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Huang W, Li X, Yang H, Huang H. The impact of maternal age on aneuploidy in oocytes: Reproductive consequences, molecular mechanisms, and future directions. Ageing Res Rev 2024; 97:102292. [PMID: 38582380 DOI: 10.1016/j.arr.2024.102292] [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: 11/26/2023] [Revised: 03/12/2024] [Accepted: 04/01/2024] [Indexed: 04/08/2024]
Abstract
Age-related aneuploidy in human oocytes is a major factor contributing to decreased fertility and adverse reproductive outcomes. As females age, their oocytes are more prone to meiotic chromosome segregation errors, leading primarily to aneuploidy. Elevated aneuploidy rates have also been observed in oocytes from very young, prepubertal conceptions. A key barrier to developing effective treatments for age-related oocyte aneuploidy is our incomplete understanding of the molecular mechanisms involved. The challenge is becoming increasingly critical as more people choose to delay childbearing, a trend that has significant societal implications. In this review, we summarize current knowledge regarding the process of oocyte meiosis and folliculogenesis, highlighting the relationship between age and chromosomal aberrations in oocytes and embryos, and integrate proposed mechanisms of age-related meiotic disturbances across structural, protein, and genomic levels. Our goal is to spur new research directions and therapeutic avenues.
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Affiliation(s)
- Weiwei Huang
- Obstetrics and Gynecology Hospital, Institute of Reproduction and Development, Fudan University, Shanghai, China; Shanghai Key Laboratory of Reproduction and Development, Shanghai, China; Research Units of Embryo Original Diseases, Chinese Academy of Medical Sciences (No. 2019RU056), Shanghai, China
| | - Xinyuan Li
- Obstetrics and Gynecology Hospital, Institute of Reproduction and Development, Fudan University, Shanghai, China; Shanghai Key Laboratory of Reproduction and Development, Shanghai, China; Research Units of Embryo Original Diseases, Chinese Academy of Medical Sciences (No. 2019RU056), Shanghai, China
| | - Hongbo Yang
- Obstetrics and Gynecology Hospital, Institute of Reproduction and Development, Fudan University, Shanghai, China; Shanghai Key Laboratory of Reproduction and Development, Shanghai, China; Research Units of Embryo Original Diseases, Chinese Academy of Medical Sciences (No. 2019RU056), Shanghai, China.
| | - Hefeng Huang
- Obstetrics and Gynecology Hospital, Institute of Reproduction and Development, Fudan University, Shanghai, China; Shanghai Key Laboratory of Reproduction and Development, Shanghai, China; Research Units of Embryo Original Diseases, Chinese Academy of Medical Sciences (No. 2019RU056), Shanghai, China; Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China; Department of Obstetrics and Gynecology, International Institutes of Medicine, the Fourth Affiliated Hospital of Zhejiang University School of Medicine, Yiwu, China; Key Laboratory of Reproductive Genetics (Ministry of Education), Department of Reproductive Endocrinology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China.
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2
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Yazdani A, Halvaei I, Boniface C, Esfandiari N. Effect of cytoplasmic fragmentation on embryo development, quality, and pregnancy outcome: a systematic review of the literature. Reprod Biol Endocrinol 2024; 22:55. [PMID: 38745305 PMCID: PMC11092204 DOI: 10.1186/s12958-024-01217-7] [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: 11/20/2023] [Accepted: 04/01/2024] [Indexed: 05/16/2024] Open
Abstract
The role of cytoplasmic fragmentation in human embryo development and reproductive potential is widely recognized, albeit without standard definition nor agreed upon implication. While fragmentation is best understood to be a natural process across species, the origin of fragmentation remains incompletely understood and likely multifactorial. Several factors including embryo culture condition, gamete quality, aneuploidy, and abnormal cytokinesis seem to have important role in the etiology of cytoplasmic fragmentation. Fragmentation reduces the volume of cytoplasm and depletes embryo of essential organelles and regulatory proteins, compromising the developmental potential of the embryo. While it has been shown that degree of fragmentation and embryo implantation potential are inversely proportional, the degree, pattern, and distribution of fragmentation as it relates to pregnancy outcome is debated in the literature. This review highlights some of the challenges in analysis of fragmentation, while revealing trends in our evolving knowledge of how fragmentation may relate to functional development of the human embryos, implantation, and pregnancy outcome.
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Affiliation(s)
- Ariella Yazdani
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Vermont Medical Center, The Robert Larner College of Medicine at the University of Vermont, Burlington, VT, 05405, USA
- Present address: Obstetrics and Gynecology Institute, Cleveland Clinic Foundation, Cleveland, OH, 44195, USA
| | - Iman Halvaei
- Department of Anatomical Sciences, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Catherine Boniface
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Vermont Medical Center, The Robert Larner College of Medicine at the University of Vermont, Burlington, VT, 05405, USA
| | - Navid Esfandiari
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Vermont Medical Center, The Robert Larner College of Medicine at the University of Vermont, Burlington, VT, 05405, USA.
