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Bartolacci A, Busnelli A, Pagliardini L, de Girolamo S, De Santis L, Esposito S, Alteri A, Setti PEL, Papaleo E. Assessing the developmental competence of oocytes matured following rescue in vitro maturation: a systematic review and meta-analysis. J Assist Reprod Genet 2024:10.1007/s10815-024-03211-9. [PMID: 39046561 DOI: 10.1007/s10815-024-03211-9] [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: 06/03/2024] [Accepted: 07/17/2024] [Indexed: 07/25/2024] Open
Abstract
PURPOSE To assess the developmental competence of oocytes matured following rescue in vitro maturation (IVM). METHODS PubMed, EmBASE, and SCOPUS were systematically searched for peer-reviewed original papers using relevant keywords and Medical Subject Heading terms. Study quality was assessed using the Newcastle-Ottawa Scale. Odds ratios with a 95% confidence interval were calculated by applying a random effects model. The primary outcomes were fertilization and blastulation rates. Secondary outcomes included abnormal fertilization, cleavage, euploidy, clinical pregnancy, and live-birth rates. RESULT Twenty-four studies were included in the meta-analysis. The oocytes matured following rescue IVM showed significantly reduced fertilization, cleavage, blastulation, and clinical pregnancy rates compared to sibling in vivo-matured oocytes. No significant differences were found for the euploidy and live-birth rates in euploid blastocyst transfer. In poor responders, a reduced fertilization rate was observed using in vitro-matured GV but not with in vitro-matured MI. A reduced cleavage rate in MI matured overnight compared to < 6 incubation hours was found. CONCLUSION Our results showed compromised developmental competence in oocytes matured following rescue IVM. However, in poor responders, rescue IVM could maximize the efficiency of the treatment. Notably, our data suggests using in vitro MI matured within 6 incubation hours. CLINICAL TRIAL REGISTRATION NUMBER CRD42023467232.
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Affiliation(s)
- Alessandro Bartolacci
- Obstetrics and Gynaecology Unit, IRCCS San Raffaele Scientific Institute, Via Olgettina, 60, 20132, Milan, Italy.
| | - Andrea Busnelli
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
- Division of Gynecology and Reproductive Medicine, Department of Gynecology, Fertility Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Luca Pagliardini
- Obstetrics and Gynaecology Unit, IRCCS San Raffaele Scientific Institute, Via Olgettina, 60, 20132, Milan, Italy
- Reproductive Sciences Laboratory, Obstetrics and Gynaecology Unit, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy
| | - Sofia de Girolamo
- Obstetrics and Gynaecology Unit, IRCCS San Raffaele Scientific Institute, Via Olgettina, 60, 20132, Milan, Italy
| | - Lucia De Santis
- Obstetrics and Gynaecology Unit, IRCCS San Raffaele Scientific Institute, Via Olgettina, 60, 20132, Milan, Italy
| | - Stefania Esposito
- Obstetrics and Gynaecology Unit, IRCCS San Raffaele Scientific Institute, Via Olgettina, 60, 20132, Milan, Italy
| | - Alessandra Alteri
- Obstetrics and Gynaecology Unit, IRCCS San Raffaele Scientific Institute, Via Olgettina, 60, 20132, Milan, Italy
| | - Paolo Emanuele Levi Setti
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
- Division of Gynecology and Reproductive Medicine, Department of Gynecology, Fertility Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Enrico Papaleo
- Obstetrics and Gynaecology Unit, IRCCS San Raffaele Scientific Institute, Via Olgettina, 60, 20132, Milan, Italy
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Li Y, Jin L, Tian W, Yan E, Li Y, Ren X, Guo N. Usable blastocysts developed from in-vitro-matured metaphase I oocytes in preimplantation genetic testing cycles. Reprod Biomed Online 2024; 48:103571. [PMID: 38244346 DOI: 10.1016/j.rbmo.2023.103571] [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: 06/16/2023] [Revised: 09/20/2023] [Accepted: 09/25/2023] [Indexed: 01/22/2024]
Abstract
RESEARCH QUESTION Are blastocysts derived from in-vitro-matured metaphase I (MI) oocytes less likely to produce usable embryos for transfer compared with those derived from in-vivo-matured oocytes in cycles undergoing preimplantation genetic testing (PGT)? DESIGN The primary outcome was usable blastocyst rate, which was compared between blastocysts derived from in-vitro-matured MI oocytes after ovarian stimulation and from in-vivo-matured oocytes. Logistic regression analysis using generalized estimating equations was used to control for confounders in the analysis of factors that may influence the chance of a blastocyst being usable and in the comparison of embryological outcomes. Student's t-test, Mann-Whitney U test, chi-squared tests or Fisher's exact tests were used to compare clinical and pregnancy outcomes. RESULTS A total of 1810 injected metaphase II (MII) oocytes from 154 PGT cycles involving 154 couples were included in this study. A total of 1577 MII oocytes were in-vivo-matured and 233 were in-vitro-matured MI oocytes. The usable blastocyst rate was similar between the in-vitro-matured MI oocyte group and the in-vivo-matured oocyte group (adjusted RR 0.97, 95% CI 0.40 to 2.34). Three live births were achieved using usable blastocysts derived from in-vitro-matured MI oocytes. CONCLUSIONS If in-vitro-matured MI oocytes can be fertilized and develop into blastocysts, their ability to provide usable embryos for transfer is similar compared with those developed from in-vivo-matured oocytes. These blastocysts could be considered valuable for women with few viable embryos in assisted reproductive technology cycles.
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Affiliation(s)
- Yuehan Li
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Lei Jin
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Wenqu Tian
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Enqi Yan
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Yufeng Li
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Xinling Ren
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China..
| | - Na Guo
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China..
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Esbert M, García C, Cutts G, Lara-Molina E, Garrido N, Ballestros A, Scott RT, Seli E, Wells D. Oocyte rescue in-vitro maturation does not adversely affect chromosome segregation during the first meiotic division. Reprod Biomed Online 2024; 48:103379. [PMID: 37919136 DOI: 10.1016/j.rbmo.2023.103379] [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: 05/23/2023] [Revised: 08/07/2023] [Accepted: 08/29/2023] [Indexed: 11/04/2023]
Abstract
RESEARCH QUESTION Does rescue in-vitro maturation (IVM) in the presence or absence of cumulus cells, affect the progress of meiosis I, compared with oocytes that mature in vivo? DESIGN This prospective study was conducted in a university-affiliated fertility centre. Ninety-five young oocyte donors (mean age 25.57 ± 4.47) with a normal karyotype and no known fertility problems were included. A total of 390 oocytes (116 mature metaphase II [MII] and 274 immature oocytes) were analysed. The immature oocytes underwent rescue IVM in the presence of cumulus cells (CC; IVM+CC; n = 137) or without them (IVM-CC; n = 137), and IVM rate was calculated. Chromosome copy number analysis using next-generation sequencing (NGS) was performed on all rescue IVM oocytes reaching MII as well as those that were mature at the time of initial denudation (in-vivo-matured oocytes [IVO]). RESULTS Maturation rates were similar in IVM+CC and IVM-CC oocytes (62.8 versus 71.5%, P = 0.16). Conclusive cytogenetic results were obtained from 65 MII oocytes from the IVM+CC group, 87 from the IVM-CC group, and 99 from the IVO group. Oocyte euploidy rates for the three groups were similar, at 75.4%, 83.9% and 80.8%, respectively (P = 0.42). CONCLUSIONS The results suggest that culture of germinal vesicle and metaphase I oocytes in the presence of cumulus cells does not improve rates of IVM. In general, the process of rescue IVM does not appear to alter the frequency of oocytes with a normal chromosome copy number.
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Affiliation(s)
- Marga Esbert
- IVIRMA Global Research Alliance, IVI Barcelona, Barcelona, Spain.
| | - Cristina García
- IVIRMA Global Research Alliance, IVI Barcelona, Barcelona, Spain
| | | | | | - Nicolás Garrido
- IVIRMA Global Research Alliance, IVI Foundation, Instituto de Investigación Sanitaria La Fe, Valencia, Spain
| | | | - Richard T Scott
- IVIRMA Global Research Alliance, RMA New Jersey, NJ, USA; Department of Obstetrics and Gynecology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
| | - Emre Seli
- IVIRMA Global Research Alliance, RMA New Jersey, NJ, USA; Department of obstetrics, gynecology and reproductive Sciences, Yale School of Medicine, New Haven, CT, USA
| | - Dagan Wells
- Juno Genetics, Oxford Science Park, Oxford, UK; Nuffield Department of Women's and Reproductive Health, John Radcliffe Hospital, University of Oxford, Oxford, UK
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Carles M, Lefranc E, Bosquet D, Capelle S, Scheffler F, Copin H, Cabry R, Benkhalifa M. In vitro maturation of oocytes from stimulated IVF-ICSI cycles using autologous cumulus cell co-culture: A preliminary study. Morphologie 2023; 107:28-37. [PMID: 35764505 DOI: 10.1016/j.morpho.2022.02.002] [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: 10/27/2021] [Revised: 02/18/2022] [Accepted: 02/18/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE OF THE STUDY In stimulated IVF-ICSI cycles, follicles at different stages of maturation can be aspirated during oocyte pickup. Nowadays, only mature oocytes (metaphase 2 stage) are used and immature oocytes (germinal vesicle and metaphase 1 stages), which are judged unfit for fertilization, are non-used at day 0. In our IVF center, the rate of immature oocytes recovered is around 25%. A significant number of this precious resource is therefore non-used every day in IVF laboratories. The objective of our study was to evaluate the competence of our in vitro maturation autologous coculture method on the maturation and developmental potential of immature oocytes obtained from stimulated IVF-ICSI cycles, in order to obtain additional embryos for the couple as a rescue system to increase the changes of cumulative pregnancy. PATIENTS AND METHODS This is a prospective study, carried out in the Reproductive Medicine and Biology Unit of the Amiens-Picardy University Hospital (France). It was included 14 couples, managed in IVF-ICSI in our center, from January to March 2020. Thirty-eight oocytes, identified as immature after cumulus-oocyte complexes (COC) stripping for ICSI, were placed in our in vitro maturation medium with the addition of autologous cumulus cells. Oocytes that had reached the metaphase II stage after a maximum of 36 hours of maturation were microinjected. The fertilization and embryonic development potential of the in vitro matured oocytes were compared to those of 148 in vivo matured "siblings" oocytes from the same oocyte retrieval, and then also compared to those of 127 in vivo matured oocytes from different patients (control group). MAIN OUTCOME MEASURE(S) Maturation rate, fertilization rate, early cleavage rate and developmental activity to blastulation rate. SECOND OUTCOME MEASURE(S) Embryo quality at cleavage and blastocyst stages, blastulation rate, and useful blastulation rate. RESULTS No significant difference was found in the main and secondary criteria of the study compared to the "siblings" in vivo matured oocytes from the same oocyte retrieval. However, a significant difference was obtained on the rate of early cleavage and useful blastulation when our cohort was compared to mature in vivo oocytes from different patients (control group). CONCLUSION This study has shown that after incubation in our in vitro maturation autologous cumulus cell co-culture with cumulus-oocyte cells, immature oocytes recovered during stimulated cycles can give rise to competent oocytes, i.e., capable of being fertilized, of cleaving, and of developing into embryos up to the blastocyst stage. Our study therefore seems to be in the direction of a favorable use of these immature oocytes obtained after stimulated IVF-ICSI cycles. The continuation of this study by including a larger number of oocytes is necessary in order to evaluate the real contribution of this technique in routine.
