Reproductive Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan
- Department of Regulatory Science, Fujita Health University, Haneda Innovation City Zone A, 1-1-4 Haneda Airport, Ota-ku, Tokyo, 144-0041, Japan
| | - Maki Fujita
- Takahashi Women's Clinic, 18-14-6F Shinmachi, Chuo-ku, Chiba, 260-0028, Japan
| | - Keiichi Takahashi
- Takahashi Women's Clinic, 18-14-6F Shinmachi, Chuo-ku, Chiba, 260-0028, Japan
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3
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Kloos J, Burks C, Purdue-Smithe A, DeVilbiss E, Mumford SL, Weinerman R. Similar pregnancy outcomes from fresh and frozen donor oocytes transferred to gestational carriers: a SART database analysis isolating the effects of oocyte vitrification. J Assist Reprod Genet 2024; 41:643-648. [PMID: 38200285 PMCID: PMC10957820 DOI: 10.1007/s10815-023-03016-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 12/21/2023] [Indexed: 01/12/2024] Open
Abstract
PURPOSE This work aimed to study clinical and neonatal outcomes of embryos derived from frozen compared to fresh donor oocytes in gestational carrier cycles. METHODS This is a retrospective cohort study using the Society for Assisted Reproductive Technology Clinic Outcome Reporting System database between 2014 and 2015, comprising of 1284 fresh transfer cycles to gestational carrier recipients of embryos resulting from fresh (n = 1119) and vitrified/thawed (n = 165) donor oocytes. Models were adjusted for gestational carrier age, preimplantation genetic testing (PGT-A), number of embryos transferred, multiple gestation, and fetal heart reduction. As our models were part of a larger analysis, intended parent BMI, smoking status, and parity were also adjusted for, but did not influence outcomes in this analysis. RESULTS There was no significant difference in probability of live birth rates when comparing embryos derived from fresh and frozen donor oocytes in gestational carrier cycles. There were also no significant differences in biochemical pregnancy losses or clinical miscarriage. There were no significant differences noted in low birthweight or high birthweight infants derived from fresh versus frozen donor oocyte after transfer into a gestational carrier. CONCLUSIONS The analysis of fresh and frozen donor oocytes in gestational carrier cycles provides the opportunity to assess for a possible effect of vitrification on the oocyte by controlling for differences in the uterine environment. We observed no significant differences in live birth, pregnancy loss, low birthweight or high birthweight infants when comparing fresh and frozen donor oocytes in gestational carrier cycles.
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Affiliation(s)
- Jacqueline Kloos
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | | | - Alexandra Purdue-Smithe
- Division of Women's Health, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Elizabeth DeVilbiss
- Division of Population Health Research, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
| | - Sunni L Mumford
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Rachel Weinerman
- Division of Reproductive Endocrinology and Infertility, University Hospitals Cleveland Medical Center, Cleveland, OH, USA.
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Raad G, Tanios J, Serdarogullari M, Bazzi M, Mourad Y, Azoury J, Yarkiner Z, Liperis G, Fakih F, Fakih C. Mature oocyte dysmorphisms may be associated with progesterone levels, mitochondrial DNA content, and vitality in luteal granulosa cells. J Assist Reprod Genet 2024; 41:795-813. [PMID: 38363455 PMCID: PMC10957819 DOI: 10.1007/s10815-024-03053-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 02/01/2024] [Indexed: 02/17/2024] Open
Abstract
PURPOSE To identify whether follicular environment parameters are associated with mature oocyte quality, embryological and clinical outcomes. METHODS This retrospective study examined 303 mature oocytes from 51 infertile women undergoing ICSI cycles between May 2018 and June 2021. Exclusion criteria consisted of advanced maternal age (> 36 years old), premature ovarian failure, obesity in women, or use of frozen gametes. Luteal granulosa cells (LGCs) were analyzed for mitochondrial DNA/genomic (g) DNA ratio and vitality. The relationships between hormone levels in the follicular fluid and oocyte features were assessed. Quantitative morphometric measurements of mature oocytes were assessed, and the association of LGC parameters and oocyte features on live birth rate after single embryo transfer was examined. RESULTS Results indicated an inverse correlation between the mtDNA/gDNA ratio of LGCs and the size of polar body I (PBI). A 4.0% decrease in PBI size was observed with each one-unit increase in the ratio (p = 0.04). Furthermore, a 1% increase in LGC vitality was linked to a 1.3% decrease in fragmented PBI (p = 0.03), and a 1 ng/mL increase in progesterone levels was associated with a 0.1% rise in oocytes with small inclusions (p = 0.015). Associations were drawn among LGC characteristics, perivitelline space (PVS) debris, cytoplasmic inclusions, PBI integrity, and progesterone levels. Certain dysmorphisms in mature oocytes were associated with embryo morphokinetics; however, live birth rates were not associated with follicular parameters and oocyte quality characteristics. CONCLUSION Follicular markers may be associated with mature oocyte quality features.
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Affiliation(s)
- Georges Raad
- Al Hadi Laboratory and Medical Center, Beirut, Lebanon
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
| | | | - Munevver Serdarogullari
- Department of Histology and Embryology, Faculty of Medicine, Cyprus International University, Northern Cyprus Via Mersin 10, Mersin, Turkey
| | - Marwa Bazzi
- Al Hadi Laboratory and Medical Center, Beirut, Lebanon
| | - Youmna Mourad
- Al Hadi Laboratory and Medical Center, Beirut, Lebanon
| | - Joseph Azoury
- Azoury IVF Clinic, ObGyn and Infertility, Beirut, Lebanon
| | - Zalihe Yarkiner
- Faculty of Arts and Sciences-Department of Basic Sciences and Humanities, Cyprus International University, Northern Cyprus Via Mersin 10, Mersin, Turkey
| | - Georgios Liperis
- Westmead Fertility Centre, Institute of Reproductive Medicine, University of Sydney, Westmead, NSW, Australia.
| | - Fadi Fakih
- Al Hadi Laboratory and Medical Center, Beirut, Lebanon
| | - Chadi Fakih
- Al Hadi Laboratory and Medical Center, Beirut, Lebanon
- Faculty of Medicine, Lebanese University, Beirut, Lebanon
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Braga DPAF, Setti A, Morishima C, Provenza RR, Iaconelli A, Borges E. The effect of sperm DNA fragmentation on ICSI outcomes depending on oocyte quality. Andrology 2023; 11:1682-1693. [PMID: 37004191 DOI: 10.1111/andr.13435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 03/21/2023] [Accepted: 03/27/2023] [Indexed: 04/03/2023]
Abstract
BACKGROUND Sperm deoxyribonucleic acid (DNA) fragmentation is commonly encountered in spermatozoa, and the oocyte assumes responsibility for repairing sperm DNA fragmentation during the oocyte-embryo transition. OBJECTIVES This study aimed to investigate whether the effect of sperm DNA fragmentation on intracytoplasmic sperm injection outcomes depends on the incidence of oocyte dimorphisms. MATERIALS AND METHODS For the present cohort, 2942 fertilized oocytes from 525 patients submitted to intracytoplasmic sperm injection cycles were assessed. The present study was conducted in a private in vitro fertilization center affiliated to a university from June 2016 to July 2019. Semen samples were divided into the following two groups depending on the sperm DNA fragmentation index: a low fragmentation index group (<30% sperm DNA fragmentation, n = 1468) and a high fragmentation index group (≥30% sperm DNA fragmentation, n = 486). In addition, mature oocytes were examined before sperm injection, and intracytoplasmic and extracytoplasmic defects were recorded. The effect of the sperm DNA fragmentation index on laboratory and clinical intracytoplasmic sperm injection outcomes (depending on the presence of oocyte defects) was evaluated. RESULTS Significant increases in the rates of fertilization, high-quality embryo, implantation, and pregnancy were noted for cycles with <30% sperm DNA fragmentation than cycles with ≥30% sperm DNA fragmentation (regardless of the presence of oocyte dimorphisms). The presence of dimorphisms significantly impacted laboratory and clinical outcomes. The lowest fertilization and high-quality embryo rates were observed when a high sperm DNA fragmentation index was associated with the presence of dark cytoplasm, vacuoles, resistant membrane, and non-resistant membrane. The lowest implantation and pregnancy rates were observed when a high sperm DNA fragmentation index was associated with the presence of vacuoles, defective perivitelline space, and fragmented polar body. The effect of sperm DNA fragmentation on miscarriage rates was significantly influenced by the presence of centrally located cytoplasmic granulation, a defective perivitelline space and non-resistant membrane. CONCLUSION A high sperm DNA fragmentation index increases the likelihood of miscarriage in intracytoplasmic sperm injection cycles, an effect that may potentially be magnified by the presence of oocyte dysmorphisms.
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Affiliation(s)
| | | | - Christina Morishima
- Instituto Sapientiae-Centro de Estudos e Pesquisa em Reprodução Assistida, Sao Paulo, Brazil
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Tatíčková M, Trebichalská Z, Kyjovská D, Otevřel P, Kloudová S, Holubcová Z. The ultrastructural nature of human oocytes' cytoplasmic abnormalities and the role of cytoskeleton dysfunction. F&S SCIENCE 2023; 4:267-278. [PMID: 37730013 DOI: 10.1016/j.xfss.2023.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 09/13/2023] [Accepted: 09/14/2023] [Indexed: 09/22/2023]
Abstract
OBJECTIVE To investigate the structural bases of human oocytes' cytoplasmic abnormalities and the causative mechanism of their emergence. Knowledge of an abnormal oocyte's intracellular organization is vital to establishing reliable criteria for clinical evaluation of oocyte morphology. DESIGN Laboratory-based study on experimental material provided by a private assisted reproduction clinic. SETTING University laboratory and imaging center. PATIENTS A total of 105 women undergoing hormonal stimulation for in vitro fertilization (IVF) donated their spare oocytes for this study. INTERVENTIONS Transmission electron microscopy (TEM) was used to analyze the fine morphology of 22 dysmorphic IVF oocytes exhibiting different types of cytoplasmic irregularities, namely, refractile bodies; centrally located cytoplasmic granularity (CLCG); smooth endoplasmic reticulum (SER) disc; and vacuoles. A total of 133 immature oocytes were exposed to cytoskeleton-targeting compounds or matured in control conditions, and their morphology was examined using fluorescent and electron microscopy. MAIN OUTCOME MEASURES The ultrastructural morphology of dysmorphic oocytes was analyzed. Drug-treated oocytes had their maturation efficiency, chromosome-microtubule configurations, and fine intracellular morphology examined. RESULTS TEM revealed ultrastructural characteristics of common oocyte aberrations and indicated that excessive organelle clustering was the underlying cause of 2 of the studied morphotypes. Inhibition experiments showed that disruption of actin, not microtubules, allows for inordinate aggregation of subcellular structures, resembling the ultrastructural pattern seen in morphologically abnormal oocytes retrieved in IVF cycles. These results imply that actin serves as a regulator of organelle distribution during human oocyte maturation. CONCLUSION The ultrastructural analogy between dysmorphic oocytes and oocytes, in which actin network integrity was perturbed, suggests that dysfunction of the actin cytoskeleton might be implicated in generating common cytoplasmic aberrations. Knowledge of human oocytes' inner workings and the origin of morphological abnormalities is a step forward to a more objective oocyte quality assessment in IVF practice.
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Affiliation(s)
- Martina Tatíčková
- Department of Histology and Embryology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Zuzana Trebichalská
- Department of Histology and Embryology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Drahomíra Kyjovská
- Reprofit International, Clinic of Reproductive Medicine, Brno, Czech Republic
| | - Pavel Otevřel
- Reprofit International, Clinic of Reproductive Medicine, Brno, Czech Republic
| | - Soňa Kloudová
- Reprofit International, Clinic of Reproductive Medicine, Brno, Czech Republic
| | - Zuzana Holubcová
- Department of Histology and Embryology, Faculty of Medicine, Masaryk University, Brno, Czech Republic; Reprofit International, Clinic of Reproductive Medicine, Brno, Czech Republic.
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7
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Latif S, Saridogan E. Endometriosis, Oocyte, and Embryo Quality. J Clin Med 2023; 12:4186. [PMID: 37445220 DOI: 10.3390/jcm12134186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 06/11/2023] [Accepted: 06/15/2023] [Indexed: 07/15/2023] Open
Abstract
Endometriosis is a common finding among women with infertility, and women who are diagnosed with endometriosis are almost twice as likely to experience infertility. Mechanisms by which endometriosis causes infertility remain poorly understood. In this review, we evaluate the current literature on the impact of endometriosis on oocyte and embryo quality. The presence of endometriosis evidently reduces ovarian reserve, oocyte quality, and embryo quality; however, this does not appear to translate to a clear clinical impact. Analysis of data from large assisted reproduction technology registries has shown that women with endometriosis have a lower oocyte yield but no reduction in reproductive outcomes. There is a need for future studies in the form of well-designed randomized controlled trials to further evaluate the role of surgical and medical treatment options in women with endometriosis undergoing assisted conception.