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology and Reproductive Sciences, University of Vermont, 111 Colchester Avenue, Burlington, Vermont, 05401, USA.
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Rahmani S, Niusha M, Kohan L, Sadeghi L, Nouri M, Nejabati H. Embryo quality and chromosomal abnormality in embryos from couples undergoing assisted reproductive technology using preimplantation genetic screening. ASIAN PACIFIC JOURNAL OF REPRODUCTION 2023. [DOI: 10.4103/2305-0500.365228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
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4
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Lebovitz O, Michaeli M, Aslih N, Poltov D, Estrada D, Atzmon Y, Shalom-Paz E. Embryonic Development in Relation to Maternal Age and Conception Probability. Reprod Sci 2021; 28:2292-2300. [PMID: 33591563 DOI: 10.1007/s43032-021-00488-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 02/02/2021] [Indexed: 10/22/2022]
Abstract
Data regarding association between early embryo development and maternal age is limited and inconclusive. This study has two aims: to evaluate differences in the cleavage stage of embryos in young versus advanced maternal age (AMA) women. To compare the early embryonic development of embryos that result in pregnancy versus no pregnancy. A retrospective study of early embryonic development which was recorded and analyzed using time-lapse imaging was conducted. The kinetic markers of time to pronuclei fading (tPNf) and appearance of two to eight cells (t2-t8) were assessed. For embryos cultured to blastocyst, times to morula (tM), start of blastulation (tSB) cavitated, and expanded blastocyst (tB, tEB) were also recorded. A total of 2021 oocytes from 364 intracytoplasmic sperm injection (ICSI) cycles were evaluated, of which 1223 (60.5%) were derived from young patients and 798 (39.5%) from those of AMA. The mean time points to t3, t4, t5, t6, tSB, tB, and tEB were significantly shorter for embryos derived from younger women, as compared to older women (p < 0.05). Overall, women who conceived presented a faster embryonic development, for both age groups. The mean time points of t2 and t8 were significantly shorter in patients who conceived versus not conceived (p < 0.05). We concluded that older women's age is associated with delayed embryonic development. Embryos that yielded pregnancy cleaved faster compared to those which did not, in both age groups. Thus, when considering which embryo to transfer to women of AMA, selecting the faster-developing embryos may improve the chances of conception.
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Affiliation(s)
- Oshrit Lebovitz
- IVF and Infertility Unit, Hillel Yaffe Medical Center, Hadera, Israel. .,Ruth and Bruce Rappaport School of Medicine, Technion, Haifa, Israel. .,Department of Obstetrics and Gynecology, Sheba Medical Center, Ramat-Gan, Israel. .,Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Mediea Michaeli
- IVF and Infertility Unit, Hillel Yaffe Medical Center, Hadera, Israel
| | - Nardin Aslih
- IVF and Infertility Unit, Hillel Yaffe Medical Center, Hadera, Israel.,Ruth and Bruce Rappaport School of Medicine, Technion, Haifa, Israel
| | - Diana Poltov
- IVF and Infertility Unit, Hillel Yaffe Medical Center, Hadera, Israel
| | - Daniela Estrada
- IVF and Infertility Unit, Hillel Yaffe Medical Center, Hadera, Israel.,Ruth and Bruce Rappaport School of Medicine, Technion, Haifa, Israel
| | - Yuval Atzmon
- IVF and Infertility Unit, Hillel Yaffe Medical Center, Hadera, Israel.,Ruth and Bruce Rappaport School of Medicine, Technion, Haifa, Israel
| | - Einat Shalom-Paz
- IVF and Infertility Unit, Hillel Yaffe Medical Center, Hadera, Israel.,Ruth and Bruce Rappaport School of Medicine, Technion, Haifa, Israel
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Khalife D, Abu-Musa A, Khalil A, Ghazeeri G. Towards the selection of embryos with the greatest implantation potential. J OBSTET GYNAECOL 2021; 41:1010-1015. [PMID: 33432866 DOI: 10.1080/01443615.2020.1835842] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Choosing the most suitable embryo remains challenging as the standard approach to select top-quality embryos for transfer rely on static morphological assessment. It is completed after fertilisation, on days 3 and 5 post oocyte retrieval and evaluates the size and number of blastomeres, presence of nucleation and percentage of fragmentation for cleavage stage embryos. Because of the limited number of observations during the morphological assessment, morphokinetic development of embryos has been implemented. It shows a broader image of embryo behaviour with precise evaluation of the timing of events. Yet, studies are inconsistent and debatable in predicting the parameters to identify chromosomal abnormalities. Pre-implantation genetic testing detects dysmorphic embryos and correlate their developmental potential to the assessed morphology. However, the clinical utility of PGT-aneuploidy remains controversial. The future relies on newly described scoring systems such as artificial intelligence and non-invasive PGT, yet their application and actual success rate still lacks supportive evidence.