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Affiliation(s)
- M Carles
- Reproductive Medicine, Reproductive Biology & Genetics, CECOS of Picardie, CHU d'Amiens Picardie, Amiens, France.
| | - E Lefranc
- Reproductive Medicine, Reproductive Biology & Genetics, CECOS of Picardie, CHU d'Amiens Picardie, Amiens, France
| | - D Bosquet
- Reproductive Medicine, Reproductive Biology & Genetics, CECOS of Picardie, CHU d'Amiens Picardie, Amiens, France; Peritox Laboratory, CURS, Picardy University Jules-Verne, Amiens, France
| | - S Capelle
- Reproductive Medicine, Reproductive Biology & Genetics, CECOS of Picardie, CHU d'Amiens Picardie, Amiens, France
| | - F Scheffler
- Reproductive Medicine, Reproductive Biology & Genetics, CECOS of Picardie, CHU d'Amiens Picardie, Amiens, France; Peritox Laboratory, CURS, Picardy University Jules-Verne, Amiens, France
| | - H Copin
- Reproductive Medicine, Reproductive Biology & Genetics, CECOS of Picardie, CHU d'Amiens Picardie, Amiens, France
| | - R Cabry
- Reproductive Medicine, Reproductive Biology & Genetics, CECOS of Picardie, CHU d'Amiens Picardie, Amiens, France; Peritox Laboratory, CURS, Picardy University Jules-Verne, Amiens, France
| | - M Benkhalifa
- Reproductive Medicine, Reproductive Biology & Genetics, CECOS of Picardie, CHU d'Amiens Picardie, Amiens, France; Peritox Laboratory, CURS, Picardy University Jules-Verne, Amiens, France
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Yang Q, Xi Q, Wang M, Liu J, Li Z, Hu J, Jin L, Zhu L. Rapamycin improves the developmental competence of human oocytes by alleviating DNA damage during IVM. Hum Reprod Open 2022; 2022:hoac050. [PMID: 36518986 PMCID: PMC9731209 DOI: 10.1093/hropen/hoac050] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 10/09/2022] [Indexed: 07/20/2023] Open
Abstract
STUDY QUESTION Can rapamycin improve the developmental competence of human oocytes during the IVM process? SUMMARY ANSWER Rapamycin at 10 nM could markedly improve the developmental competence of human oocytes undergoing IVM. WHAT IS KNOWN ALREADY Embryos derived from oocytes that mature in vitro have lower developmental competence than sibling embryos derived from oocytes matured in vivo. Rapamycin was shown to effectively improve IVM outcomes in mammalian oocytes; however, its effects on IVM of human oocytes have not been investigated. STUDY DESIGN SIZE DURATION In 2021, donated immature oocytes (n = 202) from 80 infertile couples receiving ICSI were included in a control group, and 156 oocytes from 72 couples were included in a rapamycin group. The oocytes underwent IVM with 10 nM rapamycin or without (control) rapamycin, followed by insemination by ICSI and embryo culture. PARTICIPANTS/MATERIALS SETTING METHODS The germinal vesicle breakdown (GVBD), maturation, normal fertilization, high-quality embryo (HQE) and blastocyst formation rates were calculated to evaluate the developmental competence of IVM oocytes, and fluorescence staining was used to assess DNA damage levels of oocytes in both groups. Whole-genome amplification and DNA sequencing were performed to analyze chromosome euploidy in embryos derived from the rapamycin group. MAIN RESULTS AND THE ROLE OF CHANCE The baseline characteristics of patients who donated oocytes for the two experimental groups were similar. In the control group, GVBD happened in 135 (66.8%) oocytes, and the maturation rate reached 52.5% at 24 h and 63.4% at 48 h. In the rapamycin group, 143 (91.7%) oocytes underwent GVBD, and the maturation rate reached 60.3% at 24 h and 82.7% at 48 h. Following ICSI, more HQEs were obtained in the rapamycin group versus control (34.2% versus 22.1%, respectively, P = 0.040), although with comparable fertilization rates in the two groups. In addition, the levels of histone γH2AX in oocytes cultured with 10 nM rapamycin were markedly decreased, compared with those in the control group (0.3 ± 0.0 versus 0.6 ± 0.1, respectively, P = 0.048). Embryos with normal karyotype could be obtained from oocytes cultured with rapamycin. LIMITATIONS REASONS FOR CAUTION Our preliminary results indicated that the addition of rapamycin during human oocyte IVM did not cause extra aneuploidy. However, this safety evaluation of rapamycin treatment was based on limited samples and more data are needed before possible application in the clinic. WIDER IMPLICATIONS OF THE FINDINGS In the current study, 10 nM rapamycin was applied in the IVM process of human oocytes for the first time and showed positive effects, providing new insights for potentially improving IVM outcomes in the clinic. There were subtle differences between the results presented here on human oocytes and our previous studies on mouse oocytes, indicating the necessity of more research on human samples. STUDY FUNDING/COMPETING INTERESTS This work was supported by the research grants from National Key Research and Development Project (2018YFC1002103) and Health Commission of Hubei Province scientific research project (WJ2021M110). All authors declared no conflicts of interest. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- Qiyu Yang
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qingsong Xi
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Meng Wang
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jing Liu
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhou Li
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Juan Hu
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Lei Jin
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Lixia Zhu
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Li J, Chen J, Sun T, Zhang S, Jiao T, Chian RC, Li Y, Xu Y. Chromosome aneuploidy analysis in embryos derived from in vivo and in vitro matured human oocytes. J Transl Med 2021; 19:416. [PMID: 34625066 PMCID: PMC8501569 DOI: 10.1186/s12967-021-03080-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Accepted: 09/14/2021] [Indexed: 11/10/2022] Open
Abstract
Background In vitro oocyte maturation (IVM) is being increasingly approached in assisted reproductive technology (ART). This study aimed to evaluate the quality of embryos generated by in-vitro matured immature follicles, as a guideline for further clinical decision-making. Methods A total of 52 couples with normal karyotypes underwent in vitro fertilization, and 162 embryos were donated for genetic screening. Embryos in IVF group were generated by mature follicles retrieved during gonadotrophin-stimulated in vitro fertilization (IVF) cycles. And embryos in IVM group were fertilized from IVM immature oocytes. Results The average age of the women was 30.50 ± 4.55 years (range 21–42 years) with 87 embryos from IVF group and 75 embryos from IVM group. The rate of aneuploid with 28 of the 87 (32.2%) embryos from IVF group and 21 of the 75 (28%) embryos from IVM group, with no significant difference. The frequency of aneuploid embryos was lowest in the youngest age and increased gradually with women’s age, whether in IVF group or IVM group and risen significantly over 35 years old. The embryos with morphological grade 1 have the lowest aneuploidy frequency (16.6%), and increase by the grade, especially in IVF group. In grade 3, embryos in IVM group were more likely to be euploid than IVF group (60% vs 40%, respectively). Conclusions IVM does not affect the quality of embryos and does not increase the aneuploidy rate of embryos. It is clinically recommended that women more than 35 years have a high aneuploidy rate and recommended to test by PGS (strongly recommended to screened by PGS for women more than 40 years). Women aged less than 35 years old for PGS according to their physical and economic conditions. Embryo with poor quality is also recommended to test by PGS, especially for grade III embryos.
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Affiliation(s)
- Jianhua Li
- Reproductive Medical Center, Senior Department of Obstetrics & Gynecology, The Seventh Medical Center of PLA General Hospital, Beijing, 100700, China
| | - Jing Chen
- Reproductive Medicine Center, The First Affiliated Hospital of Xiamen University, No. 6 Guchengxi Road, Si Ming, Xiamen, 361003, China.,Research Group for Reproductive Medicine and IVF Laboratory, Department of Obstetrics and Gynecology, Cologne University, Kerpener Str. 7, 50931, Cologne, Germany
| | - Tiecheng Sun
- Reproductive Medical Center, Department of Obstetrics and Gynecology, Peking University International Hospital, Beijing, 102206, China
| | - Shuiwen Zhang
- Reproductive Medical Center, Senior Department of Obstetrics & Gynecology, The Seventh Medical Center of PLA General Hospital, Beijing, 100700, China
| | - Tingting Jiao
- Reproductive Medical Center, Senior Department of Obstetrics & Gynecology, The Seventh Medical Center of PLA General Hospital, Beijing, 100700, China
| | - Ri-Cheng Chian
- Center for Reproductive Medicine, Shanghai Tenth People's Hospital of Tongji University, Shanghai, 200072, China.
| | - Youzhu Li
- Reproductive Medicine Center, The First Affiliated Hospital of Xiamen University, No. 6 Guchengxi Road, Si Ming, Xiamen, 361003, China.
| | - Ye Xu
- Reproductive Medical Center, Senior Department of Obstetrics & Gynecology, The Seventh Medical Center of PLA General Hospital, Beijing, 100700, China.
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Chen S, Yin X, Zhang S, Xia J, Liu P, Xie P, Yan H, Liang X, Zhang J, Chen Y, Fei H, Zhang L, Hu Y, Jiang H, Lin G, Chen F, Xu C. Comprehensive preimplantation genetic testing by massively parallel sequencing. Hum Reprod 2021; 36:236-247. [PMID: 33306794 DOI: 10.1093/humrep/deaa269] [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: 11/25/2019] [Revised: 09/15/2020] [Indexed: 11/14/2022] Open
Abstract
STUDY QUESTION Can whole genome sequencing (WGS) offer a relatively cost-effective approach for embryonic genome-wide haplotyping and preimplantation genetic testing (PGT) for monogenic disorders (PGT-M), aneuploidy (PGT-A) and structural rearrangements (PGT-SR)? SUMMARY ANSWER Reliable genome-wide haplotyping, PGT-M, PGT-A and PGT-SR could be performed by WGS with 10× depth of parental and 4× depth of embryonic sequencing data. WHAT IS KNOWN ALREADY Reduced representation genome sequencing with a genome-wide next-generation sequencing haplarithmisis-based solution has been verified as a generic approach for automated haplotyping and comprehensive PGT. Several low-depth massively parallel sequencing (MPS)-based methods for haplotyping and comprehensive PGT have been developed. However, an additional family member, such as a sibling, or a proband, is required for PGT-M haplotyping using low-depth MPS methods. STUDY DESIGN, SIZE, DURATION In this study, 10 families that had undergone traditional IVF-PGT and 53 embryos, including 13 embryos from two PGT-SR families and 40 embryos from eight PGT-M families, were included to evaluate a WGS-based method. There were 24 blastomeres and 29 blastocysts in total. All embryos were used for PGT-A. Karyomapping validated the WGS results. Clinical outcomes of the 10 families were evaluated. PARTICIPANTS/MATERIALS, SETTING, METHODS A blastomere or a few trophectoderm cells from the blastocyst were biopsied, and multiple displacement amplification (MDA) was performed. MDA DNA and bulk DNA of family members were used for library construction. Libraries were sequenced, and data analysis, including haplotype inheritance deduction for PGT-M and PGT-SR and read-count analysis for PGT-A, was performed using an in-house pipeline. Haplotyping with a proband and parent-only haplotyping without additional family members were performed to assess the WGS methodology. Concordance analysis between the WGS results and traditional PGT methods was performed. MAIN RESULTS AND THE ROLE OF CHANCE For the 40 PGT-M and 53 PGT-A embryos, 100% concordance between the WGS and single-nucleotide polymorphism (SNP)-array results was observed, regardless of whether additional family members or a proband was included for PGT-M haplotyping. For the 13 embryos from the two PGT-SR families, the embryonic balanced translocation was detected and 100% concordance between WGS and MicroSeq with PCR-seq was demonstrated. LIMITATIONS, REASONS FOR CAUTION The number of samples in this study was limited. In some cases, the reference embryo for PGT-M or PGT-SR parent-only haplotyping was not available owing to failed direct genotyping. WIDER IMPLICATIONS OF THE FINDINGS WGS-based PGT-A, PGT-M and PGT-SR offered a comprehensive PGT approach for haplotyping without the requirement for additional family members. It provided an improved complementary method to PGT methodologies, such as low-depth MPS- and SNP array-based methods. STUDY FUNDING/COMPETING INTEREST(S) This research was supported by the research grant from the National Key R&D Program of China (2018YFC0910201 and 2018YFC1004900), the Guangdong province science and technology project of China (2019B020226001), the Shenzhen Birth Defect Screening Project Lab (JZF No. [2016] 750) and the Shenzhen Municipal Government of China (JCYJ20170412152854656). This work was also supported by the National Natural Science Foundation of China (81771638, 81901495 and 81971344), the National Key R&D Program of China (2018YFC1004901 and 2016YFC0905103), the Shanghai Sailing Program (18YF1424800), the Shanghai Municipal Commission of Science and Technology Program (15411964000) and the Shanghai 'Rising Stars of Medical Talent' Youth Development Program Clinical Laboratory Practitioners Program (201972). The authors declare no competing interests. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- Songchang Chen
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,Shanghai Municipal Key Clinical Specialty, Shanghai, China.,Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China
| | - Xuyang Yin
- MGI, BGI-Shenzhen, Shenzhen, China.,BGI-Shenzhen, Beishan Industrial Zone, Shenzhen, China.,China National GeneBank, BGI-Shenzhen, Shenzhen, China
| | | | - Jun Xia
- MGI, BGI-Shenzhen, Shenzhen, China.,BGI-Shenzhen, Beishan Industrial Zone, Shenzhen, China.,China National GeneBank, BGI-Shenzhen, Shenzhen, China
| | - Ping Liu
- MGI, BGI-Shenzhen, Shenzhen, China.,BGI-Shenzhen, Beishan Industrial Zone, Shenzhen, China.,China National GeneBank, BGI-Shenzhen, Shenzhen, China
| | - Pingyuan Xie
- CITIC-Xiangya Reproductive & Genetic Hospital, Changsha, China
| | | | | | - Junyu Zhang
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,Shanghai Municipal Key Clinical Specialty, Shanghai, China.,Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China
| | - Yiyao Chen
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,Shanghai Municipal Key Clinical Specialty, Shanghai, China.,Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China
| | - Hongjun Fei
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,Shanghai Municipal Key Clinical Specialty, Shanghai, China.,Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China
| | - Lanlan Zhang
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,Shanghai Municipal Key Clinical Specialty, Shanghai, China.,Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China
| | - Yuting Hu
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Hui Jiang
- MGI, BGI-Shenzhen, Shenzhen, China.,BGI-Shenzhen, Beishan Industrial Zone, Shenzhen, China.,China National GeneBank, BGI-Shenzhen, Shenzhen, China
| | - Ge Lin
- CITIC-Xiangya Reproductive & Genetic Hospital, Changsha, China
| | - Fang Chen
- MGI, BGI-Shenzhen, Shenzhen, China.,BGI-Shenzhen, Beishan Industrial Zone, Shenzhen, China.,China National GeneBank, BGI-Shenzhen, Shenzhen, China
| | - Chenming Xu
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,Shanghai Municipal Key Clinical Specialty, Shanghai, China.,Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China
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8
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Buonomoa B, Peccatorib FA. Fertility preservation in endocrine responsive breast cancer: data and prejudices. Ecancermedicalscience 2021; 14:1157. [PMID: 33574902 PMCID: PMC7864682 DOI: 10.3332/ecancer.2020.1157] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Indexed: 12/21/2022] Open
Abstract
Even if current guidelines suggest an early referral of young breast cancer (BC) patients to fertility preservation counselling, physicians still lack knowledge about the different available strategies. Hormonal stimulation to harvest mature oocytes is considered unsafe by many oncologists and experts in reproductive medicine, particularly in the setting of oestrogen receptor-positive BC. The aim of this mini-review is to provide an overview on the available data about this topic in order to clarify potential misunderstandings and to highlight the new trends in the oncofertility field with their pros and limitations.