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Affiliation(s)
- Sania Latif
- Reproductive Medicine Unit, University College London Hospital, London NW1 2BU, UK
- Institute for Women's Health, University College London, London WC1E 6HU, UK
| | - Ertan Saridogan
- Reproductive Medicine Unit, University College London Hospital, London NW1 2BU, UK
- Institute for Women's Health, University College London, London WC1E 6HU, UK
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8
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Jabarpour M, Aleyasin A, Nashtaei MS, Lotfi S, Amidi F. Astaxanthin treatment ameliorates ER stress in polycystic ovary syndrome patients: a randomized clinical trial. Sci Rep 2023; 13:3376. [PMID: 36854788 PMCID: PMC9974957 DOI: 10.1038/s41598-023-28956-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 01/27/2023] [Indexed: 03/02/2023] Open
Abstract
Astaxanthin (ASX), as a natural carotenoid compound, exists in various types of seafood and microorganisms. It has several possible beneficial therapeutic effects for patients with polycystic ovary syndrome (PCOS). Patients with PCOS also suffer from endoplasmic reticulum (ER) stress. In the present work, it was hypothesized that ER stress could be improved by ASX in PCOS patients. Granulosa cells (GCs) were obtained from 58 PCOS patients. The patients were classified into ASX treatment (receiving 12 mg/day for 60 days) and placebo groups. The expression levels of ER stress pathway genes and proteins were explored using Western blotting and quantitative polymerase chain reaction. To assess oxidative stress markers, follicular fluid (FF) was gained from all patients. The Student's t test was used to perform statistical analysis. After the intervention, ASX led to a considerable reduction in the expression levels of 78-kDa glucose-regulated protein (GRP78), CCAAT/enhancer-binding protein homologous protein (CHOP), and X-box-binding protein 1 compared to the placebo group, though the reduction in the messenger RNA (mRNA) expression level of activating transcription factor 6 was not statistically significant. However, ASX significantly increased the ATF4 expression level. GRP78 and CHOP protein levels represented a considerable decrease in the treatment group after the intervention. In addition, a statistically significant increase was found in the FF level of total antioxidant capacity in the treatment group. Based on clinical outcomes, no significant differences were found between the groups in terms of the oocyte number, fertilization rate, and fertility rate, but the ASX group had higher rates of high-quality oocytes, high-quality embryo, and oocyte maturity compared to the placebo group. Our findings demonstrated that ER stress in the GCs of PCOS patients could be modulated by ASX by changing the expression of genes and proteins included in the unfolding protein response.Trial registration This study was retrospectively registered on the Iranian Registry of Clinical Trials website ( www.irct.ir ; IRCT-ID: IRCT20201029049183N, 2020-11-27).
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Affiliation(s)
- Masoome Jabarpour
- grid.411705.60000 0001 0166 0922Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Pour Sina St, Tehran, 1416753955 Iran
| | - Ashraf Aleyasin
- grid.415646.40000 0004 0612 6034Department of Infertility, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Shabani Nashtaei
- grid.411705.60000 0001 0166 0922Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Pour Sina St, Tehran, 1416753955 Iran ,grid.415646.40000 0004 0612 6034Department of Infertility, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Sara Lotfi
- grid.411705.60000 0001 0166 0922Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Pour Sina St, Tehran, 1416753955 Iran
| | - Fardin Amidi
- Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Pour Sina St, Tehran, 1416753955, Iran. .,Department of Infertility, Yas Hospital, Tehran University of Medical Sciences, Tehran, Iran.
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9
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Unique Deep Radiomic Signature Shows NMN Treatment Reverses Morphology of Oocytes from Aged Mice. Biomedicines 2022; 10:biomedicines10071544. [PMID: 35884850 PMCID: PMC9313081 DOI: 10.3390/biomedicines10071544] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 06/20/2022] [Accepted: 06/27/2022] [Indexed: 01/02/2023] Open
Abstract
The purpose of this study is to develop a deep radiomic signature based on an artificial intelligence (AI) model. This radiomic signature identifies oocyte morphological changes corresponding to reproductive aging in bright field images captured by optical light microscopy. Oocytes were collected from three mice groups: young (4- to 5-week-old) C57BL/6J female mice, aged (12-month-old) mice, and aged mice treated with the NAD+ precursor nicotinamide mononucleotide (NMN), a treatment recently shown to rejuvenate aspects of fertility in aged mice. We applied deep learning, swarm intelligence, and discriminative analysis to images of mouse oocytes taken by bright field microscopy to identify a highly informative deep radiomic signature (DRS) of oocyte morphology. Predictive DRS accuracy was determined by evaluating sensitivity, specificity, and cross-validation, and was visualized using scatter plots of the data associated with three groups: Young, old and Old + NMN. DRS could successfully distinguish morphological changes in oocytes associated with maternal age with 92% accuracy (AUC~1), reflecting this decline in oocyte quality. We then employed the DRS to evaluate the impact of the treatment of reproductively aged mice with NMN. The DRS signature classified 60% of oocytes from NMN-treated aged mice as having a ‘young’ morphology. In conclusion, the DRS signature developed in this study was successfully able to detect aging-related oocyte morphological changes. The significance of our approach is that DRS applied to bright field oocyte images will allow us to distinguish and select oocytes originally affected by reproductive aging and whose quality has been successfully restored by the NMN therapy.
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10
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Del Giudice F, Belladelli F, Chen T, Glover F, Mulloy EA, Kasman AM, Sciarra A, Salciccia S, Canale V, Maggi M, Ferro M, Busetto GM, De Berardinis E, Salonia A, Eisenberg ML. The association of impaired semen quality and pregnancy rates in assisted reproduction technology cycles: Systematic review and meta-analysis. Andrologia 2022; 54:e14409. [PMID: 35244232 PMCID: PMC9540664 DOI: 10.1111/and.14409] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 02/03/2022] [Accepted: 02/18/2022] [Indexed: 12/29/2022] Open
Abstract
Some studies suggest a relationship between semen quality and pregnancy rates of assisted reproduction technologies (ART). Others have questioned the utility of semen quality as proxy for fertility in couples attempting to conceive with or without assistance. We aimed to investigate the current body of evidence which correlates semen parameters and clinical pregnancy among couples utilizing ART (i.e. in vitro fertilization [IVF], intracytoplasmic sperm injection [ICSI]) through a systematic review and meta‐analysis of cross‐sectional and retrospective cohort studies. Pooled Odd Ratio (OR) for oligo‐, astheno‐ and teratospermic compared to normospermic number of ART cycles were calculated among. Meta‐regression and sub‐group analysis were implemented to model the contribution of clinical/demographic and laboratory standards differences among the studies. Overall, 17 studies were analysed representing 17,348 cycles were analysed. Pooled OR for impaired sperm concentration, motility and morphology was 1 (95%Confidence Interval [CI]: 0.97–1.03), 0.88 (95%CI: 0.73–1.03) and 0.88 (95%CI: 0.75–1) respectively. Further analysis on sperm morphology showed no differences with regard of IVF versus ICSI (p = 0.14) nor a significant correlation with rising reference thresholds (Coeff: −0.02, p = 0.38). A temporal trend towards a null association between semen parameters and clinical pregnancy was observed over the 20‐year observation period (Coeff: 0.01, p = 0.014). The current analysis found no association between semen quality (as measured by concentration, motility or morphology) and clinical pregnancy rates utilizing ART. Future investigations are necessary to explore the association between semen parameters and other ART outcomes (e.g. fertilization, implantation, birth and perinatal health).
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Affiliation(s)
- Francesco Del Giudice
- Department of Maternal-Infant and Urological Sciences, "Sapienza" Rome University, Policlinico Umberto I Hospital, Rome, Italy.,Department of Urology, Stanford University School of Medicine, Stanford, California, USA
| | - Federico Belladelli
- Department of Urology, Stanford University School of Medicine, Stanford, California, USA.,University Vita-Salute San Raffaele, Milan, Italy.,Division of Experimental Oncology/Unit of Urology, Urological Research Institute, IRCCS San Raffaele Hospital, Milan, Italy
| | - Tony Chen
- Department of Urology, Stanford University School of Medicine, Stanford, California, USA
| | - Frank Glover
- Emory School of Medicine - Emory University, Atlanta, Georgia, USA
| | - Evan A Mulloy
- Department of Urology, Stanford University School of Medicine, Stanford, California, USA
| | - Alex M Kasman
- Department of Urology, Stanford University School of Medicine, Stanford, California, USA
| | - Alessandro Sciarra
- Department of Maternal-Infant and Urological Sciences, "Sapienza" Rome University, Policlinico Umberto I Hospital, Rome, Italy
| | - Stefano Salciccia
- Department of Maternal-Infant and Urological Sciences, "Sapienza" Rome University, Policlinico Umberto I Hospital, Rome, Italy
| | - Vittorio Canale
- Department of Maternal-Infant and Urological Sciences, "Sapienza" Rome University, Policlinico Umberto I Hospital, Rome, Italy
| | - Martina Maggi
- Department of Maternal-Infant and Urological Sciences, "Sapienza" Rome University, Policlinico Umberto I Hospital, Rome, Italy
| | - Matteo Ferro
- Department of Urology, European Institute of Oncology (IEO), IRCCS, Milan, Italy
| | | | - Ettore De Berardinis
- Department of Maternal-Infant and Urological Sciences, "Sapienza" Rome University, Policlinico Umberto I Hospital, Rome, Italy
| | - Andrea Salonia
- University Vita-Salute San Raffaele, Milan, Italy.,Division of Experimental Oncology/Unit of Urology, Urological Research Institute, IRCCS San Raffaele Hospital, Milan, Italy
| | - Michael L Eisenberg
- Department of Urology, Stanford University School of Medicine, Stanford, California, USA.,Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, California, USA
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Campbell JM, Mahbub SB, Bertoldo MJ, Habibalahi A, Goss DM, Ledger WL, Gilchrist RB, Wu LE, Goldys EM. Multispectral autofluorescence characteristics of reproductive aging in old and young mouse oocytes. Biogerontology 2022; 23:237-249. [PMID: 35211812 PMCID: PMC9023381 DOI: 10.1007/s10522-022-09957-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 02/14/2022] [Indexed: 12/16/2022]
Abstract
Increasing age has a major detrimental impact on female fertility, which, with an ageing population, has major sociological implications. This impact is primarily mediated through deteriorating quality of the oocyte. Deteriorating oocyte quality with biological age is the greatest rate-limiting factor to female fertility. Here we have used label-free, non-invasive multi-spectral imaging to identify unique autofluorescence profiles of oocytes from young and aged animals. Discriminant analysis demonstrated that young oocytes have a distinct autofluorescent profile which accurately distinguishes them from aged oocytes. We recently showed that treatment with the nicotinamide adenine dinucleotide (NAD+) precursor nicotinamide mononucleotide (NMN) restored oocyte quality and fertility in aged animals, and when our analysis was applied to oocytes from aged animals treated with NMN, 85% of these oocytes were classified as having the autofluorescent signature of young animals. Spectral unmixing using the Robust Dependent Component Analysis (RoDECA) algorithm demonstrated that NMN treatment altered the metabolic profile of oocytes, increasing free NAD(P)H, protein bound NAD(P)H, redox ratio and the ratio of bound to free NAD(P)H. The frequency of oocytes with simultaneously high NAD(P)H and flavin content was also significantly increased in mice treated with NMN. Young and Aged + NMN oocytes had a smoother spectral distribution, with the distribution of NAD(P)H in young oocytes specifically differing from that of aged oocytes. Identifying the multispectral profile of oocyte autofluorescence during aging could have utility as a non-invasive and sensitive measure of oocyte quality.
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Affiliation(s)
- Jared M Campbell
- ARC Centre of Excellence Centre for Nanoscale Biophotonics, Graduate School of Biomedical Engineering, University of New South Wales Sydney, Kensington, Sydney, NSW, 2052, Australia.
| | - Saabah B Mahbub
- ARC Centre of Excellence Centre for Nanoscale Biophotonics, Graduate School of Biomedical Engineering, University of New South Wales Sydney, Kensington, Sydney, NSW, 2052, Australia
| | - Michael J Bertoldo
- Discipline of Women's Health, School of Clinical Medicine, University of New South Wales Sydney, Sydney, Australia
- School of Medical Sciences, University of New South Wales Sydney, Sydney, Australia
| | - Abbas Habibalahi
- ARC Centre of Excellence Centre for Nanoscale Biophotonics, Graduate School of Biomedical Engineering, University of New South Wales Sydney, Kensington, Sydney, NSW, 2052, Australia
| | - Dale M Goss
- School of Medical Sciences, University of New South Wales Sydney, Sydney, Australia
| | - William L Ledger
- Discipline of Women's Health, School of Clinical Medicine, University of New South Wales Sydney, Sydney, Australia
| | - Robert B Gilchrist
- Discipline of Women's Health, School of Clinical Medicine, University of New South Wales Sydney, Sydney, Australia
| | - Lindsay E Wu
- School of Medical Sciences, University of New South Wales Sydney, Sydney, Australia
| | - Ewa M Goldys
- ARC Centre of Excellence Centre for Nanoscale Biophotonics, Graduate School of Biomedical Engineering, University of New South Wales Sydney, Kensington, Sydney, NSW, 2052, Australia
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12
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Uk A, Decanter C, Grysole C, Keller L, Béhal H, Silva M, Dewailly D, Robin G, Barbotin AL. Polycystic ovary syndrome phenotype does not have impact on oocyte morphology. Reprod Biol Endocrinol 2022; 20:7. [PMID: 34986863 PMCID: PMC8729101 DOI: 10.1186/s12958-021-00874-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 12/07/2021] [Indexed: 11/15/2022] Open
Abstract
PURPOSE The primary objective of the present study of women participating in an ICSI program was to determine whether the morphologic quality of oocytes was related to the polycystic ovary syndrome (PCOS) phenotype. METHODS We performed a retrospective cohort study in the IVF unit at the Lille University Medical Center (Lille, France) between 2006 and 2015. Oocyte morphology (fragmented first polar body, abnormal zona pellucida, large perivitelline space, material in perivitelline space, abnormal shape of oocyte, granular cytoplasm and intracytoplasmic vacuoles) was evaluated in PCOS women and according to different subgroup (depending on the presence or absence of the cardinal features polycystic ovarian morphology (PCOM), hyperandrogenism (HA), and oligo-anovulation (OA)). RESULTS A total of 1496 metaphase II oocytes (n = 602 for phenotype A combining PCOM + HA + OA, n = 462 oocytes for phenotype C: PCOM + HA, and n = 432 for phenotype D: PCOM + OA) were assessed. The phenotypes A, C and D did not differ significantly with regard to the proportion of normal oocytes (adjusted percentages (95%CI): 35.2% (31.5 to 39.1%), 25.8% (21.9 to 29.9%) and 34.0% (29.7 to 38.6%), respectively: adjusted p = 0.13). Likewise, there were no significant intergroup differences in oocyte morphology. The ICSI outcome was not significantly associated with the PCOS phenotype. CONCLUSION The present study is the first to show that the PCOS phenotype (notably the presence vs. absence of OA and/or HA) is not significantly associated with the morphological quality of oocytes.