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Affiliation(s)
- Dalia Khalife
- Department of Obstetrics and Gynecology, Jumeirah American Clinic, Dubai, UAE
| | - Antoine Abu-Musa
- Reproductive Endocrinology and Infertility Unit, Department of Obstetrics and Gynecology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Ali Khalil
- Division of Gynecologic Oncology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Ghina Ghazeeri
- Reproductive Endocrinology and Infertility Unit, Department of Obstetrics and Gynecology, American University of Beirut Medical Center, Beirut, Lebanon
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Çakar E, Tasan HA, Kumru P, Cogendez E, Usal NT, Kutlu HT, Özkaya E, Eser SK. Combined use of oestradiol and progesterone to support luteal phase in antagonist intracytoplasmic sperm injection cycles of normoresponder women: a case-control study. J OBSTET GYNAECOL 2019; 40:264-269. [PMID: 31455122 DOI: 10.1080/01443615.2019.1631765] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
We evaluated the effect of combined use of oral oestrogen (E2) and vaginal progesterone (P) to support luteal phase in antagonist intracytoplasmic sperm injection (ICSI) cycles. We analysed data from 176 patients who underwent ICSI cycles with antagonist protocol. P 90 mg vaginal gel once a day and micronised E2 of 4 mg/day, were started from the day of oocyte pick up and continued to the 12th day of embryo transfer. Group 1 (n = 79) patients received E2 + P for luteal phase support. In group 2 (n = 97) patients, only P 90 mg vaginal gel was used for luteal phase support. There were no significant differences between group 1 and group 2 patients in terms of clinical pregnancy rates (PRs) (26.58% vs. 20.62%, p = .352), early pregnancy loss rates (6.33% vs. 6.19%, p = .969), incidence of luteal vaginal bleeding (8.86% vs. 8.25%, p = .885) and implantation rates (22.8% vs. 16.9%, p = .298). In conclusion, our study showed no beneficial effect of addition of E2 to luteal phase support on clinical PR in antagonist IVF cycles.Impact statementWhat is already known on this subject? Luteal phase deficiency is defined as a disruption in progesterone and oestrogen production after ovulation. It is clear that, luteal phase supplementation to improve the outcomes in in vitro fertilisation (IVF) cycles is mandatory. As an iatrogenic complication of assisted reproductive technique, decreased luteal oestrogen and progesterone levels lead to decreased pregnancy rates (PRs) and implantation rates.What the results of this study add? In this study, we aimed to present the role of luteal phase oestrogen administration in GnRH antagonist cycles. A total of 176 cases received progesterone vaginal gel form for luteal phase support. Study group received 4 mg oral oestradiol hemihydrate in addition to progesterone. Compared to previous studies, our study consisted of larger number of patients and we used oestradiol through oral route. We found out that luteal oestradiol support did not improve the clinical PR.What the implications are of these findings for clinical practice and/or further research? Our study showed no beneficial effect of addition of oestradiol to luteal phase support on clinical PR in antagonist IVF cycles.
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Affiliation(s)
- Erbil Çakar
- Zeynep Kamil Women and Children's Diseases Training and Research Hospital, IVF Center, Istanbul, Turkey
| | - Habibe Ayvaci Tasan
- Zeynep Kamil Women and Children's Diseases Training and Research Hospital, IVF Center, Istanbul, Turkey
| | - Pınar Kumru
- Zeynep Kamil Women and Children's Diseases Training and Research Hospital, IVF Center, Istanbul, Turkey
| | - Ebru Cogendez
- Zeynep Kamil Women and Children's Diseases Training and Research Hospital, IVF Center, Istanbul, Turkey
| | - Nazan Tarhan Usal
- Zeynep Kamil Women and Children's Diseases Training and Research Hospital, IVF Center, Istanbul, Turkey
| | - Hüseyin Tayfun Kutlu
- Zeynep Kamil Women and Children's Diseases Training and Research Hospital, IVF Center, Istanbul, Turkey
| | - Enis Özkaya
- Zeynep Kamil Women and Children's Diseases Training and Research Hospital, IVF Center, Istanbul, Turkey
| | - Semra Kayatas Eser
- Zeynep Kamil Women and Children's Diseases Training and Research Hospital, IVF Center, Istanbul, Turkey
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Cuervo-Arango J, Claes AN, Stout TA. A retrospective comparison of the efficiency of different assisted reproductive techniques in the horse, emphasizing the impact of maternal age. Theriogenology 2019; 132:36-44. [PMID: 30986613 DOI: 10.1016/j.theriogenology.2019.04.010] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2019] [Revised: 03/20/2019] [Accepted: 04/07/2019] [Indexed: 01/17/2023]
Abstract
Advancing maternal age is known to negatively affect fertility in the horse. This age-related decrease in fertility has been linked primarily to reduced oocyte quality rather than to impaired uterine function. In the past decade, the use of ovum pick-up (OPU) and ICSI to produce foals has rapidly gaining popularity amongst sport horse breeders. However, it is not yet known how maternal age influences the efficiency of a commercial OPU-ICSI program and whether the age effect is similar to that observed for other ART in the horse. To answer this question, reproductive records of 289 mares bred by natural mating (NM), 328 mares bred by AI, 205 embryo donor mares (AI-EF-ET), and 473 mares submitted for OPU-ICSI and ET were analyzed retrospectively using a regression model to investigate the effects of maternal age and breeding technique on the likelihood of producing a viable pregnancy. The reproductive efficiency (quantified as the proportion of mares that yielded at least one Day 45 pregnancy) of the different breeding techniques NM, AI, AI-EF-ET and OPU-ICSI-ET was 63.3, 43.9, 45.8 and 37.4%, respectively (P < 0.05). However, the frequent production of multiple embryos per ICSI session (up to 10 embryos in one attempt), makes OPU-ICSI-ET as effective as AI-EF-ET when measured in terms of the mean number of Day 45 pregnant recipients per donor mare. Increasing maternal age was associated with a reduction (P < 0.05) in the reproductive efficiency of all breeding techniques (NM, AI, AI-EF-ET) except OPU-ICSI-ET (P > 0.05). In the OPU-ICSI-ET group, increasing maternal age was associated with a lower number of follicles aspirated and oocytes recovered per mare. Nevertheless, the percentage of blastocysts per injected oocyte, and post-ET likelihoods of pregnancy and pregnancy loss were not influenced by the age of the oocyte donor mare (P > 0.05).
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Affiliation(s)
- Juan Cuervo-Arango
- Department of Equine Sciences, Faculty of Veterinary Medicine, Utrecht University, the Netherlands.
| | - Anthony N Claes
- Department of Equine Sciences, Faculty of Veterinary Medicine, Utrecht University, the Netherlands
| | - Tom A Stout
- Department of Equine Sciences, Faculty of Veterinary Medicine, Utrecht University, the Netherlands
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Warshaviak M, Kalma Y, Carmon A, Samara N, Dviri M, Azem F, Ben-Yosef D. The Effect of Advanced Maternal Age on Embryo Morphokinetics. Front Endocrinol (Lausanne) 2019; 10:686. [PMID: 31708867 PMCID: PMC6823873 DOI: 10.3389/fendo.2019.00686] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Accepted: 09/20/2019] [Indexed: 01/04/2023] Open
Abstract
Purpose: To compare the morphokinetic parameters of pre-implantation development between embryos of women of advanced maternal age (AMA) and young women. Methods: Time-lapse microscopy was used to compare morphokinetic variables between 495 embryos of AMA women ≥ age 42 years and 653 embryos of young patients (<age 38 years) who underwent IVF in our unit. Developmental events annotated and analyzed include observed cell divisions in correlation to the timing of fertilization, synchrony of the second (s2) and third cell cycles (s3) and the duration to the second (cc2) and third cleavages (cc3). Results: No significant differences were observed in cleavage times between the embryos of AMA and the control embryos. Interestingly, the older embryos appear to be more prone to developmental arrest (a higher percentage of embryos of older women arrested at 4-7 cells resulting in less embryos reaching the 8-cell stage (66% vs. 72%, respectively), though this difference did not reach a significance at least during the first 3 days of development (p > 0.05). Conclusions: While early morphokinetic parameters do not reflect dynamics unique to embryos of older women, a tendency toward developmental arrest was observed, which would likely be even more pronounced at later stages of development.
