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Mizobe Y, Kuwatsuru Y, Kuroki Y, Fukumoto Y, Tokudome M, Moewaki H, Iwakawa T, Takeuchi K. Effects of first and second division modes on euploidy acquisition in human embryo. Syst Biol Reprod Med 2024; 70:52-58. [PMID: 38426509 DOI: 10.1080/19396368.2024.2311643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 01/16/2024] [Indexed: 03/02/2024]
Abstract
The aim of this study was to non-invasively investigate euploid embryos using methods other than pre-implantation genetic testing for aneuploidy. The study focused on direct cleavage (DC) observed during early embryo development. We also investigated the relationship between the mode of early embryo division and embryo ploidy. Embryos were divided into the normal cleavage (NC) and DC groups, and the DC group was further subdivided into the DC-First (DC-F) and DC-Second (DC-S) groups, depending on whether DC was observed at the first or second cleavage, respectively. The acquisition rates of euploid embryos and embryos appropriate for transfer were compared between the groups. Our results revealed that the timing of the first division did not differ between blastocyst grades or in embryos with varying degrees of ploidy. Further, the timing of the first cleavage did not affect the acquisition rate of embryos appropriate for transfer and euploid embryo formation rate did not significantly differ between the DC and NC groups. We also noted that for embryos appropriate for transfer, euploidy acquisition rate did not differ significantly between the DC and NC groups. Further, the euploidy acquisition rate of embryos did not differ between the DC-F and DC-S groups. However, the acquisition rate of embryos appropriate for transfer, including those with low mosaicism, was significantly higher in the DC-S group than in the DC-F group. These findings indicated that the number of good-quality blastocysts formed was significantly higher in the NC group than in the DC group and the acquisition rate of embryos appropriate for transfer, including those with low mosaicism, was significantly higher in the DC-S group than in the DC-F group.
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Affiliation(s)
- Yamato Mizobe
- Takeuchi Ladies Clinic/Center for Reproductive Medicine, Kagoshima, Japan
| | - Yukari Kuwatsuru
- Takeuchi Ladies Clinic/Center for Reproductive Medicine, Kagoshima, Japan
| | - Yuko Kuroki
- Takeuchi Ladies Clinic/Center for Reproductive Medicine, Kagoshima, Japan
| | - Yumiko Fukumoto
- Takeuchi Ladies Clinic/Center for Reproductive Medicine, Kagoshima, Japan
| | - Mari Tokudome
- Takeuchi Ladies Clinic/Center for Reproductive Medicine, Kagoshima, Japan
| | - Harue Moewaki
- Takeuchi Ladies Clinic/Center for Reproductive Medicine, Kagoshima, Japan
| | - Tokiko Iwakawa
- Takeuchi Ladies Clinic/Center for Reproductive Medicine, Kagoshima, Japan
| | - Kazuhiro Takeuchi
- Takeuchi Ladies Clinic/Center for Reproductive Medicine, Kagoshima, Japan
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Yang L, Leynes C, Pawelka A, Lorenzo I, Chou A, Lee B, Heaney JD. Machine learning in time-lapse imaging to differentiate embryos from young vs old mice†. Biol Reprod 2024; 110:1115-1124. [PMID: 38685607 PMCID: PMC11180621 DOI: 10.1093/biolre/ioae056] [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: 11/24/2023] [Revised: 02/15/2024] [Accepted: 04/05/2024] [Indexed: 05/02/2024] Open
Abstract
Time-lapse microscopy for embryos is a non-invasive technology used to characterize early embryo development. This study employs time-lapse microscopy and machine learning to elucidate changes in embryonic growth kinetics with maternal aging. We analyzed morphokinetic parameters of embryos from young and aged C57BL6/NJ mice via continuous imaging. Our findings show that aged embryos accelerated through cleavage stages (from 5-cells) to morula compared to younger counterparts, with no significant differences observed in later stages of blastulation. Unsupervised machine learning identified two distinct clusters comprising of embryos from aged or young donors. Moreover, in supervised learning, the extreme gradient boosting algorithm successfully predicted the age-related phenotype with 0.78 accuracy, 0.81 precision, and 0.83 recall following hyperparameter tuning. These results highlight two main scientific insights: maternal aging affects embryonic development pace, and artificial intelligence can differentiate between embryos from aged and young maternal mice by a non-invasive approach. Thus, machine learning can be used to identify morphokinetics phenotypes for further studies. This study has potential for future applications in selecting human embryos for embryo transfer, without or in complement with preimplantation genetic testing.
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Affiliation(s)
- Liubin Yang
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas, USA
- Division of Reproductive Endocrinology and Infertility, Division of Reproductive Sciences, Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale School of Medicine, New Haven, Connecticut, USA
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas, USA
| | - Carolina Leynes
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas, USA
| | - Ashley Pawelka
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas, USA
| | - Isabel Lorenzo
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas, USA
| | - Andrew Chou
- Pain Research, Informatics, Multi-morbidities, and Education (PRIME) Center, VA Connecticut Healthcare System, West Haven, Connecticut, USA
- Section of Infectious Diseases, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Brendan Lee
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas, USA
| | - Jason D Heaney
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas, USA
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Sobkowiak A, Fluks M, Kosyl E, Milewski R, Szpila M, Tamborski S, Szkulmowski M, Ajduk A. The number of nuclei in compacted embryos, assessed by optical coherence microscopy, is a non-invasive and robust marker of mouse embryo quality. Mol Hum Reprod 2024; 30:gaae012. [PMID: 38407286 PMCID: PMC10978378 DOI: 10.1093/molehr/gaae012] [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: 07/07/2023] [Revised: 01/15/2024] [Indexed: 02/27/2024] Open
Abstract
Optical coherence microscopy (OCM) visualizes nuclei in live, unlabeled cells. As most cells are uninucleated, the number of nuclei in embryos may serve as a proxy of the cell number, providing important information on developmental status of the embryo. Importantly, no other non-invasive method currently allows for the cell number count in compacted embryos. We addressed the question of whether OCM, by providing the number of nuclei in compacted mouse embryos, may help evaluate embryo quality. We subjected compacted embryonic Day 3 (E3.0: 72 h after onset of insemination) mouse embryos to OCM scanning and correlated nuclei number and developmental potential. Implantation was assessed using an outgrowth assay (in vitro model meant to reflect embryonic ability to implant in vivo). Embryos with more cells at E3.0 (>18 cells) were more likely to reach the blastocyst stage by E4.0 and E5.0 (P ≪ 0.001) and initiate hatching by E5.0 (P < 0.05) than those with fewer cells (<12 cells). Moreover, the number of cells at E3.0 strongly correlated with the total number of cells in E4.0 and E5.0 embryos (ρ = 0.71, P ≪ 0.001 and ρ = 0.61, P ≪ 0.001, respectively), also when only E4.0 and E5.0 blastocysts were considered (ρ = 0.58, P ≪ 0.001 and ρ = 0.56, P ≪ 0.001, respectively). Additionally, we observed a strong correlation between the number of cells at E3.0 and the number of trophectoderm cells in E4.0 and E5.0 blastocysts (ρ = 0.59, P ≪ 0.001 and ρ = 0.57, P ≪ 0.001, respectively). Importantly, embryos that had more cells at E3.0 (>18 cells) were also more likely to implant in vitro than their counterparts with fewer cells (<12 cells; P ≪ 0.001). Finally, we tested the safety of OCM imaging, demonstrating that OCM scanning affected neither the amount of reactive oxygen species nor mitochondrial activity in the embryos. OCM also did not hinder their preimplantation development, ability to implant in vitro, or to develop to term after transfer to recipient females. Our data indicate that OCM imaging provides important information on embryo quality. As the method seems to be safe for embryos, it could be a valuable addition to the current repertoire of embryo evaluation methods. However, our study was conducted only on mouse embryos, so the proposed protocol would require optimization in order to be applied in other species.
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Affiliation(s)
- Aleksandra Sobkowiak
- Department of Embryology, Institute of Developmental Biology and Biomedical Sciences, Faculty of Biology, University of Warsaw, Warsaw, Poland
| | - Monika Fluks
- Department of Embryology, Institute of Developmental Biology and Biomedical Sciences, Faculty of Biology, University of Warsaw, Warsaw, Poland
| | - Ewa Kosyl
- Department of Embryology, Institute of Developmental Biology and Biomedical Sciences, Faculty of Biology, University of Warsaw, Warsaw, Poland
| | - Robert Milewski
- Department of Biostatistics and Medical Informatics, Medical University of Bialystok, Białystok, Poland
| | - Marcin Szpila
- Department of Embryology, Institute of Developmental Biology and Biomedical Sciences, Faculty of Biology, University of Warsaw, Warsaw, Poland
| | - Szymon Tamborski
- Department of Biophotonics and Optical Engineering, Institute of Physics, Faculty of Physics, Astronomy, and Informatics, Nicolaus Copernicus University in Torun, Toruń, Poland
| | - Maciej Szkulmowski
- Department of Biophotonics and Optical Engineering, Institute of Physics, Faculty of Physics, Astronomy, and Informatics, Nicolaus Copernicus University in Torun, Toruń, Poland
| | - Anna Ajduk
- Department of Embryology, Institute of Developmental Biology and Biomedical Sciences, Faculty of Biology, University of Warsaw, Warsaw, Poland
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Ezoe K, Takahashi T, Miki T, Kato K. Developmental perturbation in human embryos: Clinical and biological significance learned from time-lapse images. Reprod Med Biol 2024; 23:e12593. [PMID: 38983691 PMCID: PMC11232294 DOI: 10.1002/rmb2.12593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 05/30/2024] [Accepted: 06/07/2024] [Indexed: 07/11/2024] Open
Abstract
Background Time-lapse technology (TLT) has gained widespread adoption worldwide. In addition to facilitating the undisturbed culture of embryos, TLT offers the unique capability of continuously monitoring embryos to detect spatiotemporal changes. Although these observed phenomena play a role in optimal embryo selection/deselection, the clinical advantages of introducing TLT remain unclear. However, manual annotation of embryo perturbation could facilitate a comprehensive assessment of developmental competence. This process requires a thorough understanding of embryo observation and the biological significance associated with developmental dogma and variation. This review elucidates the typical behavior and variation of each phenomenon, exploring their clinical significance and research perspectives. Methods The MEDLINE database was searched using PubMed for peer-reviewed English-language original articles concerning human embryo development. Main findings TLT allows the observation of consecutive changes in embryo morphology, serving as potential biomarkers for embryo assessment. In assisted reproductive technology laboratories, several phenomena have not revealed their mechanism, posing difficulties such as fertilization deficiency and morula arrest. Conclusion A profound understanding of the biological mechanisms and significance of each phenomenon is crucial. Further collaborative efforts between the clinical and molecular fields following translational studies are required to advance embryonic outcomes and assessment.
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Garcia-Belda A, Cairó O, Martínez-Moro Á, Cuadros M, Pons MC, de Mendoza MVH, Delgado A, Rives N, Carrasco B, Cabello Y, Figueroa MJ, Cascales-Romero L, González-Soto B, Cuevas-Saiz I. Considerations for future modification of The Association for the Study of Reproductive Biology embryo grading system incorporating time-lapse observations. Reprod Biomed Online 2024; 48:103570. [PMID: 37952277 DOI: 10.1016/j.rbmo.2023.103570] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 09/13/2023] [Accepted: 09/19/2023] [Indexed: 11/14/2023]
Abstract
The Association for the Study of Reproductive Biology (ASEBIR) Interest Group in Embryology (in Spanish 'Grupo de Interés de Embriología') reviewed key morphokinetic parameters to assess the contribution of time-lapse technology (TLT) to the ASEBIR grading system. Embryo grading based on morphological characteristics is the most widely used method in human assisted reproduction laboratories. The introduction and implementation of TLT has provided a large amount of information that can be used as a complementary tool for morphological embryo evaluation and selection. As part of IVF treatments, embryologists grade embryos to decide which embryos to transfer or freeze. At the present, the embryo grading system developed by ASEBIR does not consider dynamic events observed through TLT. Laboratories that are using TLT consider those parameters as complementary data for embryo selection. The aim of this review was to evaluate review time-specific morphological changes during embryo development that are not included in the ASEBIR scoring system, and to consider them as candidates to add to the scoring system.
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Affiliation(s)
| | | | - Álvaro Martínez-Moro
- IVF Spain Madrid, Madrid, Spain.; Animal Reproduction Department, INIA-CSIC, Madrid, Spain
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Xie P, Kocur OM, Cheung S, Ng L, Albertini DF, Rosenwaks Z, Palermo GD. Sperm centriolar factors and genetic defects that can predict pregnancy. Fertil Steril 2023; 120:720-728. [PMID: 37487819 DOI: 10.1016/j.fertnstert.2023.07.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 07/17/2023] [Accepted: 07/17/2023] [Indexed: 07/26/2023]
Abstract
The human sperm centrosome, comprising the two morphologically distinct centrioles and associated pericentriolar materials, plays a crucial role in fertilization and early embryonic development after fertilization. Once inside the oocyte, the sperm centrosome serves as a microtubule-organizing center, orchestrating mitotic spindle formation, chromosome segregation, and syngamy. Abnormalities of the sperm centrosome can lead to abnormal embryonic development and embryonic chromosomal instability, and are associated with pregnancy loss. Recent research has shed light on the molecular composition, regulation, and function of this vital organelle. Understanding the intricacies of the sperm centrosome is crucial for elucidating the mechanisms underlying successful fertilization and early embryonic development, as well as addressing infertility and developmental disorders associated with centrosomal defects.
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Affiliation(s)
- Philip Xie
- The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medicine, New York, New York
| | | | - Stephanie Cheung
- The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medicine, New York, New York
| | - Lily Ng
- The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medicine, New York, New York
| | | | - Zev Rosenwaks
- The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medicine, New York, New York
| | - Gianpiero D Palermo
- The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medicine, New York, New York.
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Heydari L, Khalili MA, Rahimi AA, Shakeri F. Human embryos derived from first polar body nuclear transfer exhibit comparatively abnormal morphokinetics during development. Clin Exp Reprod Med 2023; 50:177-184. [PMID: 37643831 PMCID: PMC10477411 DOI: 10.5653/cerm.2023.05939] [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: 01/31/2023] [Revised: 05/25/2023] [Accepted: 06/10/2023] [Indexed: 08/31/2023] Open
Abstract
OBJECTIVE Reconstructed oocytes after polar body genome transfer constitute a potential therapeutic option for patients with a history of embryo fragmentation and advanced maternal age. However, the rescue of genetic material from the first polar body (PB1) through introduction into the donor cytoplasm is not yet ready for clinical application. METHODS Eighty-five oocytes were obtained following in vitro maturation (IVM) and divided into two groups: PB1 nuclear transfer (PB1NT; n=54) and control (n=31). Following enucleation and PB1 genomic transfer, PB1 fusion was assessed. Subsequently, all fused oocytes underwent intracytoplasmic sperm injection (ICSI) and were cultured in an incubator under a time-lapse monitoring system to evaluate fertilization, embryonic morphokinetic parameters, and cleavage patterns. RESULTS Following enucleation and fusion, 77.14% of oocytes survived, and 92.59% of polar bodies (PBs) fused. However, the normal fertilization rate was lower in the PB1NT group than in the control group (56.41% vs. 92%, p=0.002). No significant differences were observed in embryo kinetics between the groups, but a significant difference was detected in embryo developmental arrest after the four-cell stage, along with abnormal cleavage division in the PB1NT group. This was followed by significant between-group differences in the implantation potential rate and euploidy status. Most embryos in the PB1NT group had at least one abnormal cleavage division (93.3%, p=0.001). CONCLUSION Fresh PB1NT oocytes successfully produced normal zygotes following PB fusion and ICSI in IVM oocytes. However, this was accompanied by low efficiency in developing into cleavage embryos, along with an increase in abnormal cleavage patterns.
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Affiliation(s)
- Leila Heydari
- Research and Clinical Center for Infertility, Yazd Reproductive Science Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mohammad Ali Khalili
- Research and Clinical Center for Infertility, Yazd Reproductive Science Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Azam Agha Rahimi
- Research and Clinical Center for Infertility, Yazd Reproductive Science Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Fatemeh Shakeri
- Research and Clinical Center for Infertility, Yazd Reproductive Science Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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8
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Embryo Morphokinetic Activity Evident in Short Videos of In Vitro Bovine Embryos. DAIRY 2022. [DOI: 10.3390/dairy3040058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Embryo transfer (ET) and in vitro fertilization (IVF) are increasing in use by dairy producers as a means to breed their animals as these assisted reproductive techniques can optimize the genetics of the dairy breed or enable “beef on dairy” programs to increase the profitability of the dairy. Due to the advantages of ET and IVF, it is anticipated that their use will continue to increase despite the status of underwhelmingly low pregnancy outcomes. Pregnancy rates of bovine ET/IVF remain below 56%, with many dairy producers implementing beef on dairy programs reporting pregnancy to be lower than 23%. The inability to objectively evaluate embryo health prior to transfer into a recipient is a contributing factor to this problem as 20% of transferred embryos are inviable at the time of transfer and have little chance of establishing a pregnancy. The objective of this research was to evaluate bovine embryo real-time morphokinetic activity based on 30 s video recordings of day 7.5 morulas and correlate morphokinetic activity to developmental outcomes. Eighty-eight embryos were recorded in standard embryo culture conditions with an SMZ-1000 Stereo zoom microscope and TE-300 Nikon inverted microscope. The difference in the embryo’s morphokinetic activity was measured frame-by-frame and correlated to embryo hatching outcomes. It was found that embryos with lower morphokinetic activity demonstrated higher hatching rates and developmental outcomes, suggesting measurement of embryo morphokinetic activity is a noninvasive and non-subjective method to evaluate embryo competency prior to transfer and can be used to improve the reproductive efficiency and profitability of IVF/ET of dairy cattle.
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Nucleation status of Day 2 pre-implantation embryos, acquired by time-lapse imaging during IVF, is associated with live birth. PLoS One 2022; 17:e0274502. [PMID: 36137104 PMCID: PMC9498959 DOI: 10.1371/journal.pone.0274502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 08/26/2022] [Indexed: 11/19/2022] Open
Abstract
The primary purpose of this time-lapse data analysis was to identify the association between the nucleation status of a Day 2 preimplantation embryo and live births following in vitro fertilization (IVF). The retrospective data analysis was based on 2769 transferred embryos from 1966 treatment cycles and utilised only Known Implantation Data (KID) for live births. Nucleation errors (NE) such as micronucleation, binucleation, multinucleation and minor error groups, were annotated in the time-lapse images which were taken every 15 minutes for a minimum of 44 hours post insemination. Further, factors that may impact NE and the relationship of early morphological attributes and morphokinetic variables with NE occurrence were explored. The frequency of NE among the transferred embryos was 23.8%. The reversibility of NE evidenced by their presence at the two-cell stage, but absence at the four-cell stage was 89.6%. Embryos exhibiting nucleation errors at the two-cell stage had significantly lower live birth rates compared to embryos with no nucleation errors, constituting a significant predictor. A Generalized Additive Mixed Model was used to control for confounders and for controlling clustering effects from dual embryo transfers. Increased incidences of NE were observed with increasing age, with delayed occurrence of cell divisions and in oocytes inseminated with surgically retrieved spermatozoa. NE assessment and their impact on live birth provides valuable markers for early preimplantation embryo selection. In addition, the high incidence of reversibility of NE and their possible impact on live birth suggest that incorporating two-cell nuclear status annotations in embryo selection, alongside morphology and morphokinetics, is of value.
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10
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Regin M, Spits C, Sermon K. On the origins and fate of chromosomal abnormalities in human preimplantation embryos: an unsolved riddle. Mol Hum Reprod 2022; 28:6566308. [DOI: 10.1093/molehr/gaac011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 03/30/2022] [Indexed: 11/13/2022] Open
Abstract
Abstract
About 8 out of 10 human embryos obtained in vitro harbour chromosomal abnormalities of either meiotic or mitotic origin. Abnormalities of mitotic origin lead to chromosomal mosaicism, a phenomenon which has sparked much debate lately as it confounds results obtained through preimplantation genetic testing for aneuploidy (PGT-A). PGT-A in itself is still highly debated, not only on the modalities of its execution, but also on whether it should be offered to patients at all.
We will focus on post-zygotic chromosomal abnormalities leading to mosaicism. First, we will summarize what is known of the rates of chromosomal abnormalities at different developmental stages. Next, based on the current understanding of the origin and cellular consequences of chromosomal abnormalities, which is largely based on studies on cancer cells and model organisms, we will offer a number of hypotheses on which mechanisms may be at work in early human development. Finally, and very briefly, we will touch upon the impact our current knowledge has on the practice of PGT-A. What is the level of abnormal cells that an embryo can tolerate before it loses its potential for full development? And is blastocyst biopsy as harmless as it seems?
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Affiliation(s)
- Marius Regin
- Research group Reproduction and Genetics, Vrije Universiteit Brussel, Brussels, 1090, Belgium
| | - Claudia Spits
- Research group Reproduction and Genetics, Vrije Universiteit Brussel, Brussels, 1090, Belgium
| | - Karen Sermon
- Research group Reproduction and Genetics, Vrije Universiteit Brussel, Brussels, 1090, Belgium
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11
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Avidor-Reiss T, Achinger L, Uzbekov R. The Centriole's Role in Miscarriages. Front Cell Dev Biol 2022; 10:864692. [PMID: 35300410 PMCID: PMC8922021 DOI: 10.3389/fcell.2022.864692] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 02/14/2022] [Indexed: 12/17/2022] Open
Abstract
Centrioles are subcellular organelles essential for normal cell function and development; they form the cell’s centrosome (a major cytoplasmic microtubule organization center) and cilium (a sensory and motile hair-like cellular extension). Centrioles with evolutionarily conserved characteristics are found in most animal cell types but are absent in egg cells and exhibit unexpectedly high structural, compositional, and functional diversity in sperm cells. As a result, the centriole’s precise role in fertility and early embryo development is unclear. The centrioles are found in the spermatozoan neck, a strategic location connecting two central functional units: the tail, which propels the sperm to the egg and the head, which holds the paternal genetic material. The spermatozoan neck is an ideal site for evolutionary innovation as it can control tail movement pre-fertilization and the male pronucleus’ behavior post-fertilization. We propose that human, bovine, and most other mammals–which exhibit ancestral centriole-dependent reproduction and two spermatozoan centrioles, where one canonical centriole is maintained, and one atypical centriole is formed–adapted extensive species-specific centriolar features. As a result, these centrioles have a high post-fertilization malfunction rate, resulting in aneuploidy, and miscarriages. In contrast, house mice evolved centriole-independent reproduction, losing the spermatozoan centrioles and overcoming a mechanism that causes miscarriages.
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Affiliation(s)
- Tomer Avidor-Reiss
- Department of Biological Sciences, University of Toledo, Toledo, OH, United States.,Department of Urology, College of Medicine and Life Sciences, University of Toledo, Toledo, OH, United States
| | - Luke Achinger
- Department of Biological Sciences, University of Toledo, Toledo, OH, United States
| | - Rustem Uzbekov
- Faculté de Médecine, Université de Tours, Tours, France.,Faculty of Bioengineering and Bioinformatics, Moscow State University, Moscow, Russia
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12
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Anagnostopoulou C, Rosas IM, Singh N, Gugnani N, Chockalingham A, Singh K, Desai D, Darbandi M, Manoharan M, Darbandi S, Leonardi Diaz SI, Gupta S, Henkel R, Sallam HN, Boitrelle F, Wirka KA, Agarwal A. Oocyte quality and embryo selection strategies: a review for the embryologists, by the embryologists. Panminerva Med 2022; 64:171-184. [PMID: 35179016 DOI: 10.23736/s0031-0808.22.04680-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
With the advance of assisted reproduction techniques, and the trend towards blastocyst culture and single embryo transfer, gamete and embryo assessment have gained greater importance in ART treatment. Embryo quality depends mainly on gamete quality and culture conditions. Oocyte maturity identification is necessary in order to plan fertilization timing. Mature oocytes at the metaphase II stage show a higher fertilization rate compared to immature oocytes. Morphology assessment is a critical yet challenging task that may serve as a good prognostic tool for future development and implantation potential if done effectively. Various grading systems have been suggested to assess embryos at pronuclear, cleavage, and blastocyst stages. By identifying the embryo with the highest implantation potential, it is possible to reduce the number of embryos transferred without compromising the chances of a successful pregnancy. Apart from the conventional morphology assessment, there are several invasive or non-invasive methods for embryo selection such as preimplantation genetic testing, morphokinetics, proteomics, metabolomics, oxygen consumption, and measurement of oxidative stress in culture medium. Morphokinetics is a method based on time-lapse technology and continuous monitoring of embryos. In this review, we aim to describe and compare the most effective and widely used methods for gamete and embryo assessment as well as embryo selection.
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Affiliation(s)
| | - Israel M Rosas
- Citmer Reproductive Medicine, IVF LAB, Mexico City, Mexico
| | | | - Nivita Gugnani
- Milann-The Fertility Centre, Delhi, India.,All India Institute of Medical Sciences, Delhi, India
| | | | - Keerti Singh
- Faculty of Medical Sciences, The University of the West Indies, Cave Hill Campus, Barbados
| | - Dimple Desai
- DPU IVF & ENDOSCOPY CENTER, Dr. D. Y. Patil Hospital & Research Centre, Pune, India
| | - Mahsa Darbandi
- Fetal Health Research Center, Hope Generation Foundation, Tehran, Iran.,Gene Therapy and Regenerative Medicine Research Center, Hope Generation Foundation, Tehran, Iran
| | | | - Sara Darbandi
- Fetal Health Research Center, Hope Generation Foundation, Tehran, Iran.,Gene Therapy and Regenerative Medicine Research Center, Hope Generation Foundation, Tehran, Iran
| | | | - Sajal Gupta
- American Center for Reproductive Medicine, Cleveland, OH, USA
| | - Ralf Henkel
- American Center for Reproductive Medicine, Cleveland, OH, USA.,Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK.,Department of Medical Bioscience, University of the Western Cape, Bellville, South Africa.,Logix X Pharma, Theale, Berkshire, UK
| | - Hassan N Sallam
- Department of Obstetrics and Gynaecology, Alexandria University Faculty of Medicine, Alexandria, Egypt
| | - Florence Boitrelle
- Reproductive Biology, Fertility Preservation, Andrology, CECOS, Poissy Hospital, Poissy, France.,Department of Biology, Reproduction, Epigenetics, Environment and Development, ParisSaclay University, UVSQ, INRAE, BREED, Jouyen-Josas, France
| | - Kelly A Wirka
- Fertility & Endocrinology, Medical Affairs, EMD Serono, USA
| | - Ashok Agarwal
- American Center for Reproductive Medicine, Cleveland, OH, USA -
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Blastomere movement correlates with ploidy and mosaicism in early-stage human embryos after in vitro fertilization. ZYGOTE 2021; 30:25-39. [PMID: 34275512 DOI: 10.1017/s0967199420000817] [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] [Indexed: 11/07/2022]
Abstract
Embryos undergo chaotic division and decrease in quality on day 3 with a reduction in the rates of subsequent blastocyst formation. Disordered cleavage causes a deterioration in embryonic quality, here we assessed the relationship between an cleavage model in first mitosis and the chromosomal status of human embryos, and discuss the potential biological and clinical implications for the cleavage model as a single parameter that can be used to assess embryonic quality. Thirty-two infertile couples, with normal karyotypes and who underwent their first IVF cycle were recruited to donate one normal two-cell-stage embryo each for this study between 2019 and 2020. Twenty-eight two-cell embryos underwent preimplantation genetic testing of each blastomere, and four chaotic-division embryos were stained with Hoechst and cultured in a confocal laser-scanning microscopy incubator system. This system showed high specificity and PPV but low sensitivity and NPV using the CM in the prediction of euploidy, indicating that CM could be considered a screening method for embryo selection; additional observational studies using the CM to select transferable embryos are needed before it can be used in clinical practice.
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Coticchio G, Barrie A, Lagalla C, Borini A, Fishel S, Griffin D, Campbell A. Plasticity of the human preimplantation embryo: developmental dogmas, variations on themes and self-correction. Hum Reprod Update 2021; 27:848-865. [PMID: 34131722 DOI: 10.1093/humupd/dmab016] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 03/27/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND IVF for the treatment of infertility offers unique opportunities to observe human preimplantation development. Progress in time-lapse technology (TLT) and preimplantation genetic testing (PGT) has greatly expanded our knowledge of developmental patterns leading to a healthy pregnancy or developmental failure. These technologies have also revealed unsuspected plastic properties of the preimplantation embryo, at macromolecular, cellular and multicellular levels. OBJECTIVE AND RATIONALE This review focuses on the emerging concept of plasticity of the human embryo as revealed by recent evidence derived from TLT and PGT, calling for an updated and more precise redefinition of the boundaries between normal and abnormal development. SEARCH METHODS PubMed was used to search the MEDLINE database for peer-reviewed English-language original articles and reviews concerning human preimplantation development. Cross-searches were performed by adopting 'fertilisation', 'pronucleus', 'cleavage', 'multinucleation', 'compaction', 'embryo', 'preimplantation genetic testing', 'aneuploidy', mosaicism', 'micromanipulation', 'time-lapse microscopy' and 'IVF/assisted reproduction' as main terms. The most relevant publications, i.e. those concerning major phenomena occurring during normal and abnormal development-with a focus on the human species-were assessed and discussed critically. OUTCOMES Advances in TLT and PGT have revealed an astonishing plasticity and self-correction ability of the human preimplantation embryo in vitro. At fertilisation, an abnormal number of pronuclei do not always result in the formation of an aneuploid blastocyst. Animal studies and preliminary human observations indicate that combining of parental genomes may occur at the early cleavage stage, if not at fertilisation. Multinucleation occurs with much higher prevalence than previously thought and may be corrected at later cleavage stages. Irregular cleavage (multichotomous, direct, rapid and reverse cleavages) can generate chromosome segregation abnormalities that often lead to developmental arrest, but that sporadically may be confined to cells excluded from the blastocyst, and may sometimes result in viable pregnancy. Mitotic errors can generate mosaic blastocysts, but alternatively normal embryos may form from selective death or clonal depletion of aneuploid cells. WIDER IMPLICATIONS Deviations from developmental dogmas and the increasing evidence of plasticity of the human embryo challenge current embryological notions and suggest the need to write new rules governing cell cycle, cell determination and chromosome segregation during preimplantation development.
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Affiliation(s)
| | | | | | | | - Simon Fishel
- CARE Fertility Group, Northampton, UK.,School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University, Liverpool, UK
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Shebl O, Haslinger C, Kresic S, Enengl S, Reiter E, Oppelt P, Ebner T. The hare and the tortoise: extreme mitotic rates and how these affect live birth. Reprod Biomed Online 2020; 42:332-339. [PMID: 33250413 DOI: 10.1016/j.rbmo.2020.10.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Revised: 09/29/2020] [Accepted: 10/14/2020] [Indexed: 12/17/2022]
Abstract
RESEARCH QUESTION Is live birth of patients with excessive slow (no blastocyst on day 5) and fast mitotic rate (full blastocyst development on day 4) comparable to a matched control standard (blastocyst formation on day 5)? DESIGN In this retrospective matched (age and anti-Müllerian hormone [AMH]) case-control study rates of fertilization, blastulation, implantation, clinical pregnancy and live birth were compared in couples with male factor indication, prolonged embryo culture and fresh single morula and blastocyst transfer. RESULTS The rates of implantation, clinical pregnancy and live birth in the slow-developing group were significantly (P < 0.001) lower (17.6%, 13.7%, and 11.8%, respectively) compared with the fast (58.5%, 52.5%, 47.5%) and normal growing counterparts (51.5%, 42.6%, 39.6%). No differences in neonatal outcome could be observed between the three groups. Sex ratio in the fast-growing group was not different from the other cohorts. CONCLUSIONS Extremely slow development, as assessed by the absence of blastulation on day 5, is a negative predictor of pregnancy and live birth. In contrast, the fear that extremely fast-growing embryos may represent an aneuploid cohort of embryos is unsubstantiated. Day-4 full blastocysts can preferentially be considered for transfer.
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Affiliation(s)
- Omar Shebl
- Kepler University Hospital, Department of Gynecology, Obstetrics, and Gynecological Endocrinology, Altenberger Str. 69, Linz Upper Austria, Austria
| | - Christine Haslinger
- Kepler University Hospital, Department of Gynecology, Obstetrics, and Gynecological Endocrinology, Altenberger Str. 69, Linz Upper Austria, Austria
| | - Sanja Kresic
- Kepler University Hospital, Department of Gynecology, Obstetrics, and Gynecological Endocrinology, Altenberger Str. 69, Linz Upper Austria, Austria
| | - Sabine Enengl
- Kepler University Hospital, Department of Gynecology, Obstetrics, and Gynecological Endocrinology, Altenberger Str. 69, Linz Upper Austria, Austria
| | - Elisabeth Reiter
- Kepler University Hospital, Department of Gynecology, Obstetrics, and Gynecological Endocrinology, Altenberger Str. 69, Linz Upper Austria, Austria
| | - Peter Oppelt
- Kepler University Hospital, Department of Gynecology, Obstetrics, and Gynecological Endocrinology, Altenberger Str. 69, Linz Upper Austria, Austria
| | - Thomas Ebner
- Kepler University Hospital, Department of Gynecology, Obstetrics, and Gynecological Endocrinology, Altenberger Str. 69, Linz Upper Austria, Austria.
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Bori L, Paya E, Alegre L, Viloria TA, Remohi JA, Naranjo V, Meseguer M. Novel and conventional embryo parameters as input data for artificial neural networks: an artificial intelligence model applied for prediction of the implantation potential. Fertil Steril 2020; 114:1232-1241. [PMID: 32917380 DOI: 10.1016/j.fertnstert.2020.08.023] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 08/14/2020] [Accepted: 08/19/2020] [Indexed: 12/30/2022]
Abstract
OBJECTIVE To describe novel embryo features capable of predicting implantation potential as input data for an artificial neural network (ANN) model. DESIGN Retrospective cohort study. SETTING University-affiliated private IVF center. PATIENT(S) This study included 637 patients from the oocyte donation program who underwent single-blastocyst transfer during two consecutive years. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) The research was divided into two phases. Phase 1 consisted of the description and analysis of the following embryo features in implanted and nonimplanted embryos: distance and speed of pronuclear migration, blastocyst expanded diameter, inner cell mass area, and trophectoderm cell cycle length. Phase 2 consisted of the development of an ANN algorithm for implantation prediction. Results were obtained for four models fed with different input data. The predictive power was measured with the use of the area under the receiver operating characteristic curve (AUC). RESULT(S) Out of the five novel described parameters, blastocyst expanded diameter and trophectoderm cell cycle length had statistically different values in implanted and nonimplanted embryos. After the ANN models were trained and validated using fivefold cross-validation, they were capable of predicting implantation on testing data with AUCs of 0.64 for ANN1 (conventional morphokinetics), 0.73 for ANN2 (novel morphodynamics), 0.77 for ANN3 (conventional morphokinetics + novel morphodynamics), and 0.68 for ANN4 (discriminatory variables from statistical test). CONCLUSION(S) The novel proposed embryo features affect the implantation potential, and their combination with conventional morphokinetic parameters is effective as input data for a predictive model based on artificial intelligence.
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Affiliation(s)
| | - Elena Paya
- IVI-RMA Valencia, Valencia, Spain; Instituto de Investigación e Innovación en Bioingeniería, Universitat Politécnica de Valencia, Valencia, Spain
| | | | | | | | - Valery Naranjo
- Instituto de Investigación e Innovación en Bioingeniería, Universitat Politécnica de Valencia, Valencia, Spain
| | - Marcos Meseguer
- IVI-RMA Valencia, Valencia, Spain; Health Research Institute la Fe, Valencia, Spain
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17
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Gallego RD, Remohí J, Meseguer M. Time-lapse imaging: the state of the art†. Biol Reprod 2020; 101:1146-1154. [PMID: 30810735 DOI: 10.1093/biolre/ioz035] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 02/12/2019] [Accepted: 02/26/2019] [Indexed: 12/12/2022] Open
Abstract
The introduction of time-lapse imaging to clinical in vitro fertilization practice enabled the undisturbed monitoring of embryos throughout the entire culture period. Initially, the main objective was to achieve a better embryo development. However, this technology also provided an insight into the novel concept of morphokinetics, parameters regarding embryo cell dynamics. The vast amount of data obtained defined the optimal ranges in the cell-cycle lengths at different stages of embryo development. This added valuable information to embryo assessment prior to transfer. Kinetic markers became part of embryo evaluation strategies with the potential to increase the chances of clinical success. However, none of them has been established as an international standard. The present work aims at describing new approaches into time-lapse: progress to date, challenges, and possible future directions.
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18
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Lammers J, Reignier A, Splingart C, Moradkhani K, Barrière P, Fréour T. Morphokinetic parameters in chromosomal translocation carriers undergoing preimplantation genetic testing. Reprod Biomed Online 2019; 38:177-183. [DOI: 10.1016/j.rbmo.2018.11.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Revised: 11/08/2018] [Accepted: 11/09/2018] [Indexed: 10/27/2022]
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19
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Seikkula J, Oksjoki S, Hurme S, Mankonen H, Polo-Kantola P, Jokimaa V. Pregnancy and perinatal outcomes after transfer of binucleated or multinucleated frozen–thawed embryos: a case–control study. Reprod Biomed Online 2018. [DOI: 10.1016/j.rbmo.2018.02.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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20
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21
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Time-lapse imaging: clearly useful to both laboratory personnel and patient outcomes versus just because we can doesn't mean we should. Fertil Steril 2018; 109:584-591. [DOI: 10.1016/j.fertnstert.2018.01.042] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 01/29/2018] [Indexed: 11/20/2022]
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22
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Mangoli E, Khalili MA, Talebi AR, Ghasemi‐Esmailabad S, Hosseini A. Is there any correlation between sperm parameters and chromatin quality with embryo morphokinetics in patients with male infertility? Andrologia 2018. [DOI: 10.1111/and.12997] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Affiliation(s)
- E. Mangoli
- Department of Reproductive Biology, Research and Clinical Center for Infertility Shahid Sadoughi University of Medical Sciences Yazd Iran
| | - M. A. Khalili
- Department of Reproductive Biology, Research and Clinical Center for Infertility Shahid Sadoughi University of Medical Sciences Yazd Iran
| | - A. R. Talebi
- Department of Reproductive Biology, Research and Clinical Center for Infertility Shahid Sadoughi University of Medical Sciences Yazd Iran
| | - S. Ghasemi‐Esmailabad
- Department of Reproductive Biology, Research and Clinical Center for Infertility Shahid Sadoughi University of Medical Sciences Yazd Iran
| | - A. Hosseini
- Department of Reproductive Biology, Research and Clinical Center for Infertility Shahid Sadoughi University of Medical Sciences Yazd Iran
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23
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Daughtry BL, Chavez SL. Time-Lapse Imaging for the Detection of Chromosomal Abnormalities in Primate Preimplantation Embryos. Methods Mol Biol 2018; 1769:293-317. [PMID: 29564832 DOI: 10.1007/978-1-4939-7780-2_19] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The use of time-lapse microscopic imaging has proven to be a powerful tool for the study of mitotic divisions and other cellular processes across diverse species and cell types. Although time-lapse monitoring (TLM) of human preimplantation development was first introduced to the in vitro fertilization (IVF) community several decades ago, it was not until relatively recently that TLM systems were commercialized for clinical embryology purposes. Traditionally, human IVF embryos are assessed by successful progression and morphology under a stereomicroscope at distinct time points prior to selection for transfer. Due to the high frequency of aneuploidy, embryos may also be biopsied at the cleavage or blastocyst stage for preimplantation genetic screening (PGS) of whole and/or partial chromosomal abnormalities. However, embryo biopsy is invasive and can hinder subsequent development, and there are additional concerns over chromosomal mosaicism and resolution with PGS. Moreover, embryos are typically outside of the incubator in suboptimal culture conditions for extended periods of time during these procedures. With TLM systems, embryos remain in the stable microenvironment of an incubator and are simultaneously imaged for noninvasive embryo evaluation using a fraction of the light exposure as compared to a stereomicroscope. Each image is then compiled into a time-lapse movie, the information from which can be extrapolated to correlate morphological, spatial, and temporal parameters with embryo quality and copy number status. Here, we describe the various TLM systems available for clinical and/or research use in detail and provide step-by-step instructions on how the measurement of specific timing intervals and certain morphological criteria can be implemented into IVF protocols to enhance embryo assessment and avoid the selection of aneuploid embryos. We also discuss the biological significance of processes unique to mitotically dividing embryos and the likelihood that complex chromosomal events such as chromothripsis occur during preimplantation development in humans and other mammals, particularly nonhuman primates.
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Affiliation(s)
- Brittany L Daughtry
- Department of Cell, Developmental and Cancer Biology, Oregon Health and Science University School of Medicine, Portland, OR, USA.,Division of Reproductive and Developmental Sciences, Oregon National Primate Research Center, Beaverton, OR, USA
| | - Shawn L Chavez
- Division of Reproductive and Developmental Sciences, Oregon National Primate Research Center, Beaverton, OR, USA. .,Department and Physiology and Pharmacology, Oregon Health and Science University School of Medicine, Portland, OR, USA. .,Department of Obstetrics and Gynecology, Oregon Health and Science University School of Medicine, Portland, OR, USA.
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Zaninovic N, Irani M, Meseguer M. Assessment of embryo morphology and developmental dynamics by time-lapse microscopy: is there a relation to implantation and ploidy? Fertil Steril 2017; 108:722-729. [DOI: 10.1016/j.fertnstert.2017.10.002] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Accepted: 10/02/2017] [Indexed: 12/27/2022]
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25
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Direct Unequal Cleavages: Embryo Developmental Competence, Genetic Constitution and Clinical Outcome. PLoS One 2016; 11:e0166398. [PMID: 27907016 PMCID: PMC5132229 DOI: 10.1371/journal.pone.0166398] [Citation(s) in RCA: 84] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Accepted: 10/27/2016] [Indexed: 11/19/2022] Open
Abstract
Objective To investigate the prevalence, developmental potential, chromosomal constitution and clinical outcome of embryos with direct unequal cleavages (DUC). Design A retrospective observational study. Setting Academic Institution. Participant 21,261 embryos from 3,155 cycles cultured in EmbryoScope®. Results The total incidence of DUCs per embryo occupying the first three cleavages were 26.1%. Depending of the cell stage, DUC rate was 9.8% at first cleavage (DUC-1), 9.1% at second cleavage (DUC-2), and 3.7% at third cleavage (DUC-3) with 3.6% of embryos exhibiting multiple DUCs (DUC-Plus). The occurrence of DUCs was not correlated with female gamete age or source. The incidence of DUC-1 was significantly higher in embryos fertilized by epididymal and testicular sperm (13.6% and 11.4%, respectively) compared to ejaculated sperm (9.1%, all p<0.05). The total incidences of DUCs were strongly correlated with the onset of blastomere multinucleation (MNB) during the first three divisions. In MNB embryos, DUCs incidence are two to three times more likely to develop when compared to non-MNB embryos (OR = 3.11, 95% CI [2.64, 3.67] at 1-cell stage, OR = 2.64, 95% CI [2.39, 2.91] at 2-cell stage and OR = 2.51, 95% CI [1.84, 3.43] at 4-cell stage). The blastocyst formation rates gradually decreased from 61.0% in non-DUC to 40.2% in DUC-3, 18.8% in DUC-2, 8.2% in DUC-1 and 5.6% in multiple DUC embryos (DUC-Plus). The known implantation rates (FH) for day 3 (D3) transfers were 12.42% (n = 3172) in Non-DUC embryos, 6.3% (n = 127) in DUC-3, and 2.7% (n = 260) in DUC-2 embryos. No live births resulted from either DUC-1 (n = 225) or DUC-Plus (n = 100) embryo transfers. For blastocyst transfers, lower implantation rates (33.3%) but similar live birth (LB) rates (40%) were observed if DUC blastocysts were transferred. Comparatively rates in Non-DUC blastocyst were 45.2% and 34.8%, respectively. The euploid rate gradually increased from DUC-1, -2, -3 to Non-DUC (13.3%, 19.5%, 33.3%, 45.6%, p<0.001) for D3 biopsied embryos. Interestingly, the trend of decreased euploidy disappeared in DUC D5/6 biopsied embryos and similar rates were exemplified in DUC (D5 56.3%, D6 35.6%) vs. non-DUC (D5 51.4%, D6 33.8%) embryos. Conclusion Blastocyst formation, implantation potential and euploid rate were significantly reduced in DUC embryos. DUC embryos should be deselected for D3 transfers, but should be culture to blastocyst stage for possible ET.
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Desch L, Bruno C, Luu M, Barberet J, Choux C, Lamotte M, Schmutz E, Sagot P, Fauque P. Embryo multinucleation at the two-cell stage is an independent predictor of intracytoplasmic sperm injection outcomes. Fertil Steril 2016; 107:97-103.e4. [PMID: 28228320 DOI: 10.1016/j.fertnstert.2016.09.022] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Revised: 08/31/2016] [Accepted: 09/13/2016] [Indexed: 01/05/2023]
Abstract
OBJECTIVE To determine the prognostic impact of the nuclear status at the two-cell stage on intracytoplasmic sperm injection (ICSI) outcomes. DESIGN Retrospective study. SETTING Hospital. PATIENT(S) Only ICSI cycles with time-lapse monitoring of transferred embryos with known implantation/delivery data from November 2012 to December 2014 were included. A total of 2,449 embryos were assessed for multinucleation rates at the two- and four-cell stage, and 608 transferred embryos were studied for ICSI outcomes. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Implantation rate (IR) and live birth rate (LBR) according to the number of multinucleated blastomeres at the two-cell stage: none (Without-MNB2cell), one (MNB1/2cell), and two (MNB2/2cell); morphokinetics of MNB2cell embryos. RESULT(S) Embryos with MNB1/2cell led to lower IR (27.7%) and LBR (22.7%) than embryos Without-MNB2cell (33.4% and 29.8%, respectively). The MNB2/2cell embryos led to significantly lower IR (18.3%) and LBR (13.4%) than embryos Without-MNB2cell. This difference remained significant in multivariate analysis for implantation (odds ratio 0.57; 95% confidence interval 0.34-0.94) and birth (odds ratio 0.46; 95% confidence interval 0.26-0.80), independently of the other significant parameters (women's age, time of two-cell formation, and multinucleation at the four-cell stage). Among implanted MNB2cell, if cleavage into four cells occurred later than 37 hours after insemination, embryos were significantly more likely to lead to birth. CONCLUSION(S) The presence of multinucleation at the two-cell stage and more specifically in both blastomeres had a significant negative impact on birth potential. Thus, embryo multinucleation at the two-cell stage should be used as an additional noninvasive criterion for embryo selection.
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Affiliation(s)
- Laurent Desch
- Laboratoire de Biologie de la Reproduction, Hôpital François Mitterrand, Université de Bourgogne, Dijon, France
| | - Céline Bruno
- Laboratoire de Biologie de la Reproduction, Hôpital François Mitterrand, Université de Bourgogne, Dijon, France
| | - Maxime Luu
- Centre d'Investigations Cliniques- Plurithématique Institut National de la Santé et de la Recherche Médicale 1432, Hôpital François Mitterrand, Université de Bourgogne, Dijon, France
| | - Julie Barberet
- Laboratoire de Biologie de la Reproduction, Hôpital François Mitterrand, Université de Bourgogne, Dijon, France
| | - Cécile Choux
- Service de Gynécologie-Obstétrique, Hôpital François Mitterrand, Université de Bourgogne, Dijon, France
| | - Marjorie Lamotte
- Service de Gynécologie-Obstétrique, Hôpital François Mitterrand, Université de Bourgogne, Dijon, France
| | - Emeline Schmutz
- Service de Gynécologie-Obstétrique, Hôpital François Mitterrand, Université de Bourgogne, Dijon, France
| | - Paul Sagot
- Service de Gynécologie-Obstétrique, Hôpital François Mitterrand, Université de Bourgogne, Dijon, France
| | - Patricia Fauque
- Laboratoire de Biologie de la Reproduction, Hôpital François Mitterrand, Université de Bourgogne, Dijon, France.
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Petersen BM, Boel M, Montag M, Gardner DK. Development of a generally applicable morphokinetic algorithm capable of predicting the implantation potential of embryos transferred on Day 3. Hum Reprod 2016; 31:2231-44. [PMID: 27609980 PMCID: PMC5027927 DOI: 10.1093/humrep/dew188] [Citation(s) in RCA: 149] [Impact Index Per Article: 18.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Accepted: 06/29/2016] [Indexed: 12/19/2022] Open
Abstract
STUDY QUESTION Can a generally applicable morphokinetic algorithm suitable for Day 3 transfers of time-lapse monitored embryos originating from different culture conditions and fertilization methods be developed for the purpose of supporting the embryologist's decision on which embryo to transfer back to the patient in assisted reproduction? SUMMARY ANSWER The algorithm presented here can be used independently of culture conditions and fertilization method and provides predictive power not surpassed by other published algorithms for ranking embryos according to their blastocyst formation potential. WHAT IS KNOWN ALREADY Generally applicable algorithms have so far been developed only for predicting blastocyst formation. A number of clinics have reported validated implantation prediction algorithms, which have been developed based on clinic-specific culture conditions and clinical environment. However, a generally applicable embryo evaluation algorithm based on actual implantation outcome has not yet been reported. STUDY DESIGN, SIZE, DURATION Retrospective evaluation of data extracted from a database of known implantation data (KID) originating from 3275 embryos transferred on Day 3 conducted in 24 clinics between 2009 and 2014. The data represented different culture conditions (reduced and ambient oxygen with various culture medium strategies) and fertilization methods (IVF, ICSI). The capability to predict blastocyst formation was evaluated on an independent set of morphokinetic data from 11 218 embryos which had been cultured to Day 5. PARTICIPANTS/MATERIALS, SETTING, METHODS The algorithm was developed by applying automated recursive partitioning to a large number of annotation types and derived equations, progressing to a five-fold cross-validation test of the complete data set and a validation test of different incubation conditions and fertilization methods. The results were expressed as receiver operating characteristics curves using the area under the curve (AUC) to establish the predictive strength of the algorithm. MAIN RESULTS AND THE ROLE OF CHANCE By applying the here developed algorithm (KIDScore), which was based on six annotations (the number of pronuclei equals 2 at the 1-cell stage, time from insemination to pronuclei fading at the 1-cell stage, time from insemination to the 2-cell stage, time from insemination to the 3-cell stage, time from insemination to the 5-cell stage and time from insemination to the 8-cell stage) and ranking the embryos in five groups, the implantation potential of the embryos was predicted with an AUC of 0.650. On Day 3 the KIDScore algorithm was capable of predicting blastocyst development with an AUC of 0.745 and blastocyst quality with an AUC of 0.679. In a comparison of blastocyst prediction including six other published algorithms and KIDScore, only KIDScore and one more algorithm surpassed an algorithm constructed on conventional Alpha/ESHRE consensus timings in terms of predictive power. LIMITATIONS, REASONS FOR CAUTION Some morphological assessments were not available and consequently three of the algorithms in the comparison were not used in full and may therefore have been put at a disadvantage. Algorithms based on implantation data from Day 3 embryo transfers require adjustments to be capable of predicting the implantation potential of Day 5 embryo transfers. The current study is restricted by its retrospective nature and absence of live birth information. Prospective Randomized Controlled Trials should be used in future studies to establish the value of time-lapse technology and morphokinetic evaluation. WIDER IMPLICATIONS OF THE FINDINGS Algorithms applicable to different culture conditions can be developed if based on large data sets of heterogeneous origin. STUDY FUNDING/COMPETING INTEREST(S) This study was funded by Vitrolife A/S, Denmark and Vitrolife AB, Sweden. B.M.P.’s company BMP Analytics is performing consultancy for Vitrolife A/S. M.B. is employed at Vitrolife A/S. M.M.’s company ilabcomm GmbH received honorarium for consultancy from Vitrolife AB. D.K.G. received research support from Vitrolife AB.
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Affiliation(s)
- Bjørn Molt Petersen
- Bjørn Molt Petersen BMP Analytics, Vilhelm Becks Vej 20, 8260 Viby J, Denmark
| | - Mikkel Boel
- Vitrolife A/S, Jens Juuls Vej 20, 8260 Viby J, Denmark
| | - Markus Montag
- ilabcomm GmbH, Eisenachstr. 34, 53757 St. Augustin, Germany
| | - David K Gardner
- School of BioSciences, University of Melbourne, Parkville, Melbourne, Victoria 3010, Australia
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