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Affiliation(s)
- Audrey Uk
- CHU Lille, Institut de Biologie de la Reproduction-Spermiologie-CECOS, Jeanne de Flandre Hospital, Lille, France
- Inserm UMR-S 1172, Laboratory of Development and Plasticity of the Neuroendocrine Brain, Lille, France
- Department of Medicine, University of Lille, Lille, France
| | - Christine Decanter
- CHU Lille, Department of Endocrine Gynecology and Reproductive Medicine, Jeanne de Flandre Hospital, Lille, France
- Inserm EA 4308 Gametogenèse et Qualité du Gamète, Institut de Biologie de la Reproduction-Spermiologie-CECOS, Lille, France
| | - Camille Grysole
- CHU Lille, Department of Endocrine Gynecology and Reproductive Medicine, Jeanne de Flandre Hospital, Lille, France
| | - Laura Keller
- CHU Lille, Institut de Biologie de la Reproduction-Spermiologie-CECOS, Jeanne de Flandre Hospital, Lille, France
| | - Hélène Béhal
- Univ. Lille, CHU Lille, ULR 2694 - METRICS: Évaluation des Technologies de Santé et des Pratiques Médicales, Lille, France
| | - Mauro Silva
- Inserm UMR-S 1172, Laboratory of Development and Plasticity of the Neuroendocrine Brain, Lille, France
| | | | - Geoffroy Robin
- Department of Medicine, University of Lille, Lille, France
- CHU Lille, Department of Endocrine Gynecology and Reproductive Medicine, Jeanne de Flandre Hospital, Lille, France
- Inserm EA 4308 Gametogenèse et Qualité du Gamète, Institut de Biologie de la Reproduction-Spermiologie-CECOS, Lille, France
| | - Anne-Laure Barbotin
- CHU Lille, Institut de Biologie de la Reproduction-Spermiologie-CECOS, Jeanne de Flandre Hospital, Lille, France.
- Inserm UMR-S 1172, Laboratory of Development and Plasticity of the Neuroendocrine Brain, Lille, France.
- Department of Medicine, University of Lille, Lille, France.
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13
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Bartolacci A, Intra G, Coticchio G, dell’Aquila M, Patria G, Borini A. Does morphological assessment predict oocyte developmental competence? A systematic review and proposed score. J Assist Reprod Genet 2022; 39:3-17. [PMID: 34993709 PMCID: PMC8866588 DOI: 10.1007/s10815-021-02370-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 11/26/2021] [Indexed: 01/03/2023] Open
Abstract
PURPOSE Does existing scientific literature suggest an impact of oocyte dysmorphisms on biological or clinical outcomes of assisted reproduction treatments? METHODS Studies of interest were selected from an initial cohort of 6651 potentially relevant records retrieved. PubMed was systematically searched for peer-reviewed original papers and reviews identified by keywords and medical subject heading (MeSH) terms. The most relevant publications were critically evaluated to identify criteria for oocyte morphological evaluation and IVF outcomes. For each morphological abnormality, we generated an oocyte literature score (OLS) through the following procedure: (a) papers showing a negative, absence of, or positive correlation between a given abnormality and IVF outcome were scored 1, 0, and - 1, respectively; (b) the sum of these scores was expressed as a fraction of all analyzed papers; (c) the obtained fraction was multiplied by 10 and converted into decimal number. RESULT We identified eleven different dysmorphisms, of which six were extracytoplasmic (COC, zona pellucida, perivitelline space, polar body 1, shape, giant size) and five intracytoplasmic (vacuoles, refractile bodies, SER clusters, granularity, color). Among the extracytoplasmic dysmorphisms, abnormal morphology of the COC generated an OLS of 8.33, indicating a large prevalence (5/6) of studies associated with a negative outcome. Three intracytoplasmic dysmorphisms (vacuoles, SER clusters, and granularity) produced OLS of 7.14, 7.78, and 6.25, respectively, suggestive of a majority of studies reporting a negative outcome. CONCLUSION COC morphology, vacuoles, SER clusters, and granularity produced OLS suggestive of a prevalence of studies reporting a negative outcome.
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Affiliation(s)
| | - Giulia Intra
- 9.Baby, Family and Fertility Center, Via Dante 15, Bologna, Italy
| | | | | | - Gilda Patria
- 9.Baby, Family and Fertility Center, Via Dante 15, Bologna, Italy
| | - Andrea Borini
- 9.Baby, Family and Fertility Center, Via Dante 15, Bologna, Italy
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14
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Dimitriadis I, Zaninovic N, Badiola AC, Bormann CL. Artificial intelligence in the embryology laboratory: a review. Reprod Biomed Online 2021; 44:435-448. [PMID: 35027326 DOI: 10.1016/j.rbmo.2021.11.003] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 10/07/2021] [Accepted: 11/04/2021] [Indexed: 02/03/2023]
Abstract
The goal of an IVF cycle is a healthy live-born baby. Despite the many advances in the field of assisted reproductive technologies, accurately predicting the outcome of an IVF cycle has yet to be achieved. One reason for this is the method of selecting an embryo for transfer. Morphological assessment of embryos is the traditional method of evaluating embryo quality and selecting which embryo to transfer. However, this subjective method of assessing embryos leads to inter- and intra-observer variability, resulting in less than optimal IVF success rates. To overcome this, it is common practice to transfer more than one embryo, potentially resulting in high-risk multiple pregnancies. Although time-lapse incubators and preimplantation genetic testing for aneuploidy have been introduced to help increase the chances of live birth, the outcomes remain less than ideal. Utilization of artificial intelligence (AI) has become increasingly popular in the medical field and is increasingly being leveraged in the embryology laboratory to help improve IVF outcomes. Many studies have been published investigating the use of AI as an unbiased, automated approach to embryo assessment. This review summarizes recent AI advancements in the embryology laboratory.
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Affiliation(s)
- Irene Dimitriadis
- Department of Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School, Boston MA, USA
| | - Nikica Zaninovic
- The Ronald O Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medicine, New York NY, USA
| | - Alejandro Chavez Badiola
- New Hope Fertility Center, Av. Prado Norte 135, Lomas de Chapultepec, Mexico City, Mexico; IVF 2.0 LTD, 1 Liverpool Rd, Maghull, Merseyside, UK; School of Biosciences, University of Kent Kent, UK
| | - Charles L Bormann
- Department of Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School, Boston MA, USA.
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15
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Association between decreased ovarian reserve and poor oocyte quality. Obstet Gynecol Sci 2021; 64:532-539. [PMID: 34663062 PMCID: PMC8595049 DOI: 10.5468/ogs.20168] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 09/03/2021] [Indexed: 12/01/2022] Open
Abstract
Objective To analyze the association between oocyte quality and decreased ovarian reserve (DOR) markers in young women undergoing controlled ovarian stimulation (COS). Methods This retrospective study included 49 patients classified as having DOR based on anti-Müllerian hormone (AMH) levels, follicle-stimulating hormone (FSH) levels, or antral follicle counts (AFCs; <10). Images of all obtained oocytes were analyzed, and oocyte quality was classified according to maturity and morphology. The COS protocol utilized gonadotropin (FSH and/or human menopausal gonadotropin [hMG]) doses ranging from 150 to 300 IU/day. The Student’s t test or Mann-Whitney test was used to compare the groups. Spearman’s coefficients were estimated to verify the correlation between the administered dose of FSH/hMG and the number of mature oocytes. To evaluate the association between patient- and oocyte-related variables, logistic regression models were adjusted. Results Women with DOR classified according to FSH level had more immature oocytes (P<0.001). Women with DOR according to AMH had fewer mature oocytes and increased basal FSH levels (P<0.001). Women with DOR according to AFC had an increased risk of abnormally shaped oocytes (P=0.035). Conclusion This study showed that DOR based on AMH levels, FSH levels, and AFC was associated with poorer quality oocytes in young women who underwent COS.
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16
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Robin C, Uk A, Decanter C, Behal H, Collinet P, Rubod C, Barbotin AL, Robin G. Impact of endometriosis on oocyte morphology in IVF-ICSI: retrospective study of a cohort of more than 6000 mature oocytes. Reprod Biol Endocrinol 2021; 19:160. [PMID: 34656130 PMCID: PMC8522159 DOI: 10.1186/s12958-021-00798-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 07/11/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Infertility associated with endometriosis can be explained by several non-exclusive mechanisms. The oocyte plays a crucial role in determining embryonic competence and this is particularly relevant for in vitro fertilization (IVF) outcomes. According to some authors, the morphology of oocytes could also be a non-invasive marker of oocyte quality. The aim of this study was to evaluate the relationship between endometriosis and oocyte morphology after controlled ovarian stimulation for intracytoplasmic sperm injection (ICSI) on a large oocyte cohort. METHODS Single-center comparative retrospective study in the academic In Vitro Fertilization (IVF) unit of the Lille University Hospital. A total of 596 women treated for IVF-ICSI with ejaculated spermatozoa for sperm alterations were included. They were classified as endometriosis (n = 175) or control groups (n = 401). The morphological evaluation of 2,016 mature oocytes from 348 cycles of patients with endometriosis was compared with that of 4,073 mature oocytes from 576 control cycles. The main outcome measures were Average Oocyte Quality Index (AOQI) and metaphase II oocyte morphological scoring system (MOMS). Comparison of groups was carried out by a mixed linear model and by a generalized estimation equation model with a "patient" random effect to consider that a patient might have several attempts. RESULTS No difference in AOQI and MOMS scores was found between endometriosis and control women (adjusted p = 0.084 and 0.053, respectively). In case of endometriosis, there were significantly fewer metaphase II oocytes retrieved, embryos obtained, grade 1 embryos and number of cumulative clinical pregnancies compared to controls. In the endometriosis group, endometriosis surgery was associated with a reduced number of mature oocytes retrieved, and the presence of endometrioma(s) was associated with some abnormal oocyte shapes. Nevertheless, no difference concerning the AOQI and MOMS scores was found in these subgroups. CONCLUSION Endometriosis does not have a negative impact on oocytes' morphology in IVF-ICSI. TRIAL REGISTRATION On December 16, 2019, the Institutional Review Board of the Lille University Hospital gave unrestricted approval for the anonymous use of all patients' clinical, hormonal and ultrasound records (reference DEC20150715-0002).
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Affiliation(s)
- Camille Robin
- Service de Gynécologie Endocrinienne Et Médecine de La Reproduction, CHU Lille, Assistance Médicale À La Procréation Et Préservation de La Fertilité, Hôpital Jeanne de Flandre, Service dAvenue Eugène Avinée, 59000, Lille, France.
| | - Audrey Uk
- Institut de Biologie de La Reproduction-Spermiologie-CECOS, Hôpital Jeanne de Flandre, Centre Hospitalier Et Universitaire, 59000, Lille, France
| | - Christine Decanter
- Service de Gynécologie Endocrinienne Et Médecine de La Reproduction, CHU Lille, Assistance Médicale À La Procréation Et Préservation de La Fertilité, Hôpital Jeanne de Flandre, Service dAvenue Eugène Avinée, 59000, Lille, France
- EA 4308 Gamètogenèse Et Qualité du Gamète, Faculté de Médecine Et CHU de Lille, F-59000, Lille, France
| | - Hélène Behal
- EA 2694, Santé Publique : Épidémiologie Et Qualité Des Soins, Univ. Lille, CHU Lille, Unité de Biostatistiques, F-59000, Lille, France
| | - Pierre Collinet
- Service de Chirurgie Gynécologique, Hôpital Jeanne de Flandre, Centre Hospitalier Et Universitaire, 59000, Lille, France
- Faculté de Médecine, Université de Lille, 59045, Lille, France
| | - Chrystèle Rubod
- Service de Chirurgie Gynécologique, Hôpital Jeanne de Flandre, Centre Hospitalier Et Universitaire, 59000, Lille, France
- Faculté de Médecine, Université de Lille, 59045, Lille, France
| | - Anne-Laure Barbotin
- Institut de Biologie de La Reproduction-Spermiologie-CECOS, Hôpital Jeanne de Flandre, Centre Hospitalier Et Universitaire, 59000, Lille, France
- EA 4308 Gamètogenèse Et Qualité du Gamète, Faculté de Médecine Et CHU de Lille, F-59000, Lille, France
- Faculté de Médecine, Université de Lille, 59045, Lille, France
| | - Geoffroy Robin
- Service de Gynécologie Endocrinienne Et Médecine de La Reproduction, CHU Lille, Assistance Médicale À La Procréation Et Préservation de La Fertilité, Hôpital Jeanne de Flandre, Service dAvenue Eugène Avinée, 59000, Lille, France
- EA 4308 Gamètogenèse Et Qualité du Gamète, Faculté de Médecine Et CHU de Lille, F-59000, Lille, France
- Faculté de Médecine, Université de Lille, 59045, Lille, France
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Karibayeva G, Tevkin S, Jussubaliyeva T, Shishimorova M. DYSMORPHISMS OF OOCYTES IN ART PROCEDURES: A LITERATURE REVIEW. REPRODUCTIVE MEDICINE 2021. [DOI: 10.37800/rm.3.2021.44-53] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Relevance: Assisted reproductive technologies (ART) are rapidly developing and in recent decades have become increasingly important due to the growing number of infertile couples around the world. Human oocytes are the main objects used in ART procedures. Consequently, the quality of oocytes can determine the key parameters of ART.
The purpose of this review was to analyze the literature and the results of studies in the field of ART devoted to extracytoplasmic dysmorphisms of human oocytes – morphological changes outside the cytoplasmic structure of oocytes, their effect on fertilization, cleavage, implantation frequency, clinical pregnancy rate, as well as the possibility of their use as biomarkers for predicting the quality of embryos, blastocysts, and their further implantation potential.