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Affiliation(s)
- Miriam Warshaviak
- IVF Lab and Wolfe PGD-Stem Cell Lab, Fertility Institute, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Yael Kalma
- IVF Lab and Wolfe PGD-Stem Cell Lab, Fertility Institute, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Ariela Carmon
- IVF Lab and Wolfe PGD-Stem Cell Lab, Fertility Institute, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Nivin Samara
- IVF Lab and Wolfe PGD-Stem Cell Lab, Fertility Institute, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Michal Dviri
- IVF Lab and Wolfe PGD-Stem Cell Lab, Fertility Institute, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Foad Azem
- IVF Lab and Wolfe PGD-Stem Cell Lab, Fertility Institute, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Dalit Ben-Yosef
- IVF Lab and Wolfe PGD-Stem Cell Lab, Fertility Institute, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel
- Department of Cell Biology and Development, Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
- *Correspondence: Dalit Ben-Yosef
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Abstract
OBJECTIVE The hypothalamic gonadotropin-releasing hormone pulse generator, the pituitary gonadotropes, the ovaries, and the uterus play a crucial role in female fertility. A decline in reproductive performance represents a complex interplay of actions at all levels of the hypothalamic-pituitary-ovarian axis. Recently, in the field of female reproductive aging attention is drawn to the carbonyl stress theory. Advanced glycation end products (AGEs) contribute directly to protein damage, induce a chain of oxidative stress (OS) reactions, and increase inflammatory reactions. Here, we highlight some of the mechanisms underlying glycation damage in the ovary. METHODS Searches of electronic databases were performed. Articles relevant to possible role of OS, AGEs, and receptor for AGE (RAGE) in aging ovary were summarized in this interpretive literature review. RESULTS Follicular microenvironment undergoes an increase in OS with aging. Data support the role of OS in ovulatory dysfunction because AGEs are well-recognized mediators of increased OS. RAGE and AGE-modified proteins with activated nuclear factor-kappa B are expressed in human ovarian tissue. It was suggested that accumulation of AGEs products at the level of the ovarian follicle might trigger early ovarian aging or could be responsible for reduced glucose uptake by granulosa cells, potentially altering follicular growth. Moreover, impaired methylglyoxal detoxification causing relevant damage to the ovarian proteome might be one of the mechanisms underlying reproductive aging. CONCLUSIONS Further investigation of the role for the AGE-RAGE axis in the ovarian follicular environment is needed, and results could relate to assisted reproduction technology outcomes and new measures of ovarian reserve.
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Cimadomo D, Fabozzi G, Vaiarelli A, Ubaldi N, Ubaldi FM, Rienzi L. Impact of Maternal Age on Oocyte and Embryo Competence. Front Endocrinol (Lausanne) 2018; 9:327. [PMID: 30008696 PMCID: PMC6033961 DOI: 10.3389/fendo.2018.00327] [Citation(s) in RCA: 238] [Impact Index Per Article: 39.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Accepted: 05/31/2018] [Indexed: 12/29/2022] Open
Abstract
The overall success of human reproduction, either spontaneously or after IVF, is highly dependent upon maternal age. The main reasons for age-related infertility include reduced ovarian reserve and decreased oocyte/embryo competence due to aging insults, especially concerning an increased incidence of aneuploidies and possibly decreased mitochondrial activity. Age-related chromosomal abnormalities mainly arise because of meiotic impairments during oogenesis, following flawed chromosome segregation patterns such as non-disjunction, premature separation of sister chromatids, or the recent reverse segregation. In this review, we briefly discuss the main mechanisms putatively impaired by aging in the oocytes and the deriving embryos. We also report the main strategies proposed to improve the management of advanced maternal age women in IVF: fertility preservation through oocyte cryopreservation to prevent aging; optimization of the ovarian stimulation and enhancement of embryo selection to limit its effects; and oocyte donation to circumvent its consequences.
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Affiliation(s)
- Danilo Cimadomo
- Clinica Valle Giulia, G.en.e.r.a. Centers for Reproductive Medicine, Rome, Italy
- *Correspondence: Danilo Cimadomo,
| | - Gemma Fabozzi
- Clinica Valle Giulia, G.en.e.r.a. Centers for Reproductive Medicine, Rome, Italy
| | - Alberto Vaiarelli
- Clinica Valle Giulia, G.en.e.r.a. Centers for Reproductive Medicine, Rome, Italy
| | - Nicolò Ubaldi
- Catholic University of the Sacred Heart, Rome, Italy
| | - Filippo Maria Ubaldi
- Clinica Valle Giulia, G.en.e.r.a. Centers for Reproductive Medicine, Rome, Italy
| | - Laura Rienzi
- Clinica Valle Giulia, G.en.e.r.a. Centers for Reproductive Medicine, Rome, Italy
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Fesahat F, Montazeri F, Sheikhha MH, saeedi H, Dehghani Firouzabadi R, Kalantar SM. Frequency of chromosomal aneuploidy in high quality embryos from young couples using preimplantation genetic screening. Int J Reprod Biomed 2017. [DOI: 10.29252/ijrm.15.5.297] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
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12
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Grøndahl ML, Christiansen SL, Kesmodel US, Agerholm IE, Lemmen JG, Lundstrøm P, Bogstad J, Raaschou-Jensen M, Ladelund S. Effect of women's age on embryo morphology, cleavage rate and competence-A multicenter cohort study. PLoS One 2017; 12:e0172456. [PMID: 28422964 PMCID: PMC5396884 DOI: 10.1371/journal.pone.0172456] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Accepted: 02/06/2017] [Indexed: 11/26/2022] Open
Abstract
This multicenter cohort study on embryo assessment and outcome data from 11,744 IVF/ICSI cycles with 104,830 oocytes and 42,074 embryos, presents the effect of women’s age on oocyte, zygote, embryo morphology and cleavage parameters, as well as cycle outcome measures corrected for confounding factors as center, partner’s age and referral diagnosis. Cycle outcome data confirmed the well-known effect of women’s age. Oocyte nuclear maturation and proportion of 2 pro-nuclear (2PN) zygotes were not affected by age, while a significant increase in 3PN zygotes was observed in both IVF and ICSI (p<0.0001) with increasing age. Maternal age had no effect on cleavage parameters or on the morphology of the embryo day 2 post insemination. Interestingly, initial hCG value after single embryo transfer followed by ongoing pregnancy was increased with age in both IVF (p = 0.007) and ICSI (p = 0.001) cycles. For the first time, we show that a woman’s age does impose a significant footprint on early embryo morphological development (3PN). In addition, the developmentally competent embryos were associated with increased initial hCG values as the age of the women increased. Further studies are needed to elucidate, if this increase in initial hCG value with advancing maternal age is connected to the embryo or the uterus.
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Affiliation(s)
- Marie Louise Grøndahl
- Herlev Hospital, Fertility Clinic, Copenhagen University Hospital, Herlev, Denmark
- * E-mail:
| | | | - Ulrik Schiøler Kesmodel
- Herlev Hospital, Fertility Clinic, Copenhagen University Hospital, Herlev, Denmark
- Aarhus University Hospital, Fertility Clinic, Aarhus, Denmark
| | | | | | | | - Jeanette Bogstad
- Hvidovre Hospital, Fertility Clinic, Copenhagen University Hospital, Hvidovre, Denmark
| | | | - Steen Ladelund
- Hvidovre Hospital, Statistics, Clinical Research Center, Copenhagen University Hospital, Hvidovre, Denmark
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13
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Bianchi S, Macchiarelli G, Micara G, Linari A, Boninsegna C, Aragona C, Rossi G, Cecconi S, Nottola SA. Ultrastructural markers of quality are impaired in human metaphase II aged oocytes: a comparison between reproductive and in vitro aging. J Assist Reprod Genet 2015; 32:1343-58. [PMID: 26276431 DOI: 10.1007/s10815-015-0552-9] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Accepted: 07/27/2015] [Indexed: 11/25/2022] Open
Abstract
PURPOSE Childbearing delay contributes to the increase of subfertile couples that require assisted reproductive technology (ART). Subfertility relates with reproductive aging (RA). In vitro aging (IvA) (due to extended culture) may also impair oocyte competence. Aims of this study were to evaluate and compare the oocyte ultrastructure after RA and IvA. METHODS Cumulus-oocyte complexes (COCs) (n = 68), with metaphase II oocyte and expanded cumulus, from consenting patients (<35 years old and ≥35 years old, n = 36), were selected by phase contrast microscopy and fixed at pick up, or after 24 h culture. COCs (n = 44) were studied by light and qualitative/morphometric transmission electron microscopy. Two-way ANOVA, with age and culture as grouping factors, was applied for statistical analysis (p < 0.05). Metaphase II cumulus-free oocytes (n = 24) were selected for confocal microscopy observations. RESULTS Significant decrease of mitochondria-smooth endoplasmic reticulum aggregates, increase of mitochondria-vesicle complexes size and amount, decrease of cortical granules and microvilli, and alterations of the spindle structure characterized both RA and IvA oocytes. These changes were significantly more evident in the RA oocytes submitted to IvA. RA oocytes also showed changes of the zona pellucida and occurrence of vacuoles after culture. Cumuli appeared re-compacted after culture, irrespective of the age of the patients. CONCLUSIONS These data demonstrated that aging is related to decay of oocyte ultrastructural quality, and that oocytes from elder women are more sensitive to prolonged culture (IvA) than the oocytes from younger women. These morphological results should be considered when applying ART in aged patients, rescue ICSI, or artificial oocyte activation.
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Affiliation(s)
- S Bianchi
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - G Macchiarelli
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - G Micara
- Department of Gynaecology-Obstetrics & Urology, "Sapienza" University, Rome, Italy
| | - A Linari
- Department of Gynaecology-Obstetrics & Urology, "Sapienza" University, Rome, Italy
| | - C Boninsegna
- Department of Gynaecology-Obstetrics & Urology, "Sapienza" University, Rome, Italy
| | - C Aragona
- Department of Gynaecology-Obstetrics & Urology, "Sapienza" University, Rome, Italy
| | - G Rossi
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - S Cecconi
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - S A Nottola
- Department of Anatomy, Histology, Forensic Medicine and Orthopaedics, "Sapienza" University, Rome, Italy.
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14
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Nasiri N, Eftekhari-Yazdi P. An overview of the available methods for morphological scoring of pre-implantation embryos in in vitro fertilization. CELL JOURNAL 2015; 16:392-405. [PMID: 25685730 PMCID: PMC4297478 DOI: 10.22074/cellj.2015.486] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/03/2013] [Accepted: 10/08/2013] [Indexed: 11/17/2022]
Abstract
Assessment of embryo quality in order to choose the embryos that most likely result in
pregnancy is the critical goal in assisted reproductive technologies (ART). The current
trend in human in vitro fertilization/embryo transfer (IVF/ET) protocols is to decrease the
rate of multiple pregnancies after multiple embryo transfer with maintaining the pregnancy
rate at admissible levels (according to laboratory standards). Assessment of morphological feathers as a reliable non-invasive method that provides valuable information in prediction of IVF/intra cytoplasmic sperm injection (ICSI) outcome has been frequently proposed
in recent years. This article describes the current status of morphological embryo evaluation at different pre-implantation stages.
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Affiliation(s)
- Nahid Nasiri
- 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
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15
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Stensen MH, Tanbo TG, Storeng R, Åbyholm T, Fedorcsak P. Fragmentation of human cleavage-stage embryos is related to the progression through meiotic and mitotic cell cycles. Fertil Steril 2014; 103:374-81.e4. [PMID: 25467039 DOI: 10.1016/j.fertnstert.2014.10.031] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Revised: 10/16/2014] [Accepted: 10/20/2014] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To study whether fragmentation of human embryos is related to the progression through meiotic and mitotic cell cycles. DESIGN This report consists of two observational studies. SETTING Not applicable. PATIENT(S) A total of 1,943 oocytes from 297 patients and 372 embryos from 100 patients were imaged in the Polscope instrument and monitored in the Embryoscope, respectively. INTERVENTION(S) Completion of the first meiotic division was determined by visualization of the meiotic metaphase II spindle in human oocytes, and the duration of the first three mitotic cell cycles was determined with time-lapse microscopy. The percentage of embryo fragmentation was recorded 42-45 hours after insemination. MAIN OUTCOME MEASURE(S) Appearance of the meiotic spindle; durations of the first, second, and third mitoses. RESULT(S) Human embryos with a low degree of fragmentation (<10%) at 42-45 hours after insemination originated from oocytes with an early appearance of the meiotic spindle (mean 35.5 hours after hCG injection), early first mitosis (28.2 hours after insemination), late start of the second mitosis (38.0 hours after insemination), and a shorter duration of the third mitosis (1.1 hours). Highly fragmented embryos (>50% fragmentation) originated from oocytes with a late-appearing meiotic spindle (36.5 hours after hCG injection), delayed initiation of the first mitosis (29.8 hours after insemination), early start of the second mitosis (36.4 hours after insemination), and a longer duration of the third mitotic cell cycle (4.1 hours). CONCLUSION(S) The observed associations suggest that the process of fragmentation of in vitro-derived embryos was related to the progress of the meiotic and the mitotic cell cycles.
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Affiliation(s)
- Mette Haug Stensen
- Norwegian National Advisory Unit on Women's Health, Women and Children's Division, Oslo University Hospital Rikshospitalet, Oslo, Norway.
| | - Tom Gunnar Tanbo
- Section of Reproductive Medicine, Department of Gynecology, Oslo University Hospital Rikshospitalet, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ritsa Storeng
- Norwegian National Advisory Unit on Women's Health, Women and Children's Division, Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - Thomas Åbyholm
- Department of Obstetrics, Women and Children's Division, Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - Peter Fedorcsak
- Section of Reproductive Medicine, Department of Gynecology, Oslo University Hospital Rikshospitalet, Oslo, Norway
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16
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Stensen MH, Tanbo T, Storeng R, Fedorcsak P. Advanced glycation end products and their receptor contribute to ovarian ageing. Hum Reprod 2013; 29:125-34. [DOI: 10.1093/humrep/det419] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
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17
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Cao S, Zhao C, Zhang J, Wu X, Zhou L, Guo X, Shen R, Ling X. A minimum number of motile spermatozoa are required for successful fertilisation through artificial intrauterine insemination with husband's spermatozoa. Andrologia 2013; 46:529-34. [PMID: 23701485 DOI: 10.1111/and.12109] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/20/2013] [Indexed: 11/27/2022] Open
Affiliation(s)
- S. Cao
- State Key Laboratory of Reproductive Medicine; Department of Reproduction; Nanjing Maternity and Child Health Care Hospital Affiliated to Nanjing Medical University; Nanjing China
| | - C. Zhao
- State Key Laboratory of Reproductive Medicine; Department of Reproduction; Nanjing Maternity and Child Health Care Hospital Affiliated to Nanjing Medical University; Nanjing China
| | - J. Zhang
- State Key Laboratory of Reproductive Medicine; Department of Reproduction; Nanjing Maternity and Child Health Care Hospital Affiliated to Nanjing Medical University; Nanjing China
| | - X. Wu
- State Key Laboratory of Reproductive Medicine; Department of Reproduction; Nanjing Maternity and Child Health Care Hospital Affiliated to Nanjing Medical University; Nanjing China
| | - L. Zhou
- State Key Laboratory of Reproductive Medicine; Department of Reproduction; Nanjing Maternity and Child Health Care Hospital Affiliated to Nanjing Medical University; Nanjing China
| | - X. Guo
- State Key Laboratory of Reproductive Medicine; Department of Reproduction; Nanjing Maternity and Child Health Care Hospital Affiliated to Nanjing Medical University; Nanjing China
| | - R. Shen
- State Key Laboratory of Reproductive Medicine; Department of Reproduction; Nanjing Maternity and Child Health Care Hospital Affiliated to Nanjing Medical University; Nanjing China
| | - X. Ling
- State Key Laboratory of Reproductive Medicine; Department of Reproduction; Nanjing Maternity and Child Health Care Hospital Affiliated to Nanjing Medical University; Nanjing China
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18
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Adams GP, Singh J, Baerwald AR. Large animal models for the study of ovarian follicular dynamics in women. Theriogenology 2012; 78:1733-48. [PMID: 22626769 DOI: 10.1016/j.theriogenology.2012.04.010] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2011] [Revised: 04/11/2012] [Accepted: 04/17/2012] [Indexed: 02/05/2023]
Abstract
Initial studies of the ovaries were based on postmortem anatomic descriptions, followed by histologic and endocrine approaches. The introduction of high-resolution ultrasonography provided a long-awaited tool to image the reproductive tissues in situ in both animals and humans. Critical studies of the characteristics and control of ovarian follicular and luteal dynamics in nonhuman primates, rodents, and domestic farm animals have involved frequent (i.e., daily or multiple times a day) blood sampling and ultrasonography. Studies of this nature in women are difficult, and often unethical to conduct. Differences in antral folliculogenesis between humans and animals appear to be more in detail rather than in essence, and may reflect differences in intrinsic physiology or merely differences in our ability to detect changes in a given species. In women, the presence of endometrial shedding and symmetric luteal and follicular phases are different from that observed during the estrous cycles of domestic farm animals but despite these differences, general similarities in antral follicular dynamics exist. A continuous pattern of antral follicle development was originally proposed in domestic livestock species; however, the use of frequent serial ultrasonography and simultaneous endocrine profiling in these animal species has resulted in a broad understanding of follicular wave dynamics. Follicular waves have now been described in every species in which this approach has been used, including humans. The relatively large diameters of antral follicles in cows and mares, compared with monkeys, sheep, and rodents provide greater feasibility for characterizing antral follicular dynamics ultrasonographically. While the use of large animal models has increased our understanding of ovarian function and provides the hypothetical basis for studies in women, differences in vocabulary, culture, and research methodologies has hampered knowledge translation. These differences represent a systemic impediment to a broad understanding of ovarian function and limits progress and innovation in the development of safer and more efficacious treatments for infertility and contraception.
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Affiliation(s)
- G P Adams
- Department of Veterinary Biomedical Sciences, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
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19
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Mellembakken JR, Berga SL, Kilen M, Tanbo TG, Abyholm T, Fedorcsák P. Sustained fertility from 22 to 41 years of age in women with polycystic ovarian syndrome. Hum Reprod 2011; 26:2499-504. [PMID: 21724569 DOI: 10.1093/humrep/der214] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Subfertility due to chronic anovulation is common in women with polycystic ovary syndrome (PCOS) and is often treated with IVF. Women with PCOS have an increased ovarian follicle and oocyte count, increased ovarian reserve and/or a slower rate of follicle atresia. If so, one would expect women with PCOS to display a delayed reduction in fertility with advancing age as compared with eumenorrheic women. METHODS To test this hypothesis, we compared oocyte count and live birth rates among two groups undergoing IVF, 500 women with PCOS and 500 eumenorrheic women with infertility due to tubal factor only. RESULTS Across the age range of 22-41 years, oocyte count and live birth rates remained stable in women with PCOS. In the eumenorrheic comparison group, these parameters decreased significantly with age. CONCLUSIONS Women with PCOS display sustained fertility with advancing age as compared with infertile eumenorrheic women.
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Affiliation(s)
- Jan R Mellembakken
- Section for Reproductive Medicine, Department of Gynecology, Oslo University Hospital, Oslo, Norway.
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20
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Fujimoto VY, Browne RW, Bloom MS, Sakkas D, Alikani M. Pathogenesis, developmental consequences, and clinical correlations of human embryo fragmentation. Fertil Steril 2011; 95:1197-204. [DOI: 10.1016/j.fertnstert.2010.11.033] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2010] [Revised: 11/12/2010] [Accepted: 11/15/2010] [Indexed: 12/20/2022]
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