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9
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Abstract
In vitro fertilization is indicated for infertile women with polycystic ovarian syndrome (PCOS) after unsuccessful treatment with ovulation induction agents or in women deemed high-risk of multiple gestations who are ideal candidates for single embryo transfers. PCOS patients are at increased risk of ovarian hyperstimulation syndrome; therefore, attention should be made in the choice of in vitro fertilization treatment protocol, dose of gonadotropin utilized, and regimen to achieve final oocyte maturation. Adopting these strategies in addition to close monitoring may significantly reduce the ovarian hyperstimulation syndrome risk. Future developments may improve pregnancy outcomes and decrease complications in PCOS women undergoing fertility treatment.
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10
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Ebrahimian N, Montazeri F, Sadeghi MR, Kalantar SM, Gilany K, Khalili MA. Reanalysis of discarded blastocysts for autosomal aneuploidy after sex selection in cleavage-stage embryos. Clin Exp Reprod Med 2020; 47:293-299. [PMID: 33227189 PMCID: PMC7711103 DOI: 10.5653/cerm.2019.03426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 06/11/2020] [Indexed: 11/17/2022] Open
Abstract
Objective The goal of the present study was to investigate the rate of chromosomal aneuploidies in surplus embryos after sex determination at the cleavage stage. Then, the same chromosomal aneuploidies were evaluated in blastocysts after extended culture. Methods Sixty-eight surplus embryos were biopsied at the cleavage stage and incubated for an additional 3 days to allow them to reach the blastocyst stage. The embryos were reanalyzed via fluorescence in situ hybridization (FISH) to examine eight chromosomes (13, 15, 16, 18, 21, 22, X, and Y) in both cleavage-stage embryos and blastocysts. Results Although the total abnormality rate was lower in blastocysts (32.35%) than in cleavage-stage embryos (45.58%), the difference was not significant (p=0.113). However, when we restricted the analysis to autosomal abnormalities, we observed a significant difference in the abnormality rate between the cleavage-stage embryos (44.11%) and the blastocysts (17.64%, p=0.008). A higher rate of sex chromosomal abnormalities was also observed in cleavage-stage embryos (29.4%) than in blastocysts (14.70%, p=0.038). Conclusion The data indicated that embryo biopsy should be conducted at the blastocyst stage rather than the cleavage stage. The results also emphasized that examination of common chromosomal aneuploidies apart from sex selection cycles can be conducted in the blastocyst stage with the FISH method.
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Affiliation(s)
- Neda Ebrahimian
- Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.,Abortion Research Center, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Fatemeh Montazeri
- Abortion Research Center, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mohammad Reza Sadeghi
- Reproductive Embryology and Andrology Research Center, Avicenna Research Institute, Academic Center for Education, Culture and Research, Tehran, Iran
| | - Seyed Mehdi Kalantar
- Abortion Research Center, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Kambiz Gilany
- Reproductive Biotechnology Research Center, Avicenna Research Institute, ACECR, Tehran, Iran
| | - Mohannad Ali Khalili
- Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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11
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Elshewy N, Ji D, Zhang Z, Chen D, Chen B, Xue R, Wu H, Wang J, Zhou P, Cao Y. Association between mild stimulated IVF/M cycle and early embryo arrest in sub fertile women with/without PCOS. Reprod Biol Endocrinol 2020; 18:71. [PMID: 32669130 PMCID: PMC7362506 DOI: 10.1186/s12958-020-00622-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Accepted: 06/18/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND The in vitro maturation (IVM) technique has physical and financial benefits, but a lower efficiency and outcome that is still unclear whether it is related to polycystic ovary syndrome (PCOS) itself or the IVM procedure. In this study, we analyzed the clinical and laboratory outcomes of an optimized IVM protocol in patients with and without PCOS. We also discussed the possible reasons for early embryo arrest in the IVM cycle. METHODS This prospective study involved 58 PCOS patients and 56 non-PCOS patients who underwent mild stimulated IVF combined IVM (IVF/M) cycles. The clinical and laboratory outcomes were compared between the two groups. Also, metaphase II (MII) oocytes were obtained after IVM from the two groups, and in vivo MII oocytes randomly collected from IVF patients were examined for mitochondrial function using a laser scanning confocal microscope (LSCM). The aneuploidy rate for arrested cleavage embryos from IVM and IVF oocytes were screened using Next Generation Sequencing (NGS). RESULTS Mildly stimulated IVF/M resulted in cumulative clinical pregnancy and implantation rates (40.2, 28.7% in the PCOS group vs. 41.9, 36% in the non-PCOS group), respectively. The blastocyst formation rates were comparable (28% vs. 28.2%) in PCOS and non-PCOS groups, respectively. Using LSCM, there was a significant decrease in the mitochondrial membrane potential of IVM oocytes compared with the control IVF oocytes (P < 0.001), but no significant difference between the PCOS and non-PCOS groups. The NGS showed that the aneuploidy rates were comparable (75, 75, and 66.6%) in IVM-PCOS, IVM-non-PCOS, and control IVF arrested embryos, respectively. CONCLUSIONS The mildly stimulated IVF/M protocol produced acceptable clinical outcomes in PCOS and non-PCOS patients. IVM itself rather than the PCOS condition adversely affected the embryo development through its effect on mitochondrial function, which appeared to be a possible cause for the embryo arrest in the IVM cycles rather than chromosomal aneuploidy.
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Affiliation(s)
- Nagwa Elshewy
- grid.412679.f0000 0004 1771 3402Reproductive Medicine Center, Department of Obstetrics and Gynecology, the First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Dongmei Ji
- grid.412679.f0000 0004 1771 3402Reproductive Medicine Center, Department of Obstetrics and Gynecology, the First Affiliated Hospital of Anhui Medical University, Hefei, China
- grid.186775.a0000 0000 9490 772XKey Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People’s Republic of China, Hefei, China
- Anhui Province Key Laboratory of Reproductive Health and Genetics, Hefei, China
| | - Zhiguo Zhang
- grid.412679.f0000 0004 1771 3402Reproductive Medicine Center, Department of Obstetrics and Gynecology, the First Affiliated Hospital of Anhui Medical University, Hefei, China
- Anhui Province Key Laboratory of Reproductive Health and Genetics, Hefei, China
- grid.186775.a0000 0000 9490 772XNHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Medical University, Hefei, China
| | - Dawei Chen
- grid.412679.f0000 0004 1771 3402Reproductive Medicine Center, Department of Obstetrics and Gynecology, the First Affiliated Hospital of Anhui Medical University, Hefei, China
- Anhui Province Key Laboratory of Reproductive Health and Genetics, Hefei, China
- grid.186775.a0000 0000 9490 772XNHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Medical University, Hefei, China
| | - Beili Chen
- grid.412679.f0000 0004 1771 3402Reproductive Medicine Center, Department of Obstetrics and Gynecology, the First Affiliated Hospital of Anhui Medical University, Hefei, China
- grid.186775.a0000 0000 9490 772XKey Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People’s Republic of China, Hefei, China
- Anhui Province Key Laboratory of Reproductive Health and Genetics, Hefei, China
| | - Rufeng Xue
- grid.412679.f0000 0004 1771 3402Reproductive Medicine Center, Department of Obstetrics and Gynecology, the First Affiliated Hospital of Anhui Medical University, Hefei, China
- grid.186775.a0000 0000 9490 772XKey Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People’s Republic of China, Hefei, China
- Anhui Province Key Laboratory of Reproductive Health and Genetics, Hefei, China
| | - Huan Wu
- grid.412679.f0000 0004 1771 3402Reproductive Medicine Center, Department of Obstetrics and Gynecology, the First Affiliated Hospital of Anhui Medical University, Hefei, China
- Anhui Province Key Laboratory of Reproductive Health and Genetics, Hefei, China
| | - Jianye Wang
- grid.412679.f0000 0004 1771 3402Reproductive Medicine Center, Department of Obstetrics and Gynecology, the First Affiliated Hospital of Anhui Medical University, Hefei, China
- Anhui Province Key Laboratory of Reproductive Health and Genetics, Hefei, China
| | - Ping Zhou
- grid.412679.f0000 0004 1771 3402Reproductive Medicine Center, Department of Obstetrics and Gynecology, the First Affiliated Hospital of Anhui Medical University, Hefei, China
- grid.186775.a0000 0000 9490 772XKey Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People’s Republic of China, Hefei, China
- Anhui Province Key Laboratory of Reproductive Health and Genetics, Hefei, China
- grid.186775.a0000 0000 9490 772XNHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Medical University, Hefei, China
- Anhui Provincial Engineering Technology Research center for Bio preservation and Artificial Organs, Hefei, China
| | - Yunxia Cao
- grid.412679.f0000 0004 1771 3402Reproductive Medicine Center, Department of Obstetrics and Gynecology, the First Affiliated Hospital of Anhui Medical University, Hefei, China
- grid.186775.a0000 0000 9490 772XKey Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People’s Republic of China, Hefei, China
- Anhui Province Key Laboratory of Reproductive Health and Genetics, Hefei, China
- grid.186775.a0000 0000 9490 772XNHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Medical University, Hefei, China
- Anhui Provincial Engineering Technology Research center for Bio preservation and Artificial Organs, Hefei, China
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12
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Grynberg M, Dagher Hayeck B, Papanikolaou EG, Sifer C, Sermondade N, Sonigo C. BRCA1/2 gene mutations do not affect the capacity of oocytes from breast cancer candidates for fertility preservation to mature in vitro. Hum Reprod 2020; 34:374-379. [PMID: 30561604 DOI: 10.1093/humrep/dey358] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2018] [Accepted: 12/07/2018] [Indexed: 12/14/2022] Open
Abstract
STUDY QUESTION Are the maturation rates of oocytes recovered from small antral follicles different between breast cancer patients presenting with or without a BRCA 1/2 gene mutation? SUMMARY ANSWER BRCA 1/2 gene mutations do not affect the capacity of oocytes from breast cancer candidates for fertility preservation to mature in vitro. WHAT IS KNOWN ALREADY Mutations in the BRCA1 and BRCA2 genes are associated with an increased risk for developing breast and ovarian cancer. Controversy exists about fertility and ovarian reserve in BRCA mutation carriers. Studies suggest that these patients may have low ovarian reserve and poor response to ovarian stimulation. The impaired ability of the mutated BRCA gene to repair double-strand breaks in DNA may prompt oocyte aging, apoptosis and meiotic errors. IVM of oocytes retrieved at germinal vesicle stage, followed by vitrification of metaphase II (MII) oocytes has recently emerged as an option for young women seeking fertility preservation, when ovarian stimulation is unfeasible. STUDY DESIGN, SIZE, DURATION Retrospective cohort study involving 329 breast cancer candidates for fertility preservation using IVM between January 2014 and December 2017. PARTICIPANTS/MATERIALS, SETTING, METHODS Inclusion criteria were: age 18-40 years; two ovaries present; no history of chemotherapy; test for BRCA 1/2 mutations performed. Before immature oocyte retrieval, all follicles measuring 2-9 mm in diameter were precisely counted on both ovaries and serum anti-Müllerian hormone (AMH) was measured irrespective of the phase of the cycle. Number of cumulus oocyte complexes (COC) retrieved, maturation rate and number of MII oocytes cryopreserved were compared according to BRCA mutation status. MAIN RESULTS AND THE ROLE OF CHANCE Overall, BRCA-mutated women (n = 52) and BRCA-negative women (n = 277) were comparable in terms of age (31.7 ± 3.9 versus 32.3 ± 3.8 years, respectively, P = 0.3), BMI (23.4 ± 4.7 versus 22.6 ± 3.7 kg/m2, respectively, P = 0.3) and ovarian reserve tests (antral follicle count: 20.5 ± 11.4 versus 21.7 ± 12.1 follicles, P = 0.5; serum AMH levels: 3.6 ± 2.9 versus 4.1 ± 3.6 ng/ml, P = 0.3, respectively). The number of COCs retrieved did not differ significantly between both groups (8.9 ± 6.9 versus 9.9 ± 8.1 oocytes, P = 0.5). After similar IVM rates (67 ± 24 versus 62 ± 23%, P = 0.2), the number of MII oocytes cryopreserved was similar in patients presenting BRCA mutation or not (5.1 ± 3.8 versus 6.1 ± 5.1, P = 0.1, respectively). LIMITATIONS, REASONS FOR CAUTION Given the low incidence of the mutation, these preliminary findings should be confirmed by further multi-center studies. WIDER IMPLICATIONS OF THE FINDINGS Although BRCA mutations are known to alter DNA repair mechanism, it does not seem to impair oocyte capacity to mature in vitro. STUDY FUNDING/COMPETING INTEREST(s) None.