Materials and Methods: This literature review was based on a search conducted among domestic and foreign publications for 2000-2020 available in Russian and international search systems (PubMed, eLibrary) using the keywords «infertility,” “IVF,” «oocyte,” “morphological assessment of oocytes,” “dysmorphisms of oocytes ,” and “ assisted reproductive technologies.”
Results: This literature review contains literature data and the analysis of research results in the field of ART devoted to the morphological qualities and abnormalities (dysmorphisms) of human oocytes. It describes the types of extracytoplasmic abnormalities encountered in the clinical practice of in-vitro fertilization, their effect on fertilization, cleavage, implantation rate, and clinical pregnancy rate, as well as the possibility of their use as biomarkers to predict the quality of embryos and blastocysts and their further implantation potential.
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18
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Guimarães RM, Ribeiro LM, Sasaki LP, Nakagawa HM, Cabral IO. Oocyte Morphology and Reproductive Outcomes - Case Report and Literature Review. JBRA Assist Reprod 2021; 25:500-507. [PMID: 33739798 PMCID: PMC8312307 DOI: 10.5935/1518-0557.20210001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Oocyte quality could be negatively affected by many factors including smoking, alcohol consumption, obesity, woman's age, endometriosis and controlled ovarian stimulation (COS), during assisted reproductive technology (ART), in addition to genetic factors, such as hormone receptor polymorphisms, for example. We know that the increase in the reactive oxygen species (ROS) due to systemic disorders causes biochemical and morphological changes to the oocytes, interfering with their quality. The oocyte dysmorphism can be expressed through intra and/or extra cytoplasmic changes. In general, the size and number of oocytes' morphological abnormalities are directly related to preimplantation development failure. This case report is based on four in vitro fertilization (IVF) cycles performed by a patient with oocyte dysmorphism in all oocytes captured. The literature review on this topic aims to relate the characteristics of the oocytes, presented in the case report, with research results about the quality and morphology of the oocytes.
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Affiliation(s)
- Raquel Meirelles Guimarães
- Genesis - Human Reproduction Assistance Center - Brasílila, DF, Brazil.,Taguatinga Regional Hospital - Brasília, DF, Brazil
| | - Larissa Maciel Ribeiro
- Genesis - Human Reproduction Assistance Center - Brasílila, DF, Brazil.,Maternal-Infant Hospital of Brasília - Department of Human Reproduction - Brasília, DF, Brazil
| | - Lizandra Paravidine Sasaki
- Genesis - Human Reproduction Assistance Center - Brasílila, DF, Brazil.,University Hospital of Brasília - Brasília, DF, Brazil
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Karibayeva G, Tevkin S, Jussubaliyeva T, Shishimorova M. DYSMORPHISMS OF OOCYTES IN ART PROCEDURES. LITERATURE REVIEW. REPRODUCTIVE MEDICINE 2021. [DOI: 10.37800/rm2021-1-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Currentliterature review presents the analysis of results of studies of morphological qualities and anomalies (dysmorphisms) of human oocytes in the field of assisted reproductive technologies. The variety of intracytoplasmic anomalies encountered in the clinical practice of in vitro fertilization, their effect on fertilization, cleavage, implantation frequency, clinical pregnancy rate were described. Moreover, the morphological characteristics of oocyte could be considered to use as biomarkers in predicting the quality of embryos and blastocysts, and further implantation potential.
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Aghajanova L, Kao CN, Cedars M, Tran N. Assessing the impact of semen quality on embryo development in an egg donation model. F S Rep 2021; 2:22-29. [PMID: 34223269 PMCID: PMC8244319 DOI: 10.1016/j.xfre.2020.10.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 10/22/2020] [Accepted: 10/29/2020] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE To investigate if any of the World Health Organization semen parameters and/or male age are associated with embryo development. DESIGN Retrospective chart review between January 2008 and May 2015. SETTING Academic fertility practice. PATIENTS Anonymous egg donors aged ≤30 years. INTERVENTIONS Chart review. MAIN OUTCOME MEASURES Sperm parameters were evaluated on a continuum and were dichotomized to determine if low values (strict morphology < 4%, concentration < 15 × 106, low motility < 40%) or older age (>50 years) are associated with embryo morphology. Repeated linear regression measures to determine the associations and multivariate testing to determine independent effects for each predictor were performed. RESULTS Three hundred eighty-four donors with 574 egg donation cycles were identified, and 205 subjects with 275 cycles were included in the final analysis. The mean donor age was 25.31 ± 2.81 years, with a mean antral follicle count of 28.09 ± 10.5. The mean male age was 43.25 ± 6.65 years. The mean World Health Organization semen parameters at fertilization were 55.8 × 106 ± 44.3 × 106/mL concentration, 44.8% ± 20.2% motility, and 6.9% ± 5.3% strict morphology. Neither male age nor sperm morphology was associated with embryo morphology. A low total motile count was significantly associated with a higher cell number in day-3 embryos and a 1.56-times higher chance of poor day-3 cell symmetry. There was no statistically significant difference in blastocyst formation, clinical pregnancy, or live-birth rates. CONCLUSIONS Although statistically significant, the effect of the low total motile count on day-3 cell number and cell symmetry are likely clinically insignificant. Male age, race, or poor sperm morphology were not associated with a poor cycle outcome or impaired embryo development. The use of intracytoplasmic sperm injection likely alleviates the negative effect of diminished semen quality on treatment outcome.
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Affiliation(s)
- Lusine Aghajanova
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, San Francisco, California
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Stanford School of Medicine, Sunnyvale, California
| | - Chia-Ning Kao
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, San Francisco, California
| | - Marcelle Cedars
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, San Francisco, California
| | - Nam Tran
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, San Francisco, California
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Kim J, You S. Extended adverse effects of cyclophosphamide on mouse ovarian function. BMC Pharmacol Toxicol 2021; 22:3. [PMID: 33413693 PMCID: PMC7792169 DOI: 10.1186/s40360-020-00468-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 12/16/2020] [Indexed: 11/11/2022] Open
Abstract
PURPOSE Most patients with cancer undergo multiple administrations of anticancer drugs during treatment, resulting in chronic impairment of their reproductive health. As improved treatment options increase cancer survival, it has become increasingly important to address fertility issues in cancer survivors. In this study, we examined the pathophysiological effects of multiple exposures to cyclophosphamide (Cy) on the ovaries of mice and their underlying molecular mechanism. METHODS Female C57BL/6 mice were intraperitoneally injected with 100 mg/kg Cy six times over 2 weeks; 4 weeks later, the mice were sacrificed and their ovaries, sera, and oocytes were collected for histological observation, measurement of anti-Müllerian hormone levels, and assessment of oocyte quantity and quality in response to hormonal stimulation. Gene expression changes in Cy-treated ovaries were examined by microarray and bioinformatics analyses. RESULTS After repeated Cy exposure, the anti-Müllerian hormone level was decreased, and follicle loss and impairments in the quality of oocyte were irreversible. The expression levels of genes involved in folliculogenesis, oogenesis, and zona pellucida glycoprotein transcription displayed sustained alterations in Cy-exposed ovaries even after 4 weeks. CONCLUSION The adverse effects of Cy on ovarian function and oocytes remained even after chemotherapy was complete. Therefore, strategies to prevent ovarian damage or restore ovarian function after treatment are required to safeguard the fertility of young cancer survivors.
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Affiliation(s)
- Jihyun Kim
- Clinical Medicine Division, Korea Institute of Oriental Medicine, 1672 Yuseongdae-ro, Yuseong-gu, Daejeon, 34054, Republic of Korea
| | - Sooseong You
- Clinical Medicine Division, Korea Institute of Oriental Medicine, 1672 Yuseongdae-ro, Yuseong-gu, Daejeon, 34054, Republic of Korea.
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22
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Scheffler F, Vandecandelaere A, Soyez M, Bosquet D, Lefranc E, Copin H, Devaux A, Benkhalifa M, Cabry R, Desailloud R. Follicular GH and IGF1 Levels Are Associated With Oocyte Cohort Quality: A Pilot Study. Front Endocrinol (Lausanne) 2021; 12:793621. [PMID: 34925246 PMCID: PMC8672194 DOI: 10.3389/fendo.2021.793621] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 11/15/2021] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Oocyte quality contributes to the development of an optimal embryo and thus a successful pregnancy. The objective of this study was to analyse the association between oocyte cohort quality and the follicular levels of growth hormone (GH), insulin-like growth factor 1 (IGF1), 25-hydroxy vitamin D (25OHD), thyroid-stimulating hormone (TSH), free triiodothyronine (fT3), free thyroxine (fT4) and antithyroid antibodies, as a function of intracytoplasmic sperm injection (ICSI) outcomes. MATERIAL AND METHODS We conducted a prospective comparative pilot study from January 2013 to December 2017. 59 ICSI cycles constituted an abnormal oocyte cohort (n=34 cycles, in which more than 50% of oocytes presented at least one morphological abnormality) and a normal oocyte cohort (n=25 cycles, in which 50% or less of the oocytes presented at least one morphological abnormality). GH, IGF1, 25OHD, TSH, fT3, fT4 and antithyroid antibodies were measured in follicular fluid. RESULTS The fertilisation rate was lower in the abnormal oocyte cohort (65.5% vs. 80%, respectively, p=0.012). Oocytes' proportion with at least one abnormality was 79.4% in the abnormal oocyte cohort and 29.0% in the normal oocyte cohort. The mean number of morphological abnormalities per oocyte was significantly higher in the abnormal oocyte cohort. The follicular levels of GH (4.98 vs. 2.75 mIU/L, respectively; p <0.01) and IGF1 (72.1 vs. 54.2 ng/mL, respectively; p=0.05) were higher in the normal oocyte cohort. There was no association with follicular levels of TSH, fT3, fT4, antithyroid antibodies, or 25OHD. CONCLUSION Oocyte cohort quality appears to be associated with follicular levels of GH and IGF1.
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Affiliation(s)
- Florence Scheffler
- Reproductive Medicine and Biology Department and CECOS of Picardy, Amiens University Hospital, Amiens, France
- Peritox UMR_I 01, CURS, Jules Verne University of Picardy, Amiens, France
- *Correspondence: Florence Scheffler,
| | - Albane Vandecandelaere
- Reproductive Medicine and Biology Department and CECOS of Picardy, Amiens University Hospital, Amiens, France
| | - Marion Soyez
- Endocrine and Bone Biology Department, Amiens University Hospital, Amiens, France
| | - Dorian Bosquet
- Reproductive Medicine and Biology Department and CECOS of Picardy, Amiens University Hospital, Amiens, France
- Peritox UMR_I 01, CURS, Jules Verne University of Picardy, Amiens, France
| | - Elodie Lefranc
- Reproductive Medicine and Biology Department and CECOS of Picardy, Amiens University Hospital, Amiens, France
| | - Henri Copin
- Reproductive Medicine and Biology Department and CECOS of Picardy, Amiens University Hospital, Amiens, France
| | - Aviva Devaux
- Reproductive Medicine and Biology Department and CECOS of Picardy, Amiens University Hospital, Amiens, France
- Peritox UMR_I 01, CURS, Jules Verne University of Picardy, Amiens, France
| | - Moncef Benkhalifa
- Reproductive Medicine and Biology Department and CECOS of Picardy, Amiens University Hospital, Amiens, France
- Peritox UMR_I 01, CURS, Jules Verne University of Picardy, Amiens, France
| | - Rosalie Cabry
- Reproductive Medicine and Biology Department and CECOS of Picardy, Amiens University Hospital, Amiens, France
- Peritox UMR_I 01, CURS, Jules Verne University of Picardy, Amiens, France
| | - Rachel Desailloud
- Peritox UMR_I 01, CURS, Jules Verne University of Picardy, Amiens, France
- Endocrinology, Diabetes, and Nutrition Department, Amiens University Hospital, Amiens, France
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Haddad M, Stewart J, Xie P, Cheung S, Trout A, Keating D, Parrella A, Lawrence S, Rosenwaks Z, Palermo GD. Thoughts on the popularity of ICSI. J Assist Reprod Genet 2020; 38:101-123. [PMID: 33155089 PMCID: PMC7823003 DOI: 10.1007/s10815-020-01987-0] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 10/18/2020] [Indexed: 12/17/2022] Open
Abstract
Purpose Intracytoplasmic sperm injection (ICSI) is the most widely utilized assisted reproductive technique (ART) worldwide. In this feature, we review the early assisted fertilization attempts that eventually led to the development of ICSI, and discuss its current utilization in cases of male and non-male factor infertility. Methods We researched the literature related to the development, indications, and current use of ICSI, such as sperm structural abnormalities, male genetic indications, surgically retrieved sperm, high sperm chromatin fragmentation, oocyte dysmorphism, and preimplantation genetic testing (PGT). We also describe the potential future applications of ICSI. Results This review summarizes the early micromanipulation techniques that led to the inception of ICSI. We also explore its current indications, including non-male factor infertility, where its use is more controversial. Finally, we consider the benefits of future advancements in reproductive biology that may incorporate ICSI, such as in vitro spermatogenesis, neogametogenesis, and heritable genome editing. Conclusion The versatility, consistency, and reliability of ICSI have made it the most prevalently utilized ART procedure worldwide.
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Affiliation(s)
- Mounia Haddad
- The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Joshua Stewart
- The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Philip Xie
- The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Stephanie Cheung
- The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Aysha Trout
- The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Derek Keating
- The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Alessandra Parrella
- The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Sherina Lawrence
- The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Zev Rosenwaks
- The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Gianpiero D Palermo
- The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medicine, New York, NY, USA.
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24
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Bercaire LMN, Cavagna M, Donadio NF, Rocha AR, Portela R, Alves VR, Santos TBB, Cavagna F, Dzik A, Gebrim LH, Nahas EAP. The impact of letrozole administration on oocyte morphology in breast cancer patients undergoing fertility preservation. JBRA Assist Reprod 2020; 24:257-264. [PMID: 32293820 PMCID: PMC7365524 DOI: 10.5935/1518-0557.20200002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Objective: Patients submitted to oncological fertility preservation with letrozole and gonadotropins seem to present a higher rate of immature oocytes and lower fertilization rates in comparison to infertile patients submitted to IVF cycles with gonadotropins. The aim of this study was to evaluate the influence of letrozole on oocyte morphology in patients with breast cancer submitted to fertility preservation. Methods: Retrospective analysis performed at a public tertiary hospital in São Paulo, Brazil. The oocytes were retrieved from patients with breast cancer undergoing fertility preservation (n=69), and from infertile women undergoing in vitro fertilization (n=92). We evaluated 750 oocytes obtained from breast cancer patients submitted to ovarian stimulation with letrozole and gonadotropins, and 699 oocytes from patients without breast cancer submitted to ovarian stimulation for in vitro fertilization with gonadotropins only due to male factor infertility. The mature oocytes retrieved were analyzed for the presence of refractile bodies, ooplasm color and regularity, central granulation degree, cortical granules, zona pellucida staining and regularity, perivitelline space, presence of vacuoles or abnormal smooth-surfaced endoplasmic reticle and oocyte retraction. Results: There was a higher incidence of alterations in oocyte morphology in the letrozole group when compared to the control group: increased perivitelline space (p=0.007), irregular zona pellucida (p<0.001), refractile bodies (p<0.001), dark ooplasm (p<0.001), granular ooplasm (p<0.001), irregular ooplasm (p<0.001) and dense central granulation (p<0.001). Conclusion: Letrozole is a risk factor for worse oocyte morphology. However, the clinical impact of ovarian stimulation protocol with combined use of gonadotropins and letrozole for fertility preservation remains unclear in this setting. These data underline the importance of establishing the predictive potential of morphological dimorphisms of human oocytes in IVF outcomes.
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Affiliation(s)
- Ludmila M N Bercaire
- Human Reproduction Department. Women's Health Reference Center - Pérola Byington Hospital, São Paulo, SP, Brazil.,Gynecology and Obstetrics Department, Botucatu Medical School, UNESP - Universidade Estadual de São Paulo, Botucatu, SP, Brazil
| | - Mario Cavagna
- Human Reproduction Department. Women's Health Reference Center - Pérola Byington Hospital, São Paulo, SP, Brazil
| | - Nilka F Donadio
- Human Reproduction Department. Women's Health Reference Center - Pérola Byington Hospital, São Paulo, SP, Brazil
| | - Andressa R Rocha
- Human Reproduction Department. Women's Health Reference Center - Pérola Byington Hospital, São Paulo, SP, Brazil
| | - Rafael Portela
- Human Reproduction Department. Women's Health Reference Center - Pérola Byington Hospital, São Paulo, SP, Brazil
| | - Vanessa R Alves
- Human Reproduction Department. Women's Health Reference Center - Pérola Byington Hospital, São Paulo, SP, Brazil
| | - Thamara B B Santos
- Human Reproduction Department. Women's Health Reference Center - Pérola Byington Hospital, São Paulo, SP, Brazil
| | - Felipe Cavagna
- Human Reproduction Department. Women's Health Reference Center - Pérola Byington Hospital, São Paulo, SP, Brazil
| | - Artur Dzik
- Human Reproduction Department. Women's Health Reference Center - Pérola Byington Hospital, São Paulo, SP, Brazil
| | - Luiz H Gebrim
- Human Reproduction Department. Women's Health Reference Center - Pérola Byington Hospital, São Paulo, SP, Brazil
| | - Eliana A P Nahas
- Gynecology and Obstetrics Department, Botucatu Medical School, UNESP - Universidade Estadual de São Paulo, Botucatu, SP, Brazil
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25
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Zanetti BF, Braga DPDAF, Setti AS, Iaconelli A, Borges E. Effect of GnRH analogues for pituitary suppression on oocyte morphology in repeated ovarian stimulation cycles. JBRA Assist Reprod 2020; 24:24-29. [PMID: 31436072 PMCID: PMC6993161 DOI: 10.5935/1518-0557.20190050] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVE To compare the effect of pituitary suppression regimens on oocyte morphology in consecutive ICSI cycles of the same patients. METHODS Data was obtained from 200 matched consecutive intracytoplasmic sperm injection (ICSI) cycles performed in 100 couples undergoing the first cycle with the GnRH agonist and the following cycle with the GnRH antagonist regimen, from January 2010 to August 2016, in a private university-affiliated IVF centre. The effects of the pituitary suppression type on oocyte morphology were assessed by multivariate General Linear Models. RESULTS Mean interval between cycles was 185.32±192.85 days. Maternal age, body mass index, and total FSH dose administered were similar in both patients' cycles. Antagonist cycles presented lower incidence of dark cytoplasm (0.69±3.28% vs. 4.40±17.70%, p=0.047), Smooth endoplasmic reticulum (SER cluster (4.37±11.62% vs. 7.36±17.17%, p=0.046), and ZP defects (6.05±14.76% vs. 11.84±25.13%, p=0.049). Similar numbers of follicles retrieved oocytes, and mature oocytes were observed between the GnRH groups, as well as the fertilisation rate, number of obtained embryos, high-quality embryo rates, and the clinical outcomes. CONCLUSION GnRH antagonist's inhibitory effect on the ovaries in consecutive ICSI cycles results in improved oocyte maturity and morphology, despite similar laboratory and clinical outcomes, compared to the GnRH agonist treatment.
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Affiliation(s)
- Bianca Ferrarini Zanetti
- Fertility Medical Group, São Paulo, SP - Brazil.,Instituto Sapientiae - Centro de Estudos e Pesquisa em Reprodução Humana Assistida, São Paulo, SP - Brazil
| | - Daniela Paes de Almeida Ferreira Braga
- Fertility Medical Group, São Paulo, SP - Brazil.,Instituto Sapientiae - Centro de Estudos e Pesquisa em Reprodução Humana Assistida, São Paulo, SP - Brazil
| | - Amanda Souza Setti
- Fertility Medical Group, São Paulo, SP - Brazil.,Instituto Sapientiae - Centro de Estudos e Pesquisa em Reprodução Humana Assistida, São Paulo, SP - Brazil
| | - Assumpto Iaconelli
- Fertility Medical Group, São Paulo, SP - Brazil.,Instituto Sapientiae - Centro de Estudos e Pesquisa em Reprodução Humana Assistida, São Paulo, SP - Brazil
| | - Edson Borges
- Fertility Medical Group, São Paulo, SP - Brazil.,Instituto Sapientiae - Centro de Estudos e Pesquisa em Reprodução Humana Assistida, São Paulo, SP - Brazil
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26
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Telomere Length and Telomerase Activity in Immature Oocytes and Cumulus Cells of Women with Polycystic Ovary Syndrome. Reprod Sci 2020; 27:1293-1303. [PMID: 32046456 DOI: 10.1007/s43032-019-00120-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Accepted: 11/11/2019] [Indexed: 12/18/2022]
Abstract
Metaphase II oocytes (MII) from polycystic ovary syndrome (PCOS) frequently have impaired oocyte competence. Since telomere maintenance is important for folliculogenesis, oocyte maturation, and early embryonic development, we sought to verify the implications of PCOS on telomere length and telomerase activity in immature oocytes and cumulus cells. 43 PCOS and 67 control women were included, and anthropometric, biochemical, and hormonal characteristics were evaluated. The telomere length in germinal vesicle stage (GV) and in metaphase I (MI) oocytes, as well as in the cumulus cells of immature (CCI) and mature oocytes (CCM), and in leukocytes was measured by qPCR. The telomerase activity in reproductive cells was evaluated by the TRAPeze® XL Kit. The body mass index (p = 0.001), LH (p = 0.015), estradiol (p = 0.004), insulin (p = 0.002), testosterone (p < 0.0001), androstenedione (p = 0.001), free androgen index (p < 0.0001), and c-reactive protein (p = 0.003) were greater, while the FSH (p = 0.0002) was lower in the PCOS group. The telomere length in the CCI (p = 0.649) and CCM (p = 0.378) did not differ between the PCOS and the control groups. On the other hand, telomerase activity in the CCI (p = 0.003) and CCM (p = 0.022) was higher in the PCOS group. In the leukocyte's cells, the telomere length was reduced in the PCOS group (p = 0.025). In the GV and MI oocytes, no differences were observed in telomere length and telomerase activity between the groups. We showed that telomere length is not altered in reproductive cells from PCOS. However, higher telomerase activity in the CCI and CCM may be required for telomere length maintenance.
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27
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Is perivitelline space morphology of the oocyte associated with pregnancy outcome in intracytoplasmic sperm injection cycles? Eur J Obstet Gynecol Reprod Biol 2018; 231:225-229. [PMID: 30439650 DOI: 10.1016/j.ejogrb.2018.10.053] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Revised: 10/26/2018] [Accepted: 10/28/2018] [Indexed: 10/27/2022]
Abstract
OBJECTIVE(S) To investigate the effect of perivitelline space (PVS) abnormalities on the outcomes of intracytoplasmic sperm injection (ICSI) cycles in which the entire cohort was affected. STUDY DESIGN Data from 9752 oocytes obtained from 1151 ICSI cycles performed from June/2010 to August/2016 in a private university-affiliated IVF centre. Cycles were divided into four groups according to the presence or absence of PVS abnormalities: PVS-L group (cycles with the entire oocyte cohort affected by large PVS, n = 265), PVS-G group (cycles with the entire oocyte cohort affected by PVS granularity, n = 280), PVS-L + PVS-G group (cycles with the entire oocyte cohort affected by PVS-L and PVS-G, n = 204), and control group (cycles with the entire oocyte cohort free of PVS abnormalities, n = 402). The effect of PVS abnormalities on ICSI outcomes was assessed by GLM adjusted for potential confounders. RESULTS Groups with PVS abnormalities presented substantially higher FSH/follicle (p < 0.001) and FSH/oocyte (p < 0.001) ratios, and lower numbers of follicles (p < 0.001), oocytes (p < 0.001) and embryos (p = 0.002) compared to the control group. PVS-L + PVS-G implantation (p = 0.044) and pregnancy (p = 0.004) rates were significantly lower than in cycles with isolated PVS abnormalities and controls. CONCLUSION(S) Cycles in which the entire oocyte cohort is affected by both large PVS and PVS granularity have compromised implantation and pregnancy rates.
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28
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Testicular sperm is superior to ejaculated sperm for ICSI in cryptozoospermia: An update systematic review and meta-analysis. Sci Rep 2018; 8:7874. [PMID: 29777145 PMCID: PMC5959851 DOI: 10.1038/s41598-018-26280-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Accepted: 03/21/2018] [Indexed: 01/11/2023] Open
Abstract
Intracytoplasmic sperm injection (ICSI) is well established and provides patients with severely impaired sperm quality with an opportunity to father a child. However, previous studies do not clearly indicate whether male with cryptozoospermia should use testicular sperm or ejaculated sperm for ICSI. The newest systematic review of this topic also gave a controversial conclusion that was based on incorrect pooling result. Moreover, two clinical studies published after the systematic review. In the present update systematic review and meta-analysis, a comprehensive citation search for relevant studies was performed using the Cochrane library databases, Embase, Ovid MEDLINE, PubMed, ScienceDirect, Scopus, and Web of Science up to September 2017. The search returned 313 records, in which six studies were included in quantitative synthesis. These studies involved 578 male infertility patients who had undergone 761 ICSI cycles. The risk ratios favour fresh testicular sperm for good quality embryo rate (1.17, 95% CI 1.05–1.30, P = 0.005), implantation rate (95% CI 1.02–2.26, P = 0.04), and pregnancy rate (RR = 1.74, 95% CI 1.20–2.52, P = 0.004). In conclusion, the existing evidence suggests that testicular sperm is better than ejaculated sperm for ICSI in male with cryptozoospermia.
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29
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Park YG, Lee SE, Son YJ, Jeong SG, Shin MY, Kim WJ, Kim EY, Park SP. Antioxidant β-cryptoxanthin enhances porcine oocyte maturation and subsequent embryo development in vitro. Reprod Fertil Dev 2018; 30:1204-1213. [DOI: 10.1071/rd17444] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Accepted: 02/16/2018] [Indexed: 12/12/2022] Open
Abstract
Oxidative stress is partly responsible for the poor quality of IVM oocytes. The present study investigated the effects of the antioxidant β-cryptoxanthin on the IVM of porcine oocytes and the in vitro development of the ensuing embryos. Oocytes were matured in IVM medium containing different concentrations of β-cryptoxanthin (0, 0.1, 1, 10 or 100 μM). Treatment with 1 µM β-cryptoxanthin (Group 1B) improved polar body extrusion and the expression of maturation-related genes in cumulus cells and oocytes compared with control. In addition, levels of reactive oxygen species decreased significantly in Group 1B, whereas there were significant increases in glutathione levels and expression of the antioxidant genes superoxide dismutase 1 and peroxiredoxin 5 in this group. After parthenogenetic activation, although the cleavage rate did not differ between the control and 1B groups, the blastocyst formation rate was higher in the latter. Moreover, the total number of cells per blastocyst and relative mRNA levels of pluripotency marker and antioxidant genes were significantly higher in the 1B compared with control group. These results demonstrate that β-cryptoxanthin decreases oxidative stress in porcine oocytes and improves their quality and developmental potential.
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30
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Kellam L, Pastorelli LM, Bastida AM, Senkbeil A, Montgomery S, Fishel S, Campbell A. Perivitelline threads in cleavage-stage human embryos: observations using time-lapse imaging. Reprod Biomed Online 2017; 35:646-656. [DOI: 10.1016/j.rbmo.2017.09.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Revised: 09/12/2017] [Accepted: 09/13/2017] [Indexed: 11/28/2022]
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31
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Fan Y, Zhang X, Hao Z, Ding H, Chen Q, Tian L. Effectiveness of mild ovarian stimulation versus GnRH agonist protocol in women undergoing assisted reproductive technology: a meta-analysis. Gynecol Endocrinol 2017; 33:746-756. [PMID: 28508683 DOI: 10.1080/09513590.2017.1320385] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
OBJECTIVE our meta-analysis was conducted to evaluate the effectiveness of the mild ovulation induction protocol using CC/gonadotropin/GnRH antagonist compared to the conventional GnRH agonist protocol in women undergoing ART. METHOD Six electronic databases were searched from their date of establishment until August 2016. Outcomes in our analysis were calculated in terms of relative risk (RR) and weighted mean differences (WMD) and standard mean differences (SMD) with 95% confidence intervals (CI) using random effect models or fixed effect models. RESULTS Six prospective controlled clinical trials with 1543 women comparing the clinical impacts of the two protocols were included. The synthesized results suggested a significant reduction in the quantity of gonadotropins (SMD: -1.96, 95% CI: -2.28 to 1.64, I2 = 78.5%), the incidence of OHSS (RR: 0.16, 95% CI 0.03-0.86, I2 = 0%) and an increase in the cycle cancelation rate (RR: 1.46, 95% CI 1.05-2.03, I2 = 89.4%). While no evidence of statistically significant differences between the groups existed in the other clinical outcomes. CONCLUSION This study suggested that the probable benefits of the mild protocol, including its less costs and safer process without reducing the overall IVF treatment success rates, seemed to make it a better treatment option. Larger sample prospective trials evaluating live birth, clinical pregnancy, OHSS, multiple pregnancy incidence and so on were desired to establish.
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Affiliation(s)
- Yuan Fan
- a Reproductive Medical Centre, Peking University People's Hospital , Beijing , China
| | - Xiaowei Zhang
- b Department of Urology , Peking University People's Hospital , Beijing , China , and
| | - Zhidong Hao
- c Department of Obstetrics and Gynecology , Haidian Maternal & Child Health Hospital , Beijing , China
| | - Huanfei Ding
- a Reproductive Medical Centre, Peking University People's Hospital , Beijing , China
| | - Quanyu Chen
- a Reproductive Medical Centre, Peking University People's Hospital , Beijing , China
| | - Li Tian
- a Reproductive Medical Centre, Peking University People's Hospital , Beijing , China
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Merviel P, Cabry R, Chardon K, Haraux E, Scheffler F, Mansouri NB, Devaux A, Chahine H, Bach V, Copin H, Benkhalifa M. Impact of oocytes with CLCG on ICSI outcomes and their potential relation to pesticide exposure. J Ovarian Res 2017; 10:42. [PMID: 28693528 PMCID: PMC5504732 DOI: 10.1186/s13048-017-0335-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Accepted: 06/06/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Oocyte quality is a key limiting factor in female fertility which is primarily reflected in morphological features. Centrally located cytoplasm granulation (CLCG) is one type of cytoplasmic dimorphism exhibited by oocytes that could be linked to pesticide exposure with a significant risk of decreased ICSI outcomes. METHODS This retrospective study included 633 women who were part of an intracytoplasmic spermatozoa injection (ICSI) program between 2009 and 2011. The participants lived in the Picardy region of France and had been exposed to pesticides. The participants were divided in two groups based on prevalence of oocytes with CLCG (LCLCG [n = 83]: low prevalence of oocytes with CLCG under 25%. HCLCG [n = 68]: high prevalence of CLCG over 75%). The embryological and clinical outcomes were analysed for both groups and were calculated using the difference between the two values. RESULTS Results for couples with HCLCG compared to LCLCG showed a decrease in embryo cleavage, ongoing pregnancy, and live birth rates (82%, 14%, 13% vs 99%, 32%, 30%, respectively).The early miscarriage rate was increased (47% vs 11%), with an OR of 3.1 (95%CI [2.1-4.1]). Due to high pesticide exposure (over 3000 g/ha), there is a higher risk of a resulting disturbed oocyte cohort with a high prevalence of CLCG over 75%. CONCLUSION The high prevalence of oocytes with CLCG over 75% has a negative effect on embryos and the general ICSI clinical outcomes. Furthermore, a putative association between pesticide exposure and risk of CLCG was identified, justifying the need for further research and a potential need to find alternative assisted reproductive technologies for these couples. TRIAL REGISTRATION Tabacfertimasc. ID number: ID2011-A00634-37 ; registered 2011/2/8.
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Affiliation(s)
- Philippe Merviel
- Ob/Gyn Department, Regional University hospital, Morvan University, 29200, Brest, France
| | - Rosalie Cabry
- ART and Reproductive Biology laboratory, University hospital and school of medicine, Picardie University Jules Verne, CHU Sud, 80054, Amiens, France.,PERITOX-INERIS laboratory, CURS, Picardie University Jules Verne, CHU Sud, 80054, Amiens, France
| | - Karen Chardon
- PERITOX-INERIS laboratory, CURS, Picardie University Jules Verne, CHU Sud, 80054, Amiens, France
| | - Elodie Haraux
- PERITOX-INERIS laboratory, CURS, Picardie University Jules Verne, CHU Sud, 80054, Amiens, France
| | - Florence Scheffler
- ART and Reproductive Biology laboratory, University hospital and school of medicine, Picardie University Jules Verne, CHU Sud, 80054, Amiens, France.,PERITOX-INERIS laboratory, CURS, Picardie University Jules Verne, CHU Sud, 80054, Amiens, France
| | - Naima-Belhadri Mansouri
- ART and Reproductive Biology laboratory, University hospital and school of medicine, Picardie University Jules Verne, CHU Sud, 80054, Amiens, France
| | - Aviva Devaux
- ART and Reproductive Biology laboratory, University hospital and school of medicine, Picardie University Jules Verne, CHU Sud, 80054, Amiens, France.,PERITOX-INERIS laboratory, CURS, Picardie University Jules Verne, CHU Sud, 80054, Amiens, France
| | - Hikmat Chahine
- Forte Bio et Unilabs France, 1 Rue Mozart, 92200, Clichy La Garenne, France
| | - Véronique Bach
- PERITOX-INERIS laboratory, CURS, Picardie University Jules Verne, CHU Sud, 80054, Amiens, France
| | - Henri Copin
- ART and Reproductive Biology laboratory, University hospital and school of medicine, Picardie University Jules Verne, CHU Sud, 80054, Amiens, France
| | - Moncef Benkhalifa
- ART and Reproductive Biology laboratory, University hospital and school of medicine, Picardie University Jules Verne, CHU Sud, 80054, Amiens, France. .,PERITOX-INERIS laboratory, CURS, Picardie University Jules Verne, CHU Sud, 80054, Amiens, France.
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Oocyte morphology and embryo morphokinetics in an intra-cytoplasmic sperm injection programme. Is there a relationship? ZYGOTE 2017; 25:190-196. [PMID: 28264747 DOI: 10.1017/s0967199417000041] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The aim was to investigate the relationship between the morphological parameters of metaphase II (MII) oocytes with morphokinetic variables of embryos following an intra-cytoplasmic sperm injection (ICSI) procedure. Morphokinetic behaviour and abnormal cleavage patterns of 334 zygotes were analyzed using time-lapse monitoring (TLM). In addition, oocyte morphology was assessed in relation to embryo morphokinetic (absolute time point, including time to second polar body (PB) extrusion (ESPB), pronuclei (PN) appearance (PNA), PN fading (PNF), time to 2-cells (t2), 3c (t3), 4c (t4), 5c (t5), 6c (t6), 7c (t7), 8c (t8) and relative timing parameters (S1, S2, CC2 and CC3). Also, cleavage patterns (uneven blastomeres, reverse, direct and arbitrary) were assessed. The data showed that 79% of the normal fertilized oocytes had at least one abnormal morphological characteristic. Intra-cytoplasmic abnormalities were observed in 12% of the oocytes. Also, extra-cytoplasmic abnormalities were noticed in 29%, while combined intra- and extra-cytoplasmic abnormalities were responsible for the remaining 38% of the oocytes. Nearly all cleavage and interval times, except extrusion of the ESPB time (P = 0.003), were similar between normal and abnormal morphologic oocytes (P < 0.05). Moreover, there was significant relationship for oocyte morphology abnormalities and cleavage patterns, including uneven blastomere (P = 0.037), reverse cleavage (RC) (P = 0.0), direct (P = 0.001) and arbitrary cleavages (P = 0.001). Using TLM, the cleavage patterns of embryos were affected by the quality of MII oocytes in the ICSI cycles. So, evaluation of oocyte morphology with subsequent embryo morphokinetics is recommended in assisted reproductive programmes.
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Liu L, Cai J, Li P, Jiang X, Ren J. Clinical outcome of cycles with oocyte degeneration after intracytoplasmic sperm injection. Syst Biol Reprod Med 2017; 63:113-119. [PMID: 28151020 DOI: 10.1080/19396368.2016.1272648] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
There are variant rates of oocyte degeneration after intracytoplasmic sperm injection (ICSI) among different patients. Oocyte degeneration after ICSI may reflect the cohort of oocyte quality and subsequent embryo development capacity and clinical outcome. This retrospective study analyzed 255 cycles with at least one degenerated oocyte after ICSI (degeneration group) and 243 cycles with no degenerated oocytes after ICSI (control group). Basic characteristics like female age, body mass index, duration of infertility, hormone (FSH, LH, E2) levels on day 3 of menses, and primary infertility patient rate were similar between the two groups (p > 0.05). Total dose of gonadotropin and length of stimulation were also similar between the two groups (p > 0.05), but the degeneration group exhibited a more exuberant response to ovarian stimulation as reflected by more oocytes retrieved (p < 0.05). The number of 2PN embryos available and high quality embryos were similar between the two groups (p > 0.05), but the high quality embryo rate, early cleavage embryo rate, and available embryo rate were all statistically lower than the control group (p < 0.05). Embryo developmental kinetics seemed to be disturbed and embryo fragmentation rate increased in the degeneration group (p < 0.05). However, there was no statistical difference in the distribution of graded embryos transferred, and there were no statistical differences in the pregnancy rate, implantation rate, and abortion rate between the two groups (p > 0.05). We deduce that the presence of oocyte degeneration after ICSI may be associated with decreased embryo quality with embryo development kinetics disturbed. However, the clinical outcomes may not be affected if the premise that sufficient high quality degeneration group embryos are available for transfer.
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Affiliation(s)
- Lanlan Liu
- a Reproductive Medicine Center, Affiliated Chenggong Hospital of Xiamen University , Xiamen , Fujian , China.,b The 174th Hospital of PLA , Xiamen , Fujian , China
| | - Jiali Cai
- a Reproductive Medicine Center, Affiliated Chenggong Hospital of Xiamen University , Xiamen , Fujian , China.,b The 174th Hospital of PLA , Xiamen , Fujian , China
| | - Ping Li
- a Reproductive Medicine Center, Affiliated Chenggong Hospital of Xiamen University , Xiamen , Fujian , China.,b The 174th Hospital of PLA , Xiamen , Fujian , China
| | - Xiaoming Jiang
- a Reproductive Medicine Center, Affiliated Chenggong Hospital of Xiamen University , Xiamen , Fujian , China.,b The 174th Hospital of PLA , Xiamen , Fujian , China
| | - Jianzhi Ren
- a Reproductive Medicine Center, Affiliated Chenggong Hospital of Xiamen University , Xiamen , Fujian , China.,b The 174th Hospital of PLA , Xiamen , Fujian , China
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Halim B, Lubis HP, Novia D, Thaharuddin M. Does oval oocyte have an impact on embryo development in in vitro fertilization? JBRA Assist Reprod 2017; 21:15-18. [PMID: 28333026 PMCID: PMC5365194 DOI: 10.5935/1518-0557.20170005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE To compare the outcomes of embryo development between oval-shaped oocyte as an abnormal morphology oocyte and a normal morphology oocyte in In Vitro Fertilization (IVF). METHODS This study was a comparative analytical study with retrospective approach which lasted from September 2014 until November 2015. For this study, we used secondary data (medical records) from 24 patients submitted to IVF at the Halim Fertility Center. The oocyte morphology was divided into two groups: normal-shaped oocyte and oval-shaped oocyte. RESULTS Our study included 120 oocytes with 60 oval-shaped oocytes and 60 normal oocytes. We found fertilization rates of 68.3% in the normal oocyte group and 61.7% in the oval-shaped oocyte group; and there was no significant difference between the normal oocyte group and the oval-shaped oocyte group (p > 0.05). In the normal oocyte group, 65% had reached day 3 embryos, and in the oval-shaped oocyte group it was 50%, with no significant difference between the groups (p > 0.05). We also found 46.7% transferrable embryos in the oval oocytes group compared to 63.3% in the normal oocytes group, with no significant difference between the groups (p > 0.05). CONCLUSION There was no significant difference in fertilization rates and embryo quality between normal morphology oocytes and oval-shaped oocytes.
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Affiliation(s)
- Binarwan Halim
- HFC IVF center Division of Reproductive, Endocrinology and Infertility Department of Obstetrics and Gynecology, Faculty of Medicine University of Sumatera Utara, Medan, Indonesia
| | - Hilma Putri Lubis
- HFC IVF center Division of Reproductive, Endocrinology and Infertility Department of Obstetrics and Gynecology, Faculty of Medicine University of Sumatera Utara, Medan, Indonesia
| | - Diana Novia
- HFC IVF center Division of Reproductive, Endocrinology and Infertility Department of Obstetrics and Gynecology, Faculty of Medicine University of Sumatera Utara, Medan, Indonesia
| | - Masithah Thaharuddin
- HFC IVF center Division of Reproductive, Endocrinology and Infertility Department of Obstetrics and Gynecology, Faculty of Medicine University of Sumatera Utara, Medan, Indonesia
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Setti AS, Figueira RCS, de Almeida Ferreira Braga DP, Azevedo MDC, Iaconelli A, Borges E. Oocytes with smooth endoplasmic reticulum clusters originate blastocysts with impaired implantation potential. Fertil Steril 2016; 106:1718-1724. [PMID: 27743693 DOI: 10.1016/j.fertnstert.2016.09.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Revised: 09/05/2016] [Accepted: 09/06/2016] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To study whether embryos derived from oocytes presenting a smooth endoplasmic reticulum cluster (SERC) are less likely to develop into blastocysts and implant. DESIGN Transversal study. SETTING Private university-affiliated in vitro fertilization (IVF) center. PATIENT(S) Total of 7,609 oocytes obtained from 743 intracytoplasmic sperm injection (ICSI) cycles. INTERVENTION(S) Oocytes split between the SERC-positive cycles (with at least one SERC-positive oocyte) and the SERC-negative cycles (only oocytes free of SERC). MAIN OUTCOME MEASURE(S) Embryo implantation. RESULT(S) A statistically significantly higher mean number of follicles (24.0 ± 10.5 vs. 19.6 ± 10.5), retrieved oocytes (17.8 ± 8.3 vs. 14.3 ± 8.0), and mature oocytes (13.5 ± 6.2 vs. 10.6 ± 5.9) were observed in the SERC-positive cycles as compared with SERC-negative cycles. The implantation rate was statistically significantly lower in SERC-positive cycles as compared with SERC-negative cycles (14.8% vs. 25.6%; odds ratio 0.61; 95% confidence interval, 0.44-0.86). When only cycles with in which none (0) or all the blastocysts transferred had implanted (100%) were analyzed, the mean implantation rate per transferred blastocyst in the SERC-negative group was 20.5%; no blastocysts derived from SERC-positive oocytes implanted. CONCLUSION(S) The occurrence of SERC impairs embryo implantation. Careful oocyte observation that takes into account the presence of SERC should be part of embryo selection strategy before transfer.
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Affiliation(s)
- Amanda Souza Setti
- Fertility Medical Group, São Paulo, Brazil; Sapientiae Institute, Centro de Estudos e Pesquisa em Reprodução Humana Assistida, São Paulo, Brazil
| | | | | | | | - Assumpto Iaconelli
- Fertility Medical Group, São Paulo, Brazil; Sapientiae Institute, Centro de Estudos e Pesquisa em Reprodução Humana Assistida, São Paulo, Brazil
| | - Edson Borges
- Fertility Medical Group, São Paulo, Brazil; Sapientiae Institute, Centro de Estudos e Pesquisa em Reprodução Humana Assistida, São Paulo, Brazil.
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Freeze/thaw stress induces organelle remodeling and membrane recycling in cryopreserved human mature oocytes. J Assist Reprod Genet 2016; 33:1559-1570. [PMID: 27586998 DOI: 10.1007/s10815-016-0798-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Accepted: 08/16/2016] [Indexed: 12/12/2022] Open
Abstract
PURPOSE Our aim was to evaluate the ultrastructure of human metaphase II oocytes subjected to slow freezing and fixed after thawing at different intervals during post-thaw rehydration. METHODS Samples were studied by light and transmission electron microscopy. RESULTS We found that vacuolization was present in all cryopreserved oocytes, reaching a maximum in the intermediate stage of rehydration. Mitochondria-smooth endoplasmic reticulum (M-SER) aggregates decreased following thawing, particularly in the first and intermediate stages of rehydration, whereas mitochondria-vesicle (MV) complexes augmented in the same stages. At the end of rehydration, vacuoles and MV complexes both diminished and M-SER aggregates increased again. Cortical granules (CGs) were scarce in all cryopreserved oocytes, gradually diminishing as rehydration progressed. CONCLUSIONS This study also shows that such a membrane remodeling is mainly represented by a dynamic process of transition between M-SER aggregates and MV complexes, both able of transforming into each other. Vacuoles and CG membranes may take part in the membrane recycling mechanism.
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Yu EJ, Ahn H, Lee JM, Jee BC, Kim SH. Fertilization and embryo quality of mature oocytes with specific morphological abnormalities. Clin Exp Reprod Med 2015; 42:156-62. [PMID: 26815385 PMCID: PMC4724600 DOI: 10.5653/cerm.2015.42.4.156] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Revised: 09/08/2015] [Accepted: 10/07/2015] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE To investigate fertilization and embryo quality of dysmorphic mature oocytes with specific morphological abnormalities obtained from intracytoplasmic sperm injection (ICSI). METHODS The fertilization rate (FR) and embryo quality were compared among 58 dysmorphic and 42 normal form oocytes (control 1) obtained from 35 consecutive ICSI cycles, each of which yielded at least one dysmorphic mature oocyte, performed over a period of 5 years. The FR and embryo quality of 441 normal form oocytes from another 119 ICSI cycles that did not involve dysmorphic oocytes served as control 2. Dysmorphic oocytes were classified as having a dark cytoplasm, cytoplasmic granularity, cytoplasmic vacuoles, refractile bodies in the cytoplasm, smooth endoplasmic reticulum in the cytoplasm, an oval shape, an abnormal zona pellucida, a large perivitelline space, debris in the perivitelline space, or an abnormal polar body (PB). RESULTS The overall FR was significantly lower in dysmorphic oocytes than in normal form oocytes in both the control 1 and control 2 groups. However, embryo quality in the dysmorphic oocyte group and the normal form oocyte groups at day 3 was similar. The FR and embryo quality were similar in the oocyte groups with a single abnormality and multiple abnormalities. Specific abnormalities related with a higher percentage of top-quality embryos were dark cytoplasm (66.7%), abnormal PB (50%), and cytoplasmic vacuoles (25%). CONCLUSION The fertilization potential of dysmorphic oocytes in our study was lower, but their subsequent embryonic development and embryo quality was relatively good. We were able to define several specific abnormalities related with good or poor embryo quality.
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Affiliation(s)
- Eun Jeong Yu
- Department of Obstetrics and Gynecology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Hyojeong Ahn
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea
| | - Jang Mi Lee
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Byung Chul Jee
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea.; Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Seok Hyun Kim
- Department of Obstetrics and Gynecology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.; Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea
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Lazzaroni-Tealdi E, Barad DH, Albertini DF, Yu Y, Kushnir VA, Russell H, Wu YG, Gleicher N. Oocyte Scoring Enhances Embryo-Scoring in Predicting Pregnancy Chances with IVF Where It Counts Most. PLoS One 2015; 10:e0143632. [PMID: 26630267 PMCID: PMC4668065 DOI: 10.1371/journal.pone.0143632] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Accepted: 11/06/2015] [Indexed: 11/18/2022] Open
Abstract
Context Our center’s quality improvement optimization process on many occasions anecdotally suggested that oocyte assessments might enhance embryo assessment in predicting pregnancy chances with in vitro fertilization (IVF). Objective To prospectively compare a morphologic oocyte grading system to standard day-3 morphologic embryo assessment. Design, Setting, Patients We prospectively investigated in a private academically-affiliated infertility center 94 consecutive IVF cycles based on 6 criteria for oocyte quality: morphology, cytoplasm, perivitelline space (PVS), zona pellucida (ZP), polar body (PB) and oocyte size, each assigned a value of -1 (worst), 0 (average) or +1 (best), so establishing an average total oocyte score (TOS). Embryo assessment utilized grade and cell numbers of each embryo on day-3 after oocyte retrieval. Clinical pregnancy was defined by presence of at least one intrauterine gestational sac. Interventions Standard IVF cycles in infertile women. Main Outcome Measures Predictability of pregnancy based on oocyte and embryo-grading systems. Results Average age for all patients was 36.5 ± 7.3 years; mean oocyte yield was 7.97± 5.76; Patient specific total oocyte score (PTOS) was -1.05 ± 2.24. PTOS, adjusted for patient age, was directly related to odds of increased embryo cell numbers (OR 1.12, P = 0.025), embryo grade (OR 1.19, P < 0.001) and clinical pregnancy [OR 1.58 (95%CI 1.23 to 2.02), P < 0.001]. Restricting the analysis to day three embryos of high quality (8-cell/ good grades), TOS was still predictive of clinical pregnancy (OR 2.08 (95%CI 1.26 to 3.44, P = 0.004). Among the 69 patients with embryos of Grade 4 or better available for transfer 23 achieved Clinical Pregnancy. When the analysis was restricted to the 69 transfers with good quality embryos (≥ Grade 4) the Oocyte Scoring System (TOS) (AUC±SE 0.863±0.044, oocyte score) provided significantly greater predictive value for clinical pregnancy compared to the embryo grade alone (AUC 0.646 ± 0.072, embryo grade) p = 0.015. Conclusions Oocyte-scoring, thus, provides useful clinical information especially in good prognosis patients with large numbers of high quality embryos. This finding appears of particular importance at a time when many IVF centers are committing sizable investments to closed incubation systems with time-lapse photography, which are exclusively meant to define embryo morphology.
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Affiliation(s)
| | - David H. Barad
- The Center for Human Reproduction, New York, New York, United States of America
- The Foundation for Reproductive Medicine, New York, New York, United States of America
- Department of Obstetrics and Gynecology, Albert Einstein College of Medicine, Bronx, New York, United States of America
| | - David F. Albertini
- The Center for Human Reproduction, New York, New York, United States of America
- Department of Molecular and Integrative Physiology, University of Kansas Medical Center, Kansas City, Kansas, United States of America
| | - Yao Yu
- The Center for Human Reproduction, New York, New York, United States of America
| | - Vitaly A. Kushnir
- The Center for Human Reproduction, New York, New York, United States of America
- Department of Obstetrics and Gynecology, Wake Forest University, Winston Salem, North Carolina, United States of America
| | - Helena Russell
- School of Health Professions, Eastern Virginia Medical School, Norfolk, Virginia, United States of America
| | - Yan-Guang Wu
- The Center for Human Reproduction, New York, New York, United States of America
| | - Norbert Gleicher
- The Center for Human Reproduction, New York, New York, United States of America
- The Foundation for Reproductive Medicine, New York, New York, United States of America
- Stem Cell and Molecular Embryology Laboratory, The Rockefeller University, New York, New York, United States of America
- * E-mail:
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Ashrafi M, Karimian L, Eftekhari-Yazdi P, Hasani F, Arabipoor A, Bahmanabadi A, Akhond MR. Effect of oocyte dysmorphisms on intracytoplasmic sperm injection cycle outcomes in normal ovarian responders. J Obstet Gynaecol Res 2015; 41:1912-20. [PMID: 26419975 DOI: 10.1111/jog.12818] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2015] [Revised: 06/02/2015] [Accepted: 06/22/2015] [Indexed: 11/27/2022]
Abstract
AIM The aim of this study was to identify the influence of oocyte dysmorphisms on clinical outcomes after intracytoplasmic sperm injection cycle in normal responders. MATERIAL AND METHODS In the prospective study, morphology of 1999 metaphase II oocytes retrieved from 316 intracytoplasmic sperm injection cycles was evaluated from March 2011 to March 2013 at Royan Institute. Controlled ovarian stimulation was performed by long standard agonist protocol. Oocyte morphology was assessed before sperm injection by one embryologist. The associations between fertilization rate, embryo quality and the independent variables were analyzed using odds ratio (OR) calculated with unconditional logistic regression test. RESULTS From all retrieved oocytes, 1543 (77.1%) showed at least one morphologic aberration. Presence of cytoplasmic vacuoles and high cytoplasmic viscosity were associated with a significant decrease in the fertilization rate (OR: 0.5; P = 0.004 and OR: 0.6; P = 0.03, respectively). The results showed that oocyte morphology did not affect embryo quality. The number of gonadotrophin injections used showed a direct relation with presence of large perivitelline space. No significant difference was observed among four groups (women with total normal morphologic oocytes [group 1], women with total extracytoplasmic dysmorphic oocytes [group 2], women with total cytoplasmic dysmorphic oocytes [group 3] and women with total oocytes containing multiple dysmorphic features [group 4]) in terms of implantation and clinical pregnancy rates. CONCLUSIONS Metaphase II oocyte morphology had minor impacts on fertilization rate, pronuclear morphology and embryo quality in women with normal ovarian response.
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Affiliation(s)
- Mahnaz Ashrafi
- Department of Endocrinology and Female Infertility at Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.,Obstetrics and Gynecology Department, Faculty of Medicine, Tehran University of Medical Science, Tehran, Iran
| | - Leila Karimian
- Department of Embryology at Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Poopak Eftekhari-Yazdi
- Department of Embryology at Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Fatemeh Hasani
- Department of Embryology at Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Arezoo Arabipoor
- Department of Endocrinology and Female Infertility at Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Akram Bahmanabadi
- Department of Endocrinology and Female Infertility at Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Mohammad Reza Akhond
- Department of Epidemiology and Reproductive Health at Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
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Ciepiela P, Bączkowski T, Drozd A, Kazienko A, Stachowska E, Kurzawa R. Arachidonic and linoleic acid derivatives impact oocyte ICSI fertilization--a prospective analysis of follicular fluid and a matched oocyte in a 'one follicle--one retrieved oocyte--one resulting embryo' investigational setting. PLoS One 2015; 10:e0119087. [PMID: 25763593 PMCID: PMC4357448 DOI: 10.1371/journal.pone.0119087] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Accepted: 01/09/2015] [Indexed: 01/01/2023] Open
Abstract
Objective To evaluate human oocyte ability to undergo fertilization and subsequent preimplantation embryonic development in relation to a wide panel of follicular fluid (FF) arachidonic acid derivatives (AAD) and linoleic acid derivatives (LAD) of prospectively selected patients undergoing intracytoplasmic sperm injection (ICSI). Methodology Study was designed as a two center (a university clinic and a private clinic) prospective study. 54 women of 181 consecutive couples undergoing ICSI were prospectively found to be eligible for analysis. 'One follicle – one retrieved oocyte – one resulting embryo' approach was used. Each individual follicle was aspirated independently and matched to an oocyte growing in this particular follicular milieu. FF samples were assessed for AAD and LAD by high-performance liquid chromatography; additionally, activity of secretory phospholipase A (sPLA2) was determined by enzyme-linked immunosorbent assay. Principal Findings Increased activity of sPLA2 and significantly higher AAD and LAD levels were found in FF of oocytes that did not show two pronuclei or underwent degeneration after ICSI in comparison to oocytes with the appearance of two pronuclei. Receiver operating characteristics curve analysis identified acids with the highest sensitivity and specificity: 5oxo-hydroxyeicosatetraenoic, 16-hydroxyeicosatetraenoic, 9-hydroxyoctadecadieneoic and 12-hydroxyeicosatetraenoic. No significant differences between AAD and LAD related to embryo quality were found. Conclusions/Significance Our study demonstrates for the first time that elevated concentrations of AAD and LAD in FF at the time of oocyte retrieval significantly decrease the ability of oocytes to form pronuclei after ICSI. This may serve as a new tool for non-invasive assessment of oocyte developmental capacity. However, levels of AAD and LAD are not associated with subsequent embryo quality or pregnancy rate, and therefore more studies are needed to determine their usefulness in human IVF procedure.
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Affiliation(s)
- Przemysław Ciepiela
- Department of Reproductive Medicine and Gynecology, Pomeranian Medical University, Szczecin-Police, Zachodniopomorskie, Poland
| | - Tomasz Bączkowski
- Department of Reproductive Medicine and Gynecology, Pomeranian Medical University, Szczecin-Police, Zachodniopomorskie, Poland
- VitroLive Fertility Clinic, Szczecin, Zachodniopomorskie, Poland
| | - Arleta Drozd
- Department of Biochemistry and Human Nutrition, Pomeranian Medical University, Szczecin, Zachodniopomorskie, Poland
| | - Anna Kazienko
- Department of Reproductive Medicine and Gynecology, Pomeranian Medical University, Szczecin-Police, Zachodniopomorskie, Poland
| | - Ewa Stachowska
- Department of Biochemistry and Human Nutrition, Pomeranian Medical University, Szczecin, Zachodniopomorskie, Poland
| | - Rafał Kurzawa
- Department of Reproductive Medicine and Gynecology, Pomeranian Medical University, Szczecin-Police, Zachodniopomorskie, Poland
- VitroLive Fertility Clinic, Szczecin, Zachodniopomorskie, Poland
- * E-mail:
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Is polycystic ovarian morphology related to a poor oocyte quality after controlled ovarian hyperstimulation for intracytoplasmic sperm injection? Results from a prospective, comparative study. Fertil Steril 2015; 103:112-8. [DOI: 10.1016/j.fertnstert.2014.09.040] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2014] [Revised: 09/26/2014] [Accepted: 09/26/2014] [Indexed: 01/14/2023]
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Qassem E, Falah K, Aghaways I, Salih T. A correlative study of oocytes morphology with fertilization, cleavage, embryo quality and implantation rates after intra cytoplasmic sperm injection. ACTA MEDICA INTERNATIONAL 2015. [DOI: 10.5530/ami.2015.1.3] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Kushnir VA, Yu Y, Barad DH, Weghofer A, Himaya E, Lee HJ, Wu YG, Shohat-Tal A, Lazzaroni-Tealdi E, Gleicher N. Utilizing FMR1 gene mutations as predictors of treatment success in human in vitro fertilization. PLoS One 2014; 9:e102274. [PMID: 25019151 PMCID: PMC4096763 DOI: 10.1371/journal.pone.0102274] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Accepted: 06/16/2014] [Indexed: 11/18/2022] Open
Abstract
CONTEXT Mutations of the fragile X mental retardation 1 (FMR1) gene are associated with distinct ovarian aging patterns. OBJECTIVE To confirm in human in vitro fertilization (IVF) that FMR1 affects outcomes, and to determine whether this reflects differences in ovarian aging between FMR1 mutations, egg/embryo quality or an effect on implantation. DESIGN, SETTING, PATIENTS IVF outcomes were investigated in a private infertility center in reference to patients' FMR1 mutations based on a normal range of CGG(n = 26-34) and sub-genotypes high (CGG(n>34)) and low (CGG(<26)). The study included 3 distinct sections and study populations: (i) A generalized mixed-effects model of morphology (777 embryos, 168 IVF cycles, 125 infertile women at all ages) investigated whether embryo quality is associated with FMR1; (ii) 1041 embryos in 149 IVF cycles in presumed fertile women assessed whether the FMR1 gene is associated with aneuploidy; (iii) 352 infertile patients (< age 38; in 1st IVF cycles) and 179 donor-recipient cycles, assessed whether the FMR1 gene affects IVF pregnancy chances via oocyte/embryo quality or non-oocyte maternal factors. INTERVENTIONS Standardized IVF protocols. MAIN OUTCOME MEASURES Morphologic embryo quality, ploidy and pregnancy rates. RESULTS (i) Embryo morphology was reduced in presence of a low FMR1 allele (P = 0.032). In absence of a low allele, the odds ratio (OR) of chance of good (vs. fair/poor) embryos was 1.637. (ii) FMR1 was not associated with aneuploidy, though aneuploidy increased with female age. (iii) Recipient pregnancy rates were neither associated with donor age or donor FMR1. In absence of a low FMR1 allele, OR of clinical pregnancy (vs. chemical or no pregnancy) was 2.244 in middle-aged infertility patients. CONCLUSIONS A low FMR1 allele (CGG(<26)) is associated with significantly poorer morphologic embryo quality and pregnancy chance. As women age, low FMR1 alleles affect IVF pregnancy chances by reducing egg/embryo quality by mechanisms other than embryo aneuploidy.
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Affiliation(s)
- Vitaly A Kushnir
- Center for Human Reproduction, New York, New York, United States of America
| | - Yao Yu
- Center for Human Reproduction, New York, New York, United States of America
| | - David H Barad
- Center for Human Reproduction, New York, New York, United States of America; Foundation for Reproductive Medicine, New York, New York, United States of America
| | - Andrea Weghofer
- Center for Human Reproduction, New York, New York, United States of America; Department of Obstetrics and Gynecology, University of Vienna School of Medicine, Vienna, Austria
| | - Eric Himaya
- Gatineau Hospital, McGill University, Quebec, Canada
| | - Ho-Joon Lee
- Center for Human Reproduction, New York, New York, United States of America
| | - Yan-Guang Wu
- Center for Human Reproduction, New York, New York, United States of America
| | - Aya Shohat-Tal
- Center for Human Reproduction, New York, New York, United States of America
| | | | - Norbert Gleicher
- Center for Human Reproduction, New York, New York, United States of America; Foundation for Reproductive Medicine, New York, New York, United States of America
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Pregnancy with oocytes characterized by narrow perivitelline space and heterogeneous zona pellucida: is intracytoplasmic sperm injection necessary? J Assist Reprod Genet 2014; 31:285-94. [PMID: 24408184 DOI: 10.1007/s10815-013-0169-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Accepted: 12/26/2013] [Indexed: 12/17/2022] Open
Abstract
PURPOSE This retrospective study analyzed fertilization protocols and pregnancy outcomes for oocytes with with narrow perivitelline space and heterogeneous zona pellucid (NPVS/HZP). METHODS In 63 in-vitro fertilization cycles filled with NPVS/HZP oocytes (abnormal oocytes group) and 521 cycles with normal oocytes (normal oocytes group), major clinical and laboratory parameters were recorded and compared in different fertilization cycles (conventional IVF cycles, rescue ICSI cycles, and traditional ICSI cycles). RESULTS NPVS/HZP oocytes meant lower MIIoocytes rates in both IVF and ICSI cycles compared with normal oocytes (p < 0.05). The 2PN rates for abnormal oocytes were significantly lower than those for normal oocytes in both conventional IVF cycles (58.8% VS 71.3%, P < 0.05) and rescue ICSI cycles (58.0% VS 78.0%, P = 0.0000). The high-quality embryo rates in normal oocytes groups were significantly higher than those in abnormal oocytes groups in different fertilization cycles (52.2% VS 35.0%, P < 0.01; 42.9% VS 23.9%, P < 0.001; 50.6% VS 31.0%, P = 0.0000, respectively). No clinical pregnancy was obtained from abnormal oocytes in 11 conventional IVF cycles. The clinical pregnancy rates in rescue ICSI and traditional ICSI cycles were comparatively lower in abnormal oocytes groups, but there was no significant difference as compared with normal oocytes groups (35.0% VS 48.1% and 26.7% VS 50.7%, P > 0.05, respectively). CONCLUSIONS Retrieval of oocytes characterized by NPVS/PZP from cycle to cycle was one of the reasons for obscure infertility. ICSI may be the right way to avoid fertilization failure and get pregnancy in women with NPVS/HZP oocytes.
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Influence of oocyte dysmorphisms on blastocyst formation and quality. Fertil Steril 2013; 100:748-54. [DOI: 10.1016/j.fertnstert.2013.05.021] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2013] [Revised: 05/09/2013] [Accepted: 05/15/2013] [Indexed: 11/23/2022]
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Cota AMM, Oliveira JBA, Petersen CG, Mauri AL, Massaro FC, Silva LFI, Nicoletti A, Cavagna M, Baruffi RLR, Franco JG. GnRH agonist versus GnRH antagonist in assisted reproduction cycles: oocyte morphology. Reprod Biol Endocrinol 2012; 10:33. [PMID: 22540993 PMCID: PMC3464873 DOI: 10.1186/1477-7827-10-33] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2012] [Accepted: 04/27/2012] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The selection of developmentally competent human gametes may increase the efficiency of assisted reproduction. Spermatozoa and oocytes are usually assessed according to morphological criteria. Oocyte morphology can be affected by the age, genetic characteristics, and factors related to controlled ovarian stimulation. However, there is a lack of evidence in the literature concerning the effect of gonadotropin-releasing hormone (GnRH) analogues, either agonists or antagonists, on oocyte morphology. The aim of this randomized study was to investigate whether the prevalence of oocyte dysmorphism is influenced by the type of pituitary suppression used in ovarian stimulation. METHODS A total of 64 patients in the first intracytoplasmic sperm injection (ICSI) cycle were prospectively randomized to receive treatment with either a GnRH agonist with a long-term protocol (n: 32) or a GnRH antagonist with a multi-dose protocol (n: 32). Before being subjected to ICSI, the oocytes at metaphase II from both groups were morphologically analyzed under an inverted light microscope at 400x magnification. The oocytes were classified as follows: normal or with cytoplasmic dysmorphism, extracytoplasmic dysmorphism, or both. The number of dysmorphic oocytes per total number of oocytes was analyzed. RESULTS Out of a total of 681 oocytes, 189 (27.8%) were morphologically normal, 220 (32.3%) showed cytoplasmic dysmorphism, 124 (18.2%) showed extracytoplasmic alterations, and 148 (21.7%) exhibited both types of dysmorphism. No significant difference in oocyte dysmorphism was observed between the agonist- and antagonist-treated groups (P>0.05). Analysis for each dysmorphism revealed that the most common conditions were alterations in polar body shape (31.3%) and the presence of diffuse cytoplasmic granulations (22.8%), refractile bodies (18.5%) and central cytoplasmic granulations (13.6%). There was no significant difference among individual oocyte dysmorphisms in the agonist- and antagonist-treated groups (P>0.05). CONCLUSIONS Our randomized data indicate that in terms of the quality of oocyte morphology, there is no difference between the antagonist multi-dose protocol and the long-term agonist protocol. If a GnRH analogue used for pituitary suppression in IVF cycles influences the prevalence of oocyte dysmorphisms, there does not appear to be a difference between the use of an agonist as opposed to an antagonist.
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Affiliation(s)
- Ana Marcia M Cota
- Department of Gynecology and Obstetrics, Botucatu Medical School, São Paulo State University—UNESP, Botucatu, Brazil
| | - Joao Batista A Oliveira
- Department of Gynecology and Obstetrics, Botucatu Medical School, São Paulo State University—UNESP, Botucatu, Brazil
- Center for Human Reproduction Prof. Franco Junior, Ribeirao Preto, Brazil
- Paulista Center for Diagnosis, Research and Training, Ribeirao Preto, Brazil
| | - Claudia G Petersen
- Department of Gynecology and Obstetrics, Botucatu Medical School, São Paulo State University—UNESP, Botucatu, Brazil
- Center for Human Reproduction Prof. Franco Junior, Ribeirao Preto, Brazil
- Paulista Center for Diagnosis, Research and Training, Ribeirao Preto, Brazil
| | - Ana L Mauri
- Center for Human Reproduction Prof. Franco Junior, Ribeirao Preto, Brazil
- Paulista Center for Diagnosis, Research and Training, Ribeirao Preto, Brazil
| | - Fabiana C Massaro
- Center for Human Reproduction Prof. Franco Junior, Ribeirao Preto, Brazil
- Paulista Center for Diagnosis, Research and Training, Ribeirao Preto, Brazil
| | - Liliane FI Silva
- Department of Gynecology and Obstetrics, Botucatu Medical School, São Paulo State University—UNESP, Botucatu, Brazil
- Center for Human Reproduction Prof. Franco Junior, Ribeirao Preto, Brazil
- Paulista Center for Diagnosis, Research and Training, Ribeirao Preto, Brazil
| | - Andreia Nicoletti
- Center for Human Reproduction Prof. Franco Junior, Ribeirao Preto, Brazil
| | - Mario Cavagna
- Center for Human Reproduction Prof. Franco Junior, Ribeirao Preto, Brazil
- Paulista Center for Diagnosis, Research and Training, Ribeirao Preto, Brazil
- Women’s Health Reference Center, Perola Byington Hospital, Sao Paulo, Brazil
| | - Ricardo LR Baruffi
- Center for Human Reproduction Prof. Franco Junior, Ribeirao Preto, Brazil
- Paulista Center for Diagnosis, Research and Training, Ribeirao Preto, Brazil
| | - José G Franco
- Department of Gynecology and Obstetrics, Botucatu Medical School, São Paulo State University—UNESP, Botucatu, Brazil
- Center for Human Reproduction Prof. Franco Junior, Ribeirao Preto, Brazil
- Paulista Center for Diagnosis, Research and Training, Ribeirao Preto, Brazil
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