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The prolonged disease state of infertility is associated with embryonic epigenetic dysregulation. Fertil Steril 2021; 116:309-318. [PMID: 33745724 DOI: 10.1016/j.fertnstert.2021.01.040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 01/20/2021] [Accepted: 01/21/2021] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To evaluate the epigenetic consequence of a prolonged disease state of infertility in euploid blastocysts. DESIGN Methylome analysis as well as targeted imprinted methylation and expression analysis on individual human euploid blastocysts examined in association with duration of patient infertility and time to live birth. SETTING Research study. PATIENT(S) One hundred four surplus cryopreserved euploid blastocysts of transferrable-quality were donated with informed patient consent and grouped based on time to pregnancy (TTP). INTERVENTION(S) None MAIN OUTCOME MEASURE(S): The Methyl Maxi-Seq platform (Zymo Research) was used to determine genome-wide methylation, while targeted methylation and expression analyses were performed by pyrosequencing and quantitative real-time polymerase chain reaction, respectively. Statistical analyses used Student's t test, 1-way ANOVA, Fisher's exact test, and pairwise-fixed reallocation randomization test, where appropriate. RESULT(S) The methylome analysis of individual blastocysts revealed significant alterations at 6,609 CpG sites associated with prolonged infertility (≥60 months) compared with those of fertile controls (0 months). Significant CpG alterations were localized to numerous imprinting control regions and imprinted genes, and several signaling pathways were highly represented among genes that were differentially methylated. Targeted imprinting methylation analysis uncovered significant hypomethylation at KvDMR and MEST imprinting control regions, with significant decreases in the gene expression levels upon extended TTP (≥36 months) compared to minimal TTP (≤24 months). CONCLUSION(S) The prolonged disease state of infertility correlates with an altered methylome in euploid blastocysts, with particular emphasis on genomic imprinting regulation, compared with assisted reproductive technologies alone.
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Abstract
Most IVF-conceived children are healthy, but IVF has also been associated with adverse obstetric and perinatal outcomes as well as congenital anomalies. There is also literature suggesting an association between IVF and neurodevelopmental disorders as well as potentially long-term metabolic outcomes. The main driver for adverse outcomes is the higher risk of multiple gestations in IVF, but as the field moves toward single embryo transfer, the rate of multiple gestations is decreasing. Studies have shown that singleton IVF pregnancies still have a higher incidence of adverse outcomes compared to unassisted singleton pregnancies. Infertility itself may be an independent risk factor. Animal models suggest that epigenetic changes in genes involved in growth and development are altered in IVF during the hormonal stimulation and embryo culture. Further animal research and prospective human data are needed to elucidate the mechanisms by which IVF may contribute to adverse outcomes and to decrease risks.
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Affiliation(s)
- Chantae S Sullivan-Pyke
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Pennsylvania, 3701 Market St, Suite 810, Philadelphia, PA 19104
| | - Suneeta Senapati
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Pennsylvania, 3701 Market St, Suite 810, Philadelphia, PA 19104.
| | - Monica A Mainigi
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Pennsylvania, 3701 Market St, Suite 810, Philadelphia, PA 19104
| | - Kurt T Barnhart
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Pennsylvania, 3701 Market St, Suite 810, Philadelphia, PA 19104
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Kim ME, Cancel M, Metry D, Strawn EY, Drolet BA, Chiu YE, Siegel DH. Evaluation of maternal history of miscarriage, infertility and in vitro fertilization as associated factors in PHACE. Br J Dermatol 2017; 177:e90-e91. [PMID: 28129673 DOI: 10.1111/bjd.15341] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- M E Kim
- Department of Dermatology, Medical College of Wisconsin, 9200 W. Wisconsin Ave, Milwaukee, WI, 52336, U.S.A
| | - M Cancel
- Medical College of Wisconsin, Milwaukee, WI, U.S.A
| | - D Metry
- Departments of Pediatrics and Dermatology, Texas Children's Hospital, Houston, TX, U.S.A
| | - E Y Strawn
- Department of Obstetrics and Gynecology, Medical College of Wisconsin, 9200 W. Wisconsin Ave, Milwaukee, WI, 52336, U.S.A
| | - B A Drolet
- Department of Dermatology, Medical College of Wisconsin, 9200 W. Wisconsin Ave, Milwaukee, WI, 52336, U.S.A.,Department of Pediatrics, Medical College of Wisconsin, 9200 W. Wisconsin Ave, Milwaukee, WI, 52336, U.S.A
| | - Y E Chiu
- Department of Dermatology, Medical College of Wisconsin, 9200 W. Wisconsin Ave, Milwaukee, WI, 52336, U.S.A.,Department of Pediatrics, Medical College of Wisconsin, 9200 W. Wisconsin Ave, Milwaukee, WI, 52336, U.S.A
| | - D H Siegel
- Department of Dermatology, Medical College of Wisconsin, 9200 W. Wisconsin Ave, Milwaukee, WI, 52336, U.S.A.,Department of Pediatrics, Medical College of Wisconsin, 9200 W. Wisconsin Ave, Milwaukee, WI, 52336, U.S.A
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Turkgeldi E, Yagmur H, Seyhan A, Urman B, Ata B. Short and long term outcomes of children conceived with assisted reproductive technology. Eur J Obstet Gynecol Reprod Biol 2016; 207:129-136. [PMID: 27846448 DOI: 10.1016/j.ejogrb.2016.10.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2016] [Revised: 08/09/2016] [Accepted: 10/18/2016] [Indexed: 10/20/2022]
Abstract
Despite their wide and global use, possible short and long-term effects of fertility treatments on children is not well-established. In this review, birth defects and perinatal complications and their relationship with assisted reproductive technology (ART), along with long-term effects of ART on cardiovascular system, metabolism, behavior, cognitive skills, and childhood cancers are discussed. Children conceived through ART are at increased risk for birth defects and perinatal complications such as preterm delivery, low birth weight and small for gestational age. Parental characteristics, underlying infertility etiology and ART procedures themselves may contribute to this. The long-term effects of ART are difficult to establish. Studies so far report that ART children have normal social, emotional, cognitive, and motor functions. Likewise, despite some minor inconsistencies in some studies, they do not seem to be at increased risk for childhood cancers. However, there are a number of studies that imply vascular system may be adversely affected by ART and its possible consequences should be further investigated with follow up studies. Large scale studies with long-term follow up periods are required to determine the effects of ART on conceived children.
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Affiliation(s)
- Engin Turkgeldi
- Dept. of Obstetrics and Gynecology, Koc University Hospital, Turkey
| | - Hande Yagmur
- Dept. of Obstetrics and Gynecology, Koc University Hospital, Turkey
| | - Ayse Seyhan
- Assisted Reproduction Center, American Hospital of Istanbul, Turkey
| | - Bulent Urman
- Dept. of Obstetrics and Gynecology, Koc University School of Medicine, Turkey
| | - Baris Ata
- Dept. of Obstetrics and Gynecology, Koc University School of Medicine, Turkey.
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5
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The impact of assisted reproductive technologies on genomic imprinting and imprinting disorders. Curr Opin Obstet Gynecol 2015; 26:210-21. [PMID: 24752003 DOI: 10.1097/gco.0000000000000071] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW Genomic imprinting refers to preferential allele-specific gene expression. DNA methylation-based molecular mechanisms regulate establishment and maintenance of parental imprints during early embryo development and gametogenesis. Because of the coincident timing, a potential association between assisted reproductive technology (ART) procedures and imprinting defects has been investigated in various studies. In this review, we provide an overview of genomic imprinting and present a summary of the relevant clinical data. RECENT FINDINGS ART procedures affect DNA methylation pattern, parental imprinting status, and imprinted gene expression in the mouse embryo. In humans, several case series suggested an association between ART and imprinting disorders, with a three-fold to six-fold higher prevalence of ART use among children born with Beckwith-Wiedemann syndrome compared to the general population. However, more recent studies failed to support these findings and could not demonstrate an association between imprinting disorders and ARTs, independent of subfertility. SUMMARY ART procedures may affect methylation status of imprinted regions in the DNA, leading to imprinting disorders. Although the low prevalence of imprinting disorders makes it challenging to perform conclusive clinical trials, further studies in large registries are required to determine the real impact of ARTs on their occurrence.
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Milani D, Pezzani L, Tabano S, Miozzo M. Beckwith-Wiedemann and IMAGe syndromes: two very different diseases caused by mutations on the same gene. APPLICATION OF CLINICAL GENETICS 2014; 7:169-75. [PMID: 25258553 PMCID: PMC4173641 DOI: 10.2147/tacg.s35474] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Genomic imprinting is an epigenetically regulated mechanism leading to parental-origin allele-specific expression. Beckwith-Wiedemann syndrome (BWS) is an imprinting disease related to 11p15.5 genetic and epigenetic alterations, among them loss-of-function CDKN1C mutations. Intriguing is that CDKN1C gain-of-function variations were recently found in patients with IMAGe syndrome (intrauterine growth restriction, metaphyseal dysplasia, congenital adrenal hypoplasia, and genital anomalies). BWS and IMAGe share an imprinted mode of inheritance; familial analysis demonstrated the presence of the phenotype exclusively when the mutant CDKN1C allele is inherited from the mother. Interestingly, both IMAGe and BWS are characterized by growth disturbances, although with opposite clinical phenotypes; IMAGe patients display growth restriction whereas BWS patients display overgrowth. CDKN1C codifies for CDKN1C/KIP2, a nuclear protein and potent tight-binding inhibitor of several cyclin/Cdk complexes, playing a role in maintenance of the nonproliferative state of cells. The mirror phenotype of BWS and IMAGe can be, at least in part, explained by the effect of mutations on protein functions. All the IMAGe-associated mutations are clustered in the proliferating cell nuclear antigen-binding domain of CDKN1C and cause a dramatic increase in the stability of the protein, which probably results in a functional gain of growth inhibition properties. In contrast, BWS mutations are not clustered within a single domain, are loss-of-function, and promote cell proliferation. CDKN1C is an example of allelic heterogeneity associated with opposite syndromes.
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Affiliation(s)
- Donatella Milani
- Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Italy
| | - Lidia Pezzani
- Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Italy
| | - Silvia Tabano
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Italy
| | - Monica Miozzo
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Italy ; Division of Pathology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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Chen CP, Su YN, Chen SU, Chang TY, Wu PC, Chern SR, Wu PS, Kuo YL, Wang W. Prenatal diagnosis of hypomethylation at KvDMR1 and Beckwith–Wiedemann syndrome in a pregnancy conceived by intracytoplasmic sperm injection and in vitro fertilization and embryo transfer. Taiwan J Obstet Gynecol 2014; 53:90-4. [DOI: 10.1016/j.tjog.2013.12.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/06/2013] [Indexed: 01/08/2023] Open
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8
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Abstract
Early follow-up studies of IVF children showed that the frequency of birth anomalies resembled those arising with natural conception. More detailed analyses confirmed these findings, reinforcing the concept of the preimplantation period as teratologically "safe." The use of intracytoplasmic sperm injection (ICSI) to achieve fertilization introduced another variable.ICSI's safety has often been criticized because the fertilizing spermatozoon neither binds to the zona pellucida nor fuses with oolemma. Bypassing these physiologic steps together with the arbitrary selection of the spermatozoon has been reason for concern. Thus far, ICSI offspring undergoing adolescence and beyond has provided sufficient information to reassure these qualms. In fact, the health of the offspring generated through ICSI, once taken into consideration the gestational order, the age and the genetic makeup of the couples are generally reassuring.
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Affiliation(s)
- Gianpiero D Palermo
- The Ronald O. Perelman & Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medical College, 1305 York Avenue, Suite 720, New York, NY, 10021, USA,
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Fauser BCJM, Devroey P, Diedrich K, Balaban B, Bonduelle M, Delemarre-van de Waal HA, Estella C, Ezcurra D, Geraedts JPM, Howles CM, Lerner-Geva L, Serna J, Wells D. Health outcomes of children born after IVF/ICSI: a review of current expert opinion and literature. Reprod Biomed Online 2013; 28:162-82. [PMID: 24365026 DOI: 10.1016/j.rbmo.2013.10.013] [Citation(s) in RCA: 71] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2012] [Revised: 10/03/2013] [Accepted: 10/08/2013] [Indexed: 01/28/2023]
Abstract
The Sixth Evian Annual Reproduction (EVAR) Workshop Group Meeting was held to evaluate the impact of IVF/intracytoplasmic sperm injection on the health of assisted-conception children. Epidemiologists, reproductive endocrinologists, embryologists and geneticists presented data from published literature and ongoing research on the incidence of genetic and epigenetic abnormalities and congenital malformations in assisted-conception versus naturally conceived children to reach a consensus on the reasons for potential differences in outcomes between these two groups. IVF-conceived children have lower birthweights and higher peripheral fat, blood pressure and fasting glucose concentrations than controls. Growth, development and cognitive function in assisted-conception children are similar to controls. The absolute risk of imprinting disorders after assisted reproduction is less than 1%. A direct link between assisted reproduction and health-related outcomes in assisted-conception children could not be established. Women undergoing assisted reproduction are often older, increasing the chances of obtaining abnormal gametes that may cause deviations in outcomes between assisted-conception and naturally conceived children. However, after taking into account these factors, it is not clear to what extent poorer outcomes are due to the assisted reproduction procedures themselves. Large-scale, multicentre, prospective epidemiological studies are needed to investigate this further and to confirm long-term health consequences in assisted-conception children. Assisted reproduction treatment is a general term used to describe methods of achieving pregnancy by artificial means and includes IVF and sperm implantation. The effect of assisted reproduction treatment on the health of children born using these artificial methods is not fully understood. In April 2011, fertility research experts met to give presentations based on research in this area and to look carefully at the evidence for the effects of assisted reproduction treatment on children's health. The purpose of this review was to reach an agreement on whether there are differences in the health of assisted-conception children with naturally conceived children. The researchers discovered no increased risk in birth defects in assisted-conception children compared with naturally conceived children. They found that IVF-conceived children have lower birth weights and higher fat under the skin, higher blood pressure and higher fasting glucose concentrations than naturally conceived children; however, growth, development and cognitive function are similar between groups. A very low risk of disorders of genetic control was observed in assisted-conception children. Overall, there did not appear to be a direct link between assisted reproduction treatment and children's health. The researchers concluded that the cause of some differences in the health of children conceived using assisted reproduction treatment may be due to the age of the woman receiving treatment. Large-scale, research studies are needed to study the long-term health of children conceived using assisted reproduction treatment.
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Affiliation(s)
- B C J M Fauser
- Department of Reproductive Medicine and Gynaecology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands.
| | - P Devroey
- Center for Reproductive Medicine, Vrije Universiteit Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium
| | - K Diedrich
- Department of Obstetrics and Gynecology, University Clinic of Schleswig-Holstein, Campus Luebeck, 23538 Luebeck, Germany
| | - B Balaban
- Assisted Reproduction Unit, American Hospital of Istanbul, Guzelbahce Sokak No 20, Nisantasi, Istanbul 34365, Turkey
| | - M Bonduelle
- Centre for Medical Genetics, Vrije Universiteit Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium
| | | | - C Estella
- Fundación Instituto Valenciano de Infertilidad (FIVI), Valencia University, and Instituto Universitario IVI/INCLIVA, Parc Científic Universitat de València C/Catedrático Agustín Escardino n(o) 9, Edificio 3, 46980 Paterna, Spain; Departamento de Biología Molecular and Centro de Biología Molecular 'Severo Ochoa' (CSIC-UAM), Universidad Autónoma de Madrid, Madrid, Spain
| | - D Ezcurra
- Global Development and Medical Unit, Merck Serono SA Geneva, Chemin des Mines 9, 1202 Geneva, Switzerland
| | - J P M Geraedts
- Department of Genetics and Cell Biology, Research Institute GROW, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - C M Howles
- Global Development and Medical Unit, Merck Serono SA Geneva, Chemin des Mines 9, 1202 Geneva, Switzerland
| | - L Lerner-Geva
- Woman and Child Health Research Unit, Gertner Institute for Epidemiology and Health Policy Research, Tel Hashomer 52621, Israel
| | - J Serna
- Instituto Valenciano de Infertilidad (IVI) Zaragoza, C/María Zambrano, 31, 50018 Zaragoza, Spain
| | - D Wells
- University of Oxford, Nuffield Department of Obstetrics and Gynaecology, Women's Centre, John Radcliffe Hospital, Oxford OX3 9DU, UK
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Choufani S, Shuman C, Weksberg R. Molecular findings in Beckwith-Wiedemann syndrome. AMERICAN JOURNAL OF MEDICAL GENETICS PART C-SEMINARS IN MEDICAL GENETICS 2013; 163C:131-40. [PMID: 23592339 DOI: 10.1002/ajmg.c.31363] [Citation(s) in RCA: 98] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Our understanding of Beckwith-Wiedemann syndrome (BWS) has recently been enhanced by advances in its molecular characterization. These advances have further delineated intricate (epi)genetic regulation of the imprinted gene cluster on chromosome 11p15.5 and the role of these genes in normal growth and development. Studies of the molecular changes associated with the BWS phenotype have been instrumental in elucidating critical molecular elements in this imprinted region. This review will provide updated information on the multiple new regulatory elements that have been recently found to contribute to in cis or in trans control of imprinted gene expression in the chromosome 11p15.5 region and the clinical expression of the BWS phenotype.
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Affiliation(s)
- Sanaa Choufani
- Research Institute of the Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
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Current world literature. Curr Opin Endocrinol Diabetes Obes 2010; 17:568-80. [PMID: 21030841 DOI: 10.1097/med.0b013e328341311d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abstract
PURPOSE OF REVIEW To summarize current evidence in the association of imprinting disorders and assisted reproductive technology. RECENT FINDINGS The worldwide usage of assisted reproductive technology (ART) has continued to increase since the first successful birth of a human after IVF. Since 2002, several reports have raised concerns that children conceived by ART are at increased risk of having imprinting disorders. The majority of published studies have examined DNA methylation in children conceived by ART, but results are conflicting. Beckwith-Wiedemann syndrome and Angelman syndrome are the most extensively studied imprinting disorders and multiple case series and reports have been published on ART-conceived children with these syndromes. Overall the majority of reports suggest that ART might be associated with Beckwith-Wiedermann syndrome and Angelman syndrome, but larger collaborative studies need to be performed. SUMMARY The current data suggest an association between imprinting disorders and ART although the absolute risk appears to be low. However, animal studies have established biologic plausibility and there is continuing concern about the possibility of epigenetic changes resulting from ART.
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Affiliation(s)
- Lawrence N. Odom
- Department of Obstetrics and Gynecology, University of Tennessee Health Science Center, Memphis, Tennessee
| | - James Segars
- Reproductive Biology and Medicine Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland, USA
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