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Affiliation(s)
- Michaël Grynberg
- Department of Reproductive Medicine and Fertility Preservation, Hôpital Antoine Béclère, Hôpitaux Universitaires Paris Sud, Assistance Publique - Hôpitaux de Paris, Clamart, France.,Department of Reproductive Medicine and Fertility Preservation, Hôpital Jean Verdier, Hôpitaux Universitaires Paris-Seine-Saint-Denis, Assistance Publique- Hôpitaux de Paris, Bondy, France.,Université Paris-Sud, Université Paris Saclay, Le Kremlin Bicêtre, France.,Inserm U1133 Université Paris Diderot, Paris, France
| | - Bénédicte Dagher Hayeck
- Department of Reproductive Medicine and Fertility Preservation, Hôpital Jean Verdier, Hôpitaux Universitaires Paris-Seine-Saint-Denis, Assistance Publique- Hôpitaux de Paris, Bondy, France
| | | | - Christophe Sifer
- Department of Cytogenetic and Reproductive Biology, Hôpital Jean Verdier, Hôpitaux Universitaires Paris-Seine-Saint-Denis, Assistance Publique - Hôpitaux de Paris, Bondy, France
| | - Nathalie Sermondade
- Department of Cytogenetic and Reproductive Biology, Hôpital Jean Verdier, Hôpitaux Universitaires Paris-Seine-Saint-Denis, Assistance Publique - Hôpitaux de Paris, Bondy, France
| | - Charlotte Sonigo
- Department of Reproductive Medicine and Fertility Preservation, Hôpital Antoine Béclère, Hôpitaux Universitaires Paris Sud, Assistance Publique - Hôpitaux de Paris, Clamart, France.,Inserm U1185 Université Paris-Sud, Université Paris Saclay, Le Kremlin Bicêtre, France
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13
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Kirillova A, Kovalskaya E, Brovkina O, Ekimov A, Bunyaeva E, Gordiev M, Mishieva N, Nazarenko T, Abubakirov A, Sukikh G. Cryopreservation of euploid blastocysts obtained after fertilization of in vitro matured ovarian tissue oocytes: a case report. J Assist Reprod Genet 2020; 37:905-911. [PMID: 32206960 PMCID: PMC7183014 DOI: 10.1007/s10815-020-01729-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 02/24/2020] [Indexed: 12/18/2022] Open
Abstract
With the increased rate of stable remission after gonadotoxic cancer treatment, new methods of fertility preservation are required in order to provide the best possible care for oncological patients. Here, we report an original case of euploid blastocyst cryopreservation after in vitro maturation of ovarian tissue oocytes (OTO IVM). Thirty-three oocytes were obtained from the ovarian tissue after ovariectomy in the breast cancer patient. Six out of 12 matured oocytes fertilized successfully and 3 blastocysts were formed. Genetic investigation for mutations associated with this type of malignancy found that the patient is not a carrier. Preimplantation genetic testing was performed only for aneuploidies and found all 3 blastocysts to be euploid and suitable for embryo transfer. Our study showed that the ovarian tissue oocytes matured in vitro have the potential for euploid blastocyst formation after ICSI which could be screened for aneuploidies and inherited mutations and then be vitrified in order to provide the best fertility preservation strategy for women with cancer.
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Affiliation(s)
- Anastasia Kirillova
- National Medical Research Center for Obstetrics, Gynecology and Perinatology named after Academician V.I.Kulakov, of the Ministry of Healthcare of Russian Federation, Moscow, Russia.
| | - Evgeniya Kovalskaya
- National Medical Research Center for Obstetrics, Gynecology and Perinatology named after Academician V.I.Kulakov, of the Ministry of Healthcare of Russian Federation, Moscow, Russia
| | - Olga Brovkina
- Federal Research and Clinical Center, FMBA of Russia, Moscow, Russia
| | - Aleksey Ekimov
- National Medical Research Center for Obstetrics, Gynecology and Perinatology named after Academician V.I.Kulakov, of the Ministry of Healthcare of Russian Federation, Moscow, Russia
| | - Ekaterina Bunyaeva
- National Medical Research Center for Obstetrics, Gynecology and Perinatology named after Academician V.I.Kulakov, of the Ministry of Healthcare of Russian Federation, Moscow, Russia
| | | | - Nona Mishieva
- National Medical Research Center for Obstetrics, Gynecology and Perinatology named after Academician V.I.Kulakov, of the Ministry of Healthcare of Russian Federation, Moscow, Russia
| | - Tatiana Nazarenko
- National Medical Research Center for Obstetrics, Gynecology and Perinatology named after Academician V.I.Kulakov, of the Ministry of Healthcare of Russian Federation, Moscow, Russia
| | - Aydar Abubakirov
- National Medical Research Center for Obstetrics, Gynecology and Perinatology named after Academician V.I.Kulakov, of the Ministry of Healthcare of Russian Federation, Moscow, Russia
| | - Gennady Sukikh
- National Medical Research Center for Obstetrics, Gynecology and Perinatology named after Academician V.I.Kulakov, of the Ministry of Healthcare of Russian Federation, Moscow, Russia
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14
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Sonigo C, Bajeux J, Boubaya M, Eustache F, Sifer C, Lévy V, Grynberg M, Sermondade N. In vitro maturation is a viable option for urgent fertility preservation in young women with hematological conditions. Hematol Oncol 2020; 38:560-564. [PMID: 32065670 DOI: 10.1002/hon.2724] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 02/04/2020] [Accepted: 02/12/2020] [Indexed: 12/19/2022]
Abstract
Fertility preservation embraces different techniques developed to improve young women chances of becoming mothers after healing. Among them, in vitro maturation (IVM) procedure is based on oocyte retrieval without any gonadotropin treatment, feasible under locoregional or local anesthesia, with very low operative complications. The present retrospective analysis of a preliminary case series of 25 women diagnosed with Hodgkin or non-Hodgkin lymphoma aims to evaluate the feasibility of IVM for urgent fertility preservation purposes in hematological context. A median of five mature oocytes was cryopreserved after one cycle of IVM, performed without delaying the start of the chemotherapy (median delay from histological diagnosis to start of the chemotherapy 17.5 days). No association was found between lymphomas' characteristics and the number of recovered or frozen oocytes. Although experimental, this technique could be relevant when fertility preservation has to be performed within a short time frame and without additional surgery nor any risk of malignant cells reintroduction.
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Affiliation(s)
- Charlotte Sonigo
- Department of Reproductive Medicine and Fertility Preservation, Hôpital Jean Verdier, Hôpitaux Universitaires Paris-Seine-Saint-Denis, Assistance Publique - Hôpitaux de Paris, Bondy, France.,Inserm U1185 Université Paris-Sud, Université Paris Saclay, Le Kremlin Bicêtre, France
| | - Jeanne Bajeux
- Department of Reproductive Medicine and Fertility Preservation, Hôpital Jean Verdier, Hôpitaux Universitaires Paris-Seine-Saint-Denis, Assistance Publique - Hôpitaux de Paris, Bondy, France
| | - Marouane Boubaya
- Département de recherche clinique, Groupe Hospitalier Paris Seine Saint Denis, Assistance Publique -Hôpitaux de Paris, Université Paris 13, Bobigny et INSERM U1153, Paris, France
| | - Florence Eustache
- Department of Cytogenetic and Reproductive Biology, Hôpital Jean Verdier, Hôpitaux Universitaires Paris-Seine-Saint-Denis, Assistance Publique - Hôpitaux de Paris, Bondy, France
| | - Christophe Sifer
- Department of Cytogenetic and Reproductive Biology, Hôpital Jean Verdier, Hôpitaux Universitaires Paris-Seine-Saint-Denis, Assistance Publique - Hôpitaux de Paris, Bondy, France
| | - Vincent Lévy
- Département de recherche clinique, Groupe Hospitalier Paris Seine Saint Denis, Assistance Publique -Hôpitaux de Paris, Université Paris 13, Bobigny et INSERM U1153, Paris, France
| | - Michaël Grynberg
- Department of Reproductive Medicine and Fertility Preservation, Hôpital Jean Verdier, Hôpitaux Universitaires Paris-Seine-Saint-Denis, Assistance Publique - Hôpitaux de Paris, Bondy, France.,Inserm U1185 Université Paris-Sud, Université Paris Saclay, Le Kremlin Bicêtre, France.,Unité de Formation et de Recherche Santé Médecine et Biologie Humaine, Université Paris 13, Communauté d'Universités et Etablissements Sorbonne Paris Cité, Paris, France Inserm U1133 Université Paris Diderot, Paris, France
| | - Nathalie Sermondade
- Department of Cytogenetic and Reproductive Biology, Hôpital Jean Verdier, Hôpitaux Universitaires Paris-Seine-Saint-Denis, Assistance Publique - Hôpitaux de Paris, Bondy, France
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15
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Yu EJ, Yoon TK, Lee WS, Park EA, Heo JY, Ko YK, Kim J. Obstetrical, neonatal, and long-term outcomes of children conceived from in vitro matured oocytes. Fertil Steril 2019; 112:691-699. [PMID: 31371040 DOI: 10.1016/j.fertnstert.2019.05.034] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 05/23/2019] [Accepted: 05/28/2019] [Indexed: 01/13/2023]
Abstract
OBJECTIVE To investigate the obstetrical, neonatal, and long-term outcomes of in vitro maturation (IVM) compared with conventional in vitro fertilization (IVF) in women with polycystic ovarian syndrome (PCOS). DESIGN Matched retrospective case-control study. SETTING University fertility clinic. PATIENT(S) One hundred eighty-four patients undergoing IVM were compared with 366 patients undergoing conventional IVF. All had PCOS and were matched for patient age, gestational age at birth, and the number of fetuses. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Obstetrics, neonatal outcomes, and childhood medical problems and development. RESULT(S) Women's mean age at oocytes retrieval was 32.6 ± 2.9 years. Children's mean age was 7.5 ± 2.3 years. There were no differences in the frequency of obstetrical and neonatal outcomes between the two groups. No difference was found in birth weights between the two groups. The incidence of congenital anomalies was similar between the groups (4.3% in IVM group vs. 4.1% in IVF group). No significant difference was observed between the two groups in the frequency and duration of hospitalization during childhood. Growth developmental status of both groups was within normal range. CONCLUSION(S) In a matched setting between IVM and IVF babies born from women with PCOS, no significant increased risk associated with IVM was been identified after a mean follow-up of 7.5 years.
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Affiliation(s)
- Eun Jeong Yu
- Department of Obstetrics and Gynecology, CHA Seoul Fertility Center, CHA University, Seoul, Republic of Korea
| | - Tae Ki Yoon
- Department of Obstetrics and Gynecology, CHA Seoul Fertility Center, CHA University, Seoul, Republic of Korea
| | - Woo Sik Lee
- Department of Obstetrics and Gynecology, Fertility Center of CHA Gangnam Medical Center, CHA University, Seoul, Republic of Korea
| | - Eun A Park
- Department of Obstetrics and Gynecology, CHA Seoul Fertility Center, CHA University, Seoul, Republic of Korea
| | - Jin Young Heo
- Department of Obstetrics and Gynecology, CHA Seoul Fertility Center, CHA University, Seoul, Republic of Korea
| | - Ye Kyu Ko
- Department of Obstetrics and Gynecology, CHA Seoul Fertility Center, CHA University, Seoul, Republic of Korea
| | - Jayeon Kim
- Department of Obstetrics and Gynecology, CHA Seoul Fertility Center, CHA University, Seoul, Republic of Korea.
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16
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Vuong LN, Ho TM, Gilchrist RB, Smitz J. The Place of In Vitro Maturation in Assisted Reproductive Technology. FERTILITY & REPRODUCTION 2019. [DOI: 10.1142/s2661318219300022] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
In vitro maturation (IVM) is an assisted reproductive technology (ART) whereby immature cumulus-oocyte complexes are collected and matured in vitro, without need for controlled ovarian stimulation and ovulation triggering. Advantages of IVM over in vitro fertilization (IVF) include mild or no stimulation, lower medication costs and less patient burden. However, early clinical outcomes with IVM were suboptimal. More recently, clinical studies reported live birth rates after IVM of about 40%. New IVM culture systems are being used to improve the efficacy of IVM. These have been in widespread use for animals for many years and are now showing promise in the clinical setting. Patients more likely to benefit from IVM over IVF include those at risk of OHSS (e.g. women with polycystic ovary syndrome), when the time for ovarian stimulation is limited, or where sustained elevations of estradiol are contraindicated (e.g. oncofertility indications). The main barrier to use of IVM to date was its relative efficacy compared with IVF, and there have also been concerns over the health of infants born following IVM. However, no differences in congenital abnormalities between IVM and other ARTs have been identified. In addition, there is a lack of both experience and standardized protocols. Strategies to overcome barriers to the use of IVM include better training for clinicians, more and better funded research in the field, and improved recognition of IVM by fertility specialists. Overall, IVM offers a valuable alternative for ART in select patient populations. New approaches to IVM appear to have the potential to achieve pregnancy outcomes equivalent to those after IVF. Increasing the use of IVM in the future can be achieved with improved training and education for fertility specialists, and increased funding for IVM research, with the ultimate goal of improving fertility outcomes.
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Affiliation(s)
- Lan N. Vuong
- Department of Obstetrics and Gynecology, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
- HOPE Research Center, My Duc Hospital, Ho Chi Minh City, Vietnam
| | - Tuong M. Ho
- HOPE Research Center, My Duc Hospital, Ho Chi Minh City, Vietnam
| | - Robert B. Gilchrist
- Fertility and Research Centre, School of Women’s and Children’s Health, University of New South Wales Sydney, Australia
| | - Johan Smitz
- Follicle Biology Laboratory, Vrije Universiteit Brussels, Brussels, Belgium
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Shao YH, Zhang XY, Buckett W, Ao A. Impact of in vitro fertilization-preimplantation genetic testing (IVF-PGT) funding policy on clinical outcome: An issue that stems beyond effectiveness of treatment. Eur J Obstet Gynecol Reprod Biol 2019; 235:1-5. [PMID: 30743159 DOI: 10.1016/j.ejogrb.2019.01.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Revised: 12/10/2018] [Accepted: 01/01/2019] [Indexed: 01/02/2023]
Abstract
OBJECTIVE(S) The aim of this study was to compare the patient characteristics, type of genetic disease and inheritance, volume of activity, practice patterns and pregnancy outcomes, in private versus publically funded IVF pre-implantation genetic testing (PGT) for translocation (IVF-PGT-SR) and aneuploidy (PGT-A) periods. STUDY DESIGN This study retrospectively analyzed data during both privately funded period (PRP) and publically funded period (PUP) of assisted reproductive technology (ART) for a total of 275 patients. 83 patients underwent IVF-PGT-SR and 192 patients underwent IVF-PGT-A. Given that PGT-SR is a chromosomal abnormality hereditary in nature, whereas PGT-A is sporadic in addition to the contrasting funding policies, the two cohorts were analyzed separately. To achieve the proposed objective, the two groups under analysis were grouped in accordance with their respective coverage systems for infertility. RESULTS Among translocation patients, 94 normal/balanced embryos were obtained from 47 IVF-PGT cycles in PRP whereas 145 embryos were obtained from 92 IVF-PGT cycles in PUP. The average number of embryos transferred per embryo transfer cycle was significantly lower in PUP in comparison to PRP (1.13 vs. 1.74, p < 0.0001). 13 singletons and 2 sets of twins were conceived in PRP. 14 singletons were conceived in PUP. Regardless of funding period, there were more reciprocal translocation carriers (79.4% in PRP and 76.4% in PUP) and more male carriers (82.4% in PRP and 60% in PUP), of which the majority had abnormal sperm parameters. Among aneuploidy patients, on average 2.5 embryos in PRP and 1.4 embryos in PUP were transferred per ET cycle (p = 0.05). There was a 13.3% increase in number of IVF-PGT-A attempts per patient in PRP compared to PUP. Live birth rate per IVF-PGT-A was higher in PRP (29.7% vs. 15%, P = 0.02), which consisted of 48 singletons and 18 multiparous pregnancies in PRP and 9 singletons in PUP. CONCLUSION(S) Public coverage of ART is associated with a greater utilization ART, as well as a reduced number in embryo transfer (ET) per cycle, a lower proportion of cycles resulting in successful pregnancy and a lower multiple birth rate. Our study ultimately shines light on the effect of providers' and patients' monetary conscious on pregnancy outcome.
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Affiliation(s)
- Yi-Hong Shao
- Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Xiao Yun Zhang
- MUHC Reproductive Centre, Department of Obstetrics and Gynecology, McGill Univeristy, Montreal, Quebec, Canada
| | - William Buckett
- MUHC Reproductive Centre, Department of Obstetrics and Gynecology, McGill Univeristy, Montreal, Quebec, Canada
| | - Asangla Ao
- MUHC Reproductive Centre, Department of Obstetrics and Gynecology, McGill Univeristy, Montreal, Quebec, Canada; Department of Human Genetics, McGill University, Montreal, Quebec, Canada.
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Vuong LN, Ho VNA, Ho TM, Dang VQ, Phung TH, Giang NH, Le AH, Pham TD, Wang R, Norman RJ, Smitz J, Gilchrist RB, Mol BW. Effectiveness and safety of in vitro maturation of oocytes versus in vitro fertilisation in women with high antral follicle count: study protocol for a randomised controlled trial. BMJ Open 2018; 8:e023413. [PMID: 30530584 PMCID: PMC6303647 DOI: 10.1136/bmjopen-2018-023413] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
INTRODUCTION In vitro maturation (IVM) is a potential alternative to conventional in vitro fertilisation (IVF) to avoid ovarian hyperstimulation syndrome (OHSS). This is particularly relevant in women with a high antral follicle count (AFC) and/or polycystic ovary syndrome (PCOS), who are at increased risk for OHSS. However, no randomised controlled trials of IVM versus IVF in women with high AFC have reported both pregnancy and OHSS rates. The aim of this study is to compare the effectiveness and safety of one IVM cycle and one IVF with segmentation cycle within women with PCOS or high AFC-related subfertility. METHODS AND ANALYSIS This randomised controlled trial will be conducted at a specialist IVF centre in Vietnam. Eligible subfertile women with PCOS and/or high AFC will be randomised to undergo either IVM or IVF. The primary outcome is live birth after the first embryo transfer of the started treatment cycle. Cycles in which no embryo is available for transfer will be considered as failures. The study has a non-inferiority design, with a maximal acceptable between-group difference of 5%. Rates of OHSS will also be reported. ETHICS AND DISSEMINATION Ethical approval was obtained from the participating centre, and informed patient consent was obtained before study enrolment. Results of the study will be submitted for publication in a peer-reviewed journal. TRIAL REGISTRATION NUMBER NCT03405701; Pre-results.
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Affiliation(s)
- Lan N Vuong
- Department of Obstetrics and Gynaecology, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
- IVFMD, My Duc Hospital, Ho Chi Minh City, Vietnam
| | - Vu N A Ho
- IVFMD, My Duc Hospital, Ho Chi Minh City, Vietnam
| | - Tuong M Ho
- IVFMD, My Duc Hospital, Ho Chi Minh City, Vietnam
| | - Vinh Q Dang
- IVFMD, My Duc Hospital, Ho Chi Minh City, Vietnam
| | - Tuan H Phung
- IVFMD, My Duc Hospital, Ho Chi Minh City, Vietnam
| | - Nhu H Giang
- IVFMD, My Duc Hospital, Ho Chi Minh City, Vietnam
| | - Anh H Le
- IVFMD, My Duc Hospital, Ho Chi Minh City, Vietnam
| | - Toan D Pham
- IVFMD, My Duc Hospital, Ho Chi Minh City, Vietnam
| | - Rui Wang
- Robinson Research Institute and Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia
| | - Rob J Norman
- Robinson Research Institute and Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia
- Fertility SA, Adelaide, South Australia, Australia
| | - Johan Smitz
- Follicle Biology Laboratory, Free University of Brussels (VUB), Brussels, Belgium
| | - Robert B Gilchrist
- School of Women's and Children's Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Ben W Mol
- Department of Obstetrics and Gynaecology, School of Medicine, Monash University, Melbourne, Victoria, Australia
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Sermondade N, Sonigo C, Sifer C, Valtat S, Ziol M, Eustache F, Grynberg M. Serum antimüllerian hormone is associated with the number of oocytes matured in vitro and with primordial follicle density in candidates for fertility preservation. Fertil Steril 2018; 111:357-362. [PMID: 30527837 DOI: 10.1016/j.fertnstert.2018.10.018] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 10/11/2018] [Accepted: 10/18/2018] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To assess whether serum antimüllerian hormone (AMH) levels and antral follicle count (AFC) can predict primordial follicle density within ovarian cortex and the number of oocytes cryopreserved after in vitro maturation (IVM). DESIGN Retrospective analysis of a case series of patients. SETTING University hospital. PATIENT(S) Fifty-four women, 18 to 35 years of age, with breast cancer who were candidates for fertility preservation (FP) using ovarian tissue cryopreservation (OTC) associated with oocyte vitrification after unstimulated IVM between July 2013 and December 2016. INTERVENTION(S) Serum AMH levels and transvaginal AFC evaluated before FP, cumulus-oocyte complexes (COC) recovered under ultrasound guidance and incubated for IVM, and ovarian tissue laparoscopically harvested and cryopreserved. MAIN OUTCOME MEASURE(S) Univariate and multivariate analysis between ovarian reserve tests, number of recovered and in vitro matured oocytes, and primordial follicle density histologically obtained within ovarian cortex. RESULT(S) Univariate analysis showed a statistically significant correlation between AMH or AFC and primordial follicle density. Multivariate analysis showed a predominant statistically significant correlation of serum AMH with density. Antimüllerian hormone also correlated with the number of COC and in vitro matured oocytes. CONCLUSION(S) Serum AMH levels may reflect the primordial follicle stockpile and may predict outcomes of IVM and OTC when performed for FP. Further analyses are required to evaluate the relevance of performing such procedures in young women who have low values on ovarian reserve tests.
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Affiliation(s)
- Nathalie Sermondade
- Department of Cytogenetic and Reproductive Biology, Hôpital Jean Verdier, Hôpitaux Universitaires Paris-Seine-Saint-Denis, Assistance Publique, Hôpitaux de Paris, Bondy, France.
| | - Charlotte Sonigo
- Department of Reproductive Medicine and Fertility Preservation, Hôpital Jean Verdier, Hôpitaux Universitaires Paris-Seine-Saint-Denis, Assistance Publique, Hôpitaux de Paris, Bondy, France; Inserm U1185, Université Paris-Sud, Université Paris Saclay, Le Kremlin Bicêtre, France
| | - Christophe Sifer
- Department of Cytogenetic and Reproductive Biology, Hôpital Jean Verdier, Hôpitaux Universitaires Paris-Seine-Saint-Denis, Assistance Publique, Hôpitaux de Paris, Bondy, France
| | - Sophie Valtat
- Inserm UMR1169, Université Paris-Sud, Université Paris Saclay, Le Kremlin Bicêtre, France
| | - Marianne Ziol
- Service d'Anatomie Pathologique, Hôpital Jean Verdier, Hôpitaux Universitaires Paris-Seine-Saint-Denis, Assistance Publique, Hôpitaux de Paris, Bondy, France; Unité de Formation et de Recherche Santé Médecine et Biologie Humaine, Université Paris 13, Communauté d'Universités et Etablissements Sorbonne Paris Cité, Paris, France
| | - Florence Eustache
- Department of Cytogenetic and Reproductive Biology, Hôpital Jean Verdier, Hôpitaux Universitaires Paris-Seine-Saint-Denis, Assistance Publique, Hôpitaux de Paris, Bondy, France
| | - Michaël Grynberg
- Department of Reproductive Medicine and Fertility Preservation, Hôpital Jean Verdier, Hôpitaux Universitaires Paris-Seine-Saint-Denis, Assistance Publique, Hôpitaux de Paris, Bondy, France; Unité de Formation et de Recherche Santé Médecine et Biologie Humaine, Université Paris 13, Communauté d'Universités et Etablissements Sorbonne Paris Cité, Paris, France; Inserm U1133 Université Paris Diderot, Paris, France
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Comparison of GnRH agonist and hCG for priming in vitro maturation cycles in cancer patients undergoing urgent fertility preservation. PLoS One 2018; 13:e0208576. [PMID: 30521621 PMCID: PMC6283534 DOI: 10.1371/journal.pone.0208576] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Accepted: 11/20/2018] [Indexed: 11/20/2022] Open
Abstract
In vitro maturation (IVM) of oocytes retrieved at germinal vesicle or Metaphase I stage, followed by vitrification of Metaphase II (MII) oocytes, has recently emerged as an option for urgent fertility preservation (FP). Priming is usually achieved with an injection of hCG, 10,000 IU, 36 hours before retrieval. This study aimed to assess a new method of priming, using GnRH agonists, and compare it to hCG, in cancer patients undergoing urgent FP. From 2009 to 2015, 373 cancer patients underwent MII oocyte cryopreservation after IVM cycles primed either with GnRHa (triptorelin 0.2 mg) (n = 138) or hCG (10,000 IU) (n = 235). Patients’ characteristics were comparable between the two groups. The number of COC retrieved was significantly higher in the GnRHa group (9.1 ± 6.8 versus 7.7 ± 5.5 oocytes, p = 0.04). However, the maturation rates (59 ±25% versus 64 ±26%, p = 0.07, respectively), and the total number of MII oocytes frozen (5.2 ±4.2 versus 4.9 ±4.0, p = 0.6, respectively) were similar between the GnRha and hCG groups. We did not find any difference between GnRHa and hCG priming for IVM. GnRHa priming is more physiological since it stimulates endogenous FSH and LH activity, and is well suited for FP in hormone-sensitive cancers and urgent cases.
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Ho VNA, Pham TD, Le AH, Ho TM, Vuong LN. Live birth rate after human chorionic gonadotropin priming in vitro maturation in women with polycystic ovary syndrome. J Ovarian Res 2018; 11:70. [PMID: 30149808 PMCID: PMC6112143 DOI: 10.1186/s13048-018-0445-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 08/16/2018] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND In vitro maturation (IVM) has some advantages over conventional in vitro fertilization (IVF), particularly in polycystic ovary syndrome (PCOS) where the risk of ovarian hyperstimulation is high. We studied the live birth rate in a large series of PCOS women undergoing human chorionic gonadotropin (hCG)-priming IVM. METHODS This retrospective study included women with PCOS aged 18-42 years undergoing IVM with hCG priming. We reported live birth rate after the first embryo transfer and cumulative live birth rate from embryos obtained in the IVM cycle. We also performed logistic regression to assess which factors predicted number of oocytes and live birth. RESULTS We included 921 women (age 28.9±3.5 years, body mass index 21.8±3.1 kg/m2, infertility duration 3.7±2.6 years, 81% primary infertility, 88% first IVF attempt, 94% ovulation induction failure). Live birth rate after the first embryo transfer was 31.7%, with a cumulative live birth rate from the cycle of 33.7%. High anti-Müllerian hormone levels predicted a high number of oocytes and a high oocyte maturation rate while the opposite was the case when luteinizing hormone levels were high. CONCLUSIONS In women with PCOS, hCG priming IVM was feasible and resulted in acceptable live birth rates.
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Affiliation(s)
- V. N. A. Ho
- IVFMD, My Duc Hospital, Ho Chi Minh City, Vietnam
| | - T. D. Pham
- IVFMD, My Duc Hospital, Ho Chi Minh City, Vietnam
| | - A. H. Le
- IVFMD, My Duc Hospital, Ho Chi Minh City, Vietnam
| | - T. M. Ho
- IVFMD, My Duc Hospital, Ho Chi Minh City, Vietnam
| | - L. N. Vuong
- IVFMD, My Duc Hospital, Ho Chi Minh City, Vietnam
- Department of Obstetrics and Gynecology, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
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Hatırnaz Ş, Ata B, Hatırnaz ES, Dahan MH, Tannus S, Tan J, Tan SL. Oocyte in vitro maturation: A sytematic review. Turk J Obstet Gynecol 2018; 15:112-125. [PMID: 29971189 PMCID: PMC6022428 DOI: 10.4274/tjod.23911] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2018] [Accepted: 04/26/2018] [Indexed: 02/07/2023] Open
Abstract
In vitro maturation (IVM) is one of the most controversial aspects of assisted reproductive technology. Although it has been studied extensively, it is still not a conventional treatment option and is accepted as an alternative treatment. However, studies have shown that IVM can be used in almost all areas where in vitro fertilization (IVF) is used and it has a strong place in fertility protection and Ovarian Hyperstimulation syndrome management. The aim of this systematic review was to address all aspects of the current knowledge of IVM treatment together with the evolution of IVM and IVF.
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Affiliation(s)
- Şafak Hatırnaz
- Medicana International Hospital, In Vitro Fertilization Center, Samsun, Turkey
| | - Barış Ata
- Koç University Faculty of Medicine, Department of Obstetrics and Gynecology, In Vitro Fertilization Center, İstanbul, Turkey
| | | | - Michael Haim Dahan
- Mc Gill University Faculty of Medicine, Department of Obstetrics and Gynecology, Quebec, Canada
| | - Samer Tannus
- Mc Gill University Faculty of Medicine, Department of Obstetrics and Gynecology, Quebec, Canada
| | - Justin Tan
- Mc Gill University Faculty of Medicine, Department of Obstetrics and Gynecology, Quebec, Canada
| | - Seang Lin Tan
- Originelle Women and Reproductive Medicine Center, Clinic of Obstetrics and Gynecology, Montreal, Quebec, Canada
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Fesahat F, Kalantar SM, Sheikhha MH, Saeedi H, Montazeri F, Firouzabadi RD, Khalili MA. Developmental and cytogenetic assessments of preimplantation embryos derived from in-vivo or in-vitro matured human oocytes. Eur J Med Genet 2018; 61:235-241. [DOI: 10.1016/j.ejmg.2017.12.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2017] [Revised: 10/25/2017] [Accepted: 12/06/2017] [Indexed: 12/28/2022]
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Developmental competence and apoptotic gene expression patterns of mature and immature human oocytes retrieved from controlled ovarian stimulation cycles. Reprod Biol 2017; 18:27-32. [PMID: 29196048 DOI: 10.1016/j.repbio.2017.11.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2017] [Revised: 11/14/2017] [Accepted: 11/21/2017] [Indexed: 11/22/2022]
Abstract
The purpose was to assess the developmental competence of the in vitro or in vivo matured human oocytes as well as the apoptotic genes expression of cumulus cells (CCs) regarding nuclear maturity status of associated oocytes retrieved from stimulated ICSI cycles. A total of 590 oocytes and the associated CCs were retrieved and divided into groups of test and control according to the nuclear maturity status in order to the developmental evaluation as well as expression patterns of apoptosis-related genes using real time PCR. The fertilization and embryo formation rates were 60.3% and 87.5% vs.69.1% and 92.8% in test and control groups, respectively. Good quality embryos on day 3 were 62.2% in test and 69.1% in control groups. There were significant differences in the rates of normal fertilized as well as unfertilized oocytes between the groups. Also, mRNA levels of some apoptotic genes were significantly higher in the CCs obtained from immature oocytes among patients with premature ovarian factors (POF) rather than other infertility etiologies (p < 0.001). The data demonstrated the developmental competence of in vitro matured oocytes -even to good quality cleavage embryos- is not completely consistent with molecular integrity and well-mannered gene expression patterns resulting to ICSI success. It seems that using immature oocytes could be helpful for patients at risk of ovarian hyperstimulation syndrome (OHSS) as the same as patients with diminished ovarian reserve.
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25
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Ho JR, Paulson RJ. Modified natural cycle in in vitro fertilization. Fertil Steril 2017; 108:572-576. [DOI: 10.1016/j.fertnstert.2017.08.021] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Accepted: 08/10/2017] [Indexed: 11/30/2022]
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Shirasawa H, Terada Y. In vitro maturation of human immature oocytes for fertility preservation and research material. Reprod Med Biol 2017; 16:258-267. [PMID: 29259476 PMCID: PMC5715881 DOI: 10.1002/rmb2.12042] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Accepted: 05/22/2017] [Indexed: 01/10/2023] Open
Abstract
Aim In recent years, the importance of fertility preservation (FP) has increased. In vitro maturation (IVM), an important technique in FP, has started to be used in the clinic, but controversies persist regarding this technique. Here, a survey of IVM for FP is provided. Methods Based on a literature review, the applications of FP, methods of FP, IVM of oocytes that had been collected in vivo and ex vivo, maturation of oocytes after IVM for FP, cryopreservation of oocytes for FP, explanation of the procedures to patients, and recent research on FP using IVM were investigated. Results Although IVM for FP remains controversial, the application of FP is expected to expand. Depending on the age and disease status of the patient, various methods of oocyte collection and ovarian stimulation, as well as various needle types and aspiration pressures, have been reported. The maturation rate of IVM in FP ranges widely and requires optimization in the future. In regard to cryopreservation for matured oocytes, the vitrification method is currently recommended. Conclusion Regarding FP for patients with cancer, the treatment of cancer is prioritized; thus, the time and use of medicines are often constrained. As several key points regarding IVM remain unclear, well‐designed and specific counseling for patients is necessary.
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Affiliation(s)
- Hiromitsu Shirasawa
- Department of Obstetrics and Gynecology Akita University Graduate School of Medicine Akita Japan
| | - Yukihiro Terada
- Department of Obstetrics and Gynecology Akita University Graduate School of Medicine Akita Japan
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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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Time-lapse imaging reveals differences in growth dynamics of embryos after in vitro maturation compared with conventional stimulation. Fertil Steril 2017; 107:606-612.e3. [DOI: 10.1016/j.fertnstert.2016.12.026] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Revised: 12/16/2016] [Accepted: 12/21/2016] [Indexed: 12/30/2022]
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Can we modify assisted reproductive technology practice to broaden reproductive care access? Fertil Steril 2016; 105:1138-1143. [DOI: 10.1016/j.fertnstert.2016.03.013] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Revised: 02/20/2016] [Accepted: 03/04/2016] [Indexed: 12/15/2022]
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Affiliation(s)
- Michel De Vos
- Clinical Professor of Reproductive Medicine, Centre for Reproductive Medicine, UZ Brussel, Belgium
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32
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Grynberg M, Poulain M, le Parco S, Sifer C, Fanchin R, Frydman N. Similar in vitro maturation rates of oocytes retrieved during the follicular or luteal phase offer flexible options for urgent fertility preservation in breast cancer patients. Hum Reprod 2016; 31:623-9. [PMID: 26759139 DOI: 10.1093/humrep/dev325] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2015] [Accepted: 11/30/2015] [Indexed: 12/23/2022] Open
Abstract
STUDY QUESTION Are in vitro maturation (IVM) rates of cumulus-oocyte complexes (COCs), retrieved from breast cancer patients seeking urgent fertility preservation (FP) before neoadjuvant chemotherapy, different between those recovered in the follicular or in the luteal phase of the cycle? SUMMARY ANSWER The present investigation reveals no major difference in the number of COCs recovered or their IVM rates whatever the phase of the cycle at which egg retrieval is performed, suggesting that IVM is a promising tool for breast cancer patients seeking urgent oocyte cryopreservation. WHAT IS KNOWN ALREADY FP now represents a standard of care for young cancer patients having to undergo gonadotoxic treatment. Mature oocyte cryopreservation after IVM of COCs has been proposed for urgent FP, especially in women, who have no time to undergo ovarian stimulation, or when it is contraindicated. STUDY DESIGN, SIZE, DURATION From January 2011 to December 2014, we prospectively studied 248 breast cancer patients awaiting neoadjuvant chemotherapy, aged 18-40 years, candidates for oocyte vitrification following IVM, either at the follicular or the luteal phase of the cycle. PARTICIPANTS/MATERIALS, SETTING, METHODS Serum anti-Müllerian hormone and progesterone levels and antral follicle count (AFC) were measured prior to oocyte retrieval. Patients were sorted into two groups according to the phase of the cycle during which eggs were harvested (Follicular phase group, n = 127 and Luteal phase group, n = 121). Number of COCs recovered, maturation rates after 48 h of culture and total number of oocytes cryopreserved were assessed. Moreover, the oocyte retrieval rate (ORR) was calculated by the number of COCs recovered ×100/AFC. MAIN RESULTS AND THE ROLE OF CHANCE In the Follicular and the Luteal phase groups, women were comparable in terms of age, BMI and markers of follicular ovarian status. There was no significant difference in the number of COCs recovered (mean ± SEM), 9.3 ± 0.7 versus 11.1 ± 0.8, and ORR (median (range)) 43.1 (1-100) versus 47.8 (7.7-100)%. Moreover, maturation rates after 48 h of culture (median (range)) were comparable in the follicular and luteal phase groups, 66.7 (20-100) versus 64.5 (0-100)%. Finally, the total number of oocytes cryopreserved (mean ± SEM) was similar in both groups (6.2 ± 0.4 versus 6.8 ± 0.5). LIMITATIONS, REASONS FOR CAUTION Despite the intact meiotic competence of immature oocytes recovered during the follicular or the luteal phase, there is a dramatic lack of data regarding the outcome of IVM oocytes cryopreserved in cancer patients. WIDER IMPLICATIONS OF THE FINDINGS IVM of oocytes may be an interesting method of FP in urgent situations. Improving the culture conditions will be needed to increase the maturation rates and the overall potential of in vitro matured oocytes. STUDY FUNDING/COMPETING INTERESTS None. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- M Grynberg
- Department of Reproductive Medicine, AP-HP, Hôpital Jean Verdier, Avenue du 14 Juillet, 93140 Bondy, France University Paris XIII, 93000 Bobigny, France Unit Inserm U1133, Université Paris-Diderot, 75013 Paris, France
| | - M Poulain
- Unit of Reproductive Biology, AP-HP, Hôpital Antoine Béclère, Clamart F-92141, France Univ Paris-Sud, Clamart F-92140, France
| | - S le Parco
- Department of Obstetric-Gynecology and Reproductive Medicine, Hôpital Antoine Béclère, Clamart F-92140, France
| | - C Sifer
- Department of Cytogenetic and Reproductive Biology, AP-HP, Hôpital Jean Verdier, Avenue du 14 Juillet, 93140 Bondy, France
| | - R Fanchin
- Unit Inserm U1133, Université Paris-Diderot, 75013 Paris, France Univ Paris-Sud, Clamart F-92140, France Department of Obstetric-Gynecology and Reproductive Medicine, Hôpital Antoine Béclère, Clamart F-92140, France
| | - N Frydman
- Unit of Reproductive Biology, AP-HP, Hôpital Antoine Béclère, Clamart F-92141, France Univ Paris-Sud, Clamart F-92140, France
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Fan Y, Zhao HC, Liu J, Tan T, Ding T, Li R, Zhao Y, Yan J, Sun X, Yu Y, Qiao J. Aberrant expression of maternal Plk1 and Dctn3 results in the developmental failure of human in-vivo- and in-vitro-matured oocytes. Sci Rep 2015; 5:8192. [PMID: 25645239 PMCID: PMC4314639 DOI: 10.1038/srep08192] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Accepted: 01/12/2015] [Indexed: 12/31/2022] Open
Abstract
Fertilisation is the first step in embryonic development, and dynamic changes of key genes may potentially improve assisted reproduction techniques efficiency during this process. Here, we analysed genes that were differentially expressed between oocytes and zygotes and focused on cytokinesis-related genes. Plk1 and Dctn3 were identified as showing dramatic changes in expression during fertilisation and were suggested to play a key role in inducing aneuploidy in zygotes and 8-cell embryos. Moreover, we found that maternal Plk1 and Dctn3 were expressed at lower levels in in vitro matured oocytes, which may have contributed to the high ratio of resulting embryos with abnormal Plk1 and Dctn3 expression levels, thereby reducing the developmental competence of the resulting embryos. Furthermore, the overexpression of Dctn3 can silence Plk1 expression, which suggests a potential regulation mechanism. In conclusion, our present study showed that aberrant expression of Plk1 and Dctn3 increases embryo aneuploidy and developmental failure, particularly in in vitro matured oocytes. Our results facilitate a better understanding of the effects of oocyte maternal gene expression on embryonic development and can be used to improve the outcome of assisted reproduction techniques.
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Affiliation(s)
- Yong Fan
- Key Laboratory for Major Obstetric Diseases of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510150, China
| | - Hong-Cui Zhao
- Center of Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, 100191, China
- Key Laboratory of Assisted Reproduction, Ministry of Education, Beijing, 100191, China
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing, 100191, China
| | - Jianqiao Liu
- Key Laboratory for Major Obstetric Diseases of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510150, China
| | - Tao Tan
- Yunnan Key Laboratory of Primate Biomedical Research and Kunming Biomed International and National Engineering Research Center of Biomedicine and Animal Science, Kunming, 650500, China
| | - Ting Ding
- Center of Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, 100191, China
- Key Laboratory of Assisted Reproduction, Ministry of Education, Beijing, 100191, China
| | - Rong Li
- Center of Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, 100191, China
- Key Laboratory of Assisted Reproduction, Ministry of Education, Beijing, 100191, China
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing, 100191, China
| | - Yue Zhao
- Center of Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, 100191, China
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing, 100191, China
| | - Jie Yan
- Center of Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, 100191, China
- Key Laboratory of Assisted Reproduction, Ministry of Education, Beijing, 100191, China
| | - Xiaofang Sun
- Key Laboratory for Major Obstetric Diseases of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510150, China
| | - Yang Yu
- Center of Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, 100191, China
- Key Laboratory of Assisted Reproduction, Ministry of Education, Beijing, 100191, China
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing, 100191, China
| | - Jie Qiao
- Center of Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, 100191, China
- Key Laboratory of Assisted Reproduction, Ministry of Education, Beijing, 100191, China
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing, 100191, China
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Spits C, Guzman L, Mertzanidou A, Jacobs K, Ortega-Hrepich C, Gilchrist RB, Thompson JG, De Vos M, Smitz J, Sermon K. Chromosome constitution of human embryos generated after in vitro maturation including 3-isobutyl-1-methylxanthine in the oocyte collection medium. Hum Reprod 2014; 30:653-63. [PMID: 25475586 DOI: 10.1093/humrep/deu329] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
STUDY QUESTION Do cleavage-stage embryos obtained from oocytes matured in vitro after pre-incubation with a phosphodiesterase inhibitor (IBMX) carry more chromosomal abnormalities than those generated from oocytes matured in vivo? SUMMARY ANSWER The rate and type of chromosomal abnormalities in normally developing cleavage-stage embryos generated with an in vitro maturation (IVM) system including pre-incubation with IBMX are not different from those observed in supernumerary embryos obtained from oocytes matured in vivo. WHAT IS KNOWN ALREADY Very limited information is available about the chromosomal constitution of IVM embryos. Previous studies were carried out using FISH on single biopsied blastomeres or arrested whole embryos and only provided fragmentary information on chromosomal abnormalities in IVM embryos. There is no systematic study of chromosomal abnormalities in all blastomeres of human Day 3 embryos with good morphology. STUDY DESIGN, SIZE, DURATION Between July 2012 and December 2012, 16 young (age <35 years old) egg donors underwent 18 IVM cycles for the generation of research embryos. Eighteen embryos developed to Day 3 and were analysed using array comparative genomic hybridization (aCGH). PARTICIPANTS/MATERIALS, SETTING, METHODS Immature oocytes were retrieved from 2 to 10 mm follicles after mild ovarian stimulation with gonadotrophins but without hCG ovulation trigger. At collection, oocytes were pre-incubated with 3-isobutyl-1-methylxanthine (IBMX), a phosphodiesterase inhibitor and matured in vitro. After IVM culture, mature oocytes were microinjected with sperm from a single donor. Embryos were cultured to Day 3 after ICSI and all blastomeres of 18 good-morphology embryos were collected individually for aCGH. MAIN RESULTS AND THE ROLE OF CHANCE Oocyte maturation rate in vitro was 50.2% (120/239). The mean fertilization rate was 68.3% (82/120) and 30.5% (25/82) of fertilized oocytes developed into a morphologically good quality embryo on Day 3 after ICSI. Of these, 18 embryos that developed well up to Day 3 were analysed using aCGH. Eighty of the 123 blastomeres analysed showed at least one chromosomal abnormality. Three out of eighteen embryos had completely normal cells. A single embryo carried a meiotic abnormality, 11 embryos were mosaic and three were chaotic. Although the aneuploidy data of this study are too limited to allow statistical analysis, these data are comparable to our own published data on the chromosome constitution of whole day 3 and day 4 embryos after conventional ART. LIMITATIONS, REASONS FOR CAUTION Array CGH technology determines relative quantification of chromosomal domains but does not allow for the visualization of chromosomal rearrangements, assessment of ploidy or detection of uniparental isodisomy. Conclusions drawn on segmental abnormalities should be treated with caution. Although the limited number of embryos analysed here precludes firm conclusions, they provide valuable data on possible causes of the reduced potential of IVM embryos. WIDER IMPLICATIONS OF THE FINDINGS This is the first study to describe the complete chromosome complement of all single blastomeres of good-morphology day 3 embryos obtained with IVM (including the presence of IBMX in a pre-incubation medium). The results demonstrate that a high proportion of good-morphology embryos are aneuploid and that there is no obvious increase in aneuploidies as a result of IVM which seems to suggest that the reduced efficiency of IVM technology compared with standard IVF may be accounted for by factors other than aneuploidy, such as cytoplasmic defects or reduced endometrial receptivity. STUDY FUNDING/COMPETING INTERESTS This study was funded by the TBM (Applied Biomedical Research with Societal Finality) programme of the IWT (Agency for Innovation through Science and Technology - Flanders, 110680) and by a Methusalem grant of the Vrije Universiteit Brussel. C.S. is a post-doctoral fellow of the Fund for Scientific Research Flanders (FWO - Vlaanderen). K.J. is a PhD student funded by the FWO. The University of Adelaide owns a patent family associated with IVM technologies that is licensed to Cook Medical. R.B.G. and J.G.T. are inventors. The remaining authors have no conflict of interest to declare.
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Affiliation(s)
- C Spits
- Research Group Reproduction and Genetics, Vrije Universiteit Brussel, 1090 Brussels, Belgium Centre for Reproductive Medicine, UZ Brussel, 1090 Brussels, Belgium
| | - L Guzman
- Research Group Follicle Biology, Vrije Universiteit Brussel, 1090 Brussels, Belgium
| | - A Mertzanidou
- Research Group Reproduction and Genetics, Vrije Universiteit Brussel, 1090 Brussels, Belgium Centre for Reproductive Medicine, UZ Brussel, 1090 Brussels, Belgium
| | - K Jacobs
- Research Group Reproduction and Genetics, Vrije Universiteit Brussel, 1090 Brussels, Belgium Centre for Reproductive Medicine, UZ Brussel, 1090 Brussels, Belgium
| | - C Ortega-Hrepich
- Research Group Reproduction and Genetics, Vrije Universiteit Brussel, 1090 Brussels, Belgium Centre for Reproductive Medicine, UZ Brussel, 1090 Brussels, Belgium
| | - R B Gilchrist
- Discipline of Obstetrics & Gynaecology, School of Women's & Children's Health, University of New South Wales, Sydney, Australia
| | - J G Thompson
- Robinson Research Institute, School of Paediatrics and Reproductive Health, ARC Centre of Excellence for Nanoscale BioPhotonics, The University of Adelaide, Adelaide, Australia
| | - M De Vos
- Research Group Reproduction and Genetics, Vrije Universiteit Brussel, 1090 Brussels, Belgium Centre for Reproductive Medicine, UZ Brussel, 1090 Brussels, Belgium Research Group Follicle Biology, Vrije Universiteit Brussel, 1090 Brussels, Belgium
| | - J Smitz
- Research Group Follicle Biology, Vrije Universiteit Brussel, 1090 Brussels, Belgium
| | - K Sermon
- Research Group Reproduction and Genetics, Vrije Universiteit Brussel, 1090 Brussels, Belgium Centre for Reproductive Medicine, UZ Brussel, 1090 Brussels, Belgium
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Li M, Zhao HC, Li R, Yu Y, Qiao J. Chromosomal aberrations in in-vitro matured oocytes influence implantation and ongoing pregnancy rates in a mouse model undergoing intracytoplasmic sperm injection. PLoS One 2014; 9:e103347. [PMID: 25058692 PMCID: PMC4110001 DOI: 10.1371/journal.pone.0103347] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2014] [Accepted: 06/25/2014] [Indexed: 11/19/2022] Open
Abstract
Implantation failure and early pregnancy loss have been reported to be closely related to the quality of mammalian oocytes; however, the pregnant outcome of embryos from in-vitro matured (IVM) oocytes remains unknown. In this study we examined spindle assembly and chromosome segregation during differentiation, and the duration of IVM of mouse oocytes. The resulting implantation and pregnancy outcomes were analyzed to clarify the relationship between the spindle and chromosomes of IVM oocytes and implantation and early pregnancy. Cumulus-enclosed germinal vesicle oocytes were collected and randomly cultured in IVM medium with different IVM durations. One part of IVM oocytes were analyzed the spindle and chromosome morphology by immunofluorescence method, and the other part of them were fertilized by intracytoplasmic sperm injection. The resulting embryos were transferred into pseudo-pregnant female mice, and the post-implantation and full term development was observed. The chromosome aberrations and incorrect spindle assembly seems not affect the early development and blastocyst cell number derived from IVM oocytes, however the development potential of the resulting embryos after implantation were significant decreased with the ratio increasing of chromosome aberrations and incorrect spindle assembly. Accordingly, the full-term development was also decreased. In conclusion, the present study showed the spindle assembly of in vitro-matured oocytes was one of the most important factors that affected the implantation and ongoing pregnancy rates of IVM oocytes, and the improvement by an appropriate duration of maturation in vitro will enhance the post-implantation development potential of the resulting embryos, and decrease implantation failure and early pregnancy loss.
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Affiliation(s)
- Min Li
- Center of Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
| | - Hong-Cui Zhao
- Center of Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
| | - Rong Li
- Center of Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- * E-mail: (YY); (RL)
| | - Yang Yu
- Center of Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- * E-mail: (YY); (RL)
| | - Jie Qiao
- Center of Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
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Yilmaz A, Zhang L, Zhang XY, Son WY, Holzer H, Ao A. Chromosomal complement and clinical relevance of multinucleated embryos in PGD and PGS cycles. Reprod Biomed Online 2014; 28:380-7. [DOI: 10.1016/j.rbmo.2013.11.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2012] [Revised: 10/16/2013] [Accepted: 11/05/2013] [Indexed: 01/11/2023]
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Live birth following serial vitrification of embryos and PGD for fragile X syndrome in a patient with the premutation and decreased ovarian reserve. J Assist Reprod Genet 2013; 30:1439-44. [PMID: 24062195 DOI: 10.1007/s10815-013-0079-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2013] [Accepted: 08/05/2013] [Indexed: 10/26/2022] Open
Abstract
PURPOSE To present a live birth resulting from serial vitrification of embryos and pre-implantation genetic diagnosis (PGD). METHODS A 31-year-old with primary infertility, fragile-X premutation, and decreased ovarian reserve (DOR) (baseline FSH level 33 IU/L), presented after failing to stimulate to follicle diameters >10 mm with three cycles of invitro fertilization (IVF). After counseling, the couple opted for serial in-vitro maturation (IVM), embryo vitrification, and genetic testing using array comparative genomic hybridization (aCGH) and PGD. Embryos were vitrified 2 days after intra-cytoplasmic sperm injection (ICSI). Thawed embryos were biopsied on day-three and transferred on day-five. RESULTS The couple underwent 20 cycles of assisted reproductive technology. A total of 23 in-vivo mature and five immature oocytes were retrieved, of which one matured in-vitro. Of 24 embryos, 17/24 (71 %) developed to day two and 11/24 (46 %) survived to blastocyst stage with a biopsy result available. Four blastocysts had normal PGD and aCGH results. Both single embryo transfers resulted in a successful implantation, one a blighted ovum and the other in a live birth. CONCLUSIONS Young patients with DOR have potential for live birth as long as oocytes can be obtained and embryos created. Serial vitrification may be the mechanism of choice in these patients when PGD is needed.
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Qiao J, Wang ZB, Feng HL, Miao YL, Wang Q, Yu Y, Wei YC, Yan J, Wang WH, Shen W, Sun SC, Schatten H, Sun QY. The root of reduced fertility in aged women and possible therapentic options: current status and future perspects. Mol Aspects Med 2013; 38:54-85. [PMID: 23796757 DOI: 10.1016/j.mam.2013.06.001] [Citation(s) in RCA: 87] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2013] [Accepted: 06/06/2013] [Indexed: 12/21/2022]
Abstract
It is well known that maternal ageing not only causes increased spontaneous abortion and reduced fertility, but it is also a high genetic disease risk. Although assisted reproductive technologies (ARTs) have been widely used to treat infertility, the overall success is still low. The main reasons for age-related changes include reduced follicle number, compromised oocyte quality especially aneuploidy, altered reproductive endocrinology, and increased reproductive tract defect. Various approaches for improving or treating infertility in aged women including controlled ovarian hyperstimulation with intrauterine insemination (IUI), IVF/ICSI-ET, ovarian reserve testing, preimplantation genetic diagnosis and screening (PGD/PGS), oocyte selection and donation, oocyte and ovary tissue cryopreservation before ageing, miscarriage prevention, and caloric restriction are summarized in this review. Future potential reproductive techniques for infertile older women including oocyte and zygote micromanipulations, derivation of oocytes from germ stem cells, ES cells, and iPS cells, as well as through bone marrow transplantation are discussed.
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Affiliation(s)
- Jie Qiao
- Center of Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, People's Republic of China
| | - Zhen-Bo Wang
- State Key Laboratory of Reproductive Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, People's Republic of China
| | - Huai-Liang Feng
- Department of Laboratory Medicine, and Obstetrics and Gynecology, New York Hospital Queens, Weill Medical College of Cornell University, New York, NY, USA
| | - Yi-Liang Miao
- Reproductive Medicine Group, Laboratory of Reproductive and Developmental Toxicology, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC 27709, USA
| | - Qiang Wang
- Department of Obstetrics and Gynecology, Washington University School of Medicine, 660 South Euclid Ave., St. Louis, MO 63110, USA
| | - Yang Yu
- Center of Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, People's Republic of China
| | - Yan-Chang Wei
- State Key Laboratory of Reproductive Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, People's Republic of China
| | - Jie Yan
- Center of Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, People's Republic of China
| | - Wei-Hua Wang
- Houston Fertility Institute, Tomball Regional Hospital, Tomball, TX 77375, USA
| | - Wei Shen
- Laboratory of Germ Cell Biology, Department of Animal Science, Qingdao Agricultural University, Qingdao 266109, People's Republic of China
| | - Shao-Chen Sun
- Department of Animal Science, Nanjing Agricultural University, Nanjing 210095, People's Republic of China
| | - Heide Schatten
- Department of Veterinary Pathobiology, University of Missouri, Columbia, MO 65211, USA
| | - Qing-Yuan Sun
- State Key Laboratory of Reproductive Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, People's Republic of China.
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Choi MH, Lee SH, Kim HO, Cha SH, Kim JY, Yang KM, Song IO, Koong MK, Kang IS, Park CW. Comparison of assisted reproductive technology outcomes in infertile women with polycystic ovary syndrome: In vitro maturation, GnRH agonist, and GnRH antagonist cycles. Clin Exp Reprod Med 2012; 39:166-71. [PMID: 23346527 PMCID: PMC3548075 DOI: 10.5653/cerm.2012.39.4.166] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2012] [Revised: 11/23/2012] [Accepted: 11/27/2012] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE We compared the assisted reproductive technology (ART) outcomes among infertile women with polycystic ovary syndrome (PCOS) treated with IVM, conventional IVF, GnRH agonist, and GnRH antagonist cycles. METHODS The prospective study included a total of 67 cycles in 61 infertile women with PCOS. The women with PCOS were randomized into three IVF protocols: IVM/IVF with FSH and hCG priming with immature oocyte retrieval 38 hours later (group A, 14 cycles), GnRH agonist long protocol (group B, 14 cycles), and GnRH antagonist multi-dose flexible protocol (group C, 39 cycles). IVF outcomes, such as clinical pregnancy rate (CPR), implantation rate (IR), miscarriage rate (MR), and live birth rate (LBR), were compared among the three groups. RESULTS Age, BMI, and basal FSH and LH levels did not differ among the three groups. The number of retrieved oocytes and 2 pronucleus embryos was significantly lower in group A compared with groups B and C. The CPR, IR, MR, and LBR per embryo transfer showed no differences among the three groups. There was no incidence of ovarian hyperstimulation syndrome in group A. CONCLUSION The IR, MR, and LBR in the IVM cycles were comparable to those of the GnRH agonist and GnRH antagonist cycles. The IVM protocol, FSH and hCG priming with oocyte retrieval 38 hours later, is an effective ART option that is comparable with conventional IVF for infertile women with PCOS.
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Affiliation(s)
- Min Hye Choi
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Cheil General Hospital and Women's Healthcare Center, Kwandong University College of Medicine, Seoul, Korea
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Yilmaz A, Zhang XY, Chung JT, Tan SL, Holzer H, Ao A. Chromosome segregation analysis in human embryos obtained from couples involving male carriers of reciprocal or Robertsonian translocation. PLoS One 2012; 7:e46046. [PMID: 23029381 PMCID: PMC3459837 DOI: 10.1371/journal.pone.0046046] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2012] [Accepted: 08/27/2012] [Indexed: 11/19/2022] Open
Abstract
The objective of this study was to investigate the frequency and type of chromosome segregation patterns in cleavage stage embryos obtained from male carriers of Robertsonian (ROB) and reciprocal (REC) translocations undergoing preimplantation genetic diagnosis (PGD) at our reproductive center. We used FISH to analyze chromosome segregation in 308 day 3 cleavage stage embryos obtained from 26 patients. The percentage of embryos consistent with normal or balanced segregation (55.1% vs. 27.1%) and clinical pregnancy (62.5% vs. 19.2%) rates were higher in ROB than the REC translocation carriers. Involvement of non-acrocentric chromosome(s) or terminal breakpoint(s) in reciprocal translocations was associated with an increase in the percent of embryos consistent with adjacent 1 but with a decrease in 3∶1 segregation. Similar results were obtained in the analysis of nontransferred embryos donated for research. 3∶1 segregation was the most frequent segregation type in both day 3 (31%) and spare (35%) embryos obtained from carriers of t(11;22)(q23;q11), the only non-random REC with the same breakpoint reported in a large number of unrelated families mainly identified by the birth of a child with derivative chromosome 22. These results suggest that chromosome segregation patterns in day 3 and nontransferred embryos obtained from male translocation carriers vary with the type of translocation and involvement of acrocentric chromosome(s) or terminal breakpoint(s). These results should be helpful in estimating reproductive success in translocation carriers undergoing PGD.
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Affiliation(s)
- Ahmet Yilmaz
- Department of Obstetrics and Gynecology, McGill University, Montreal, Quebec, Canada
| | - Xiao Yun Zhang
- Department of Obstetrics and Gynecology, McGill University, Montreal, Quebec, Canada
| | - Jin-Tae Chung
- Department of Obstetrics and Gynecology, McGill University, Montreal, Quebec, Canada
| | - Seang Lin Tan
- Department of Obstetrics and Gynecology, McGill University, Montreal, Quebec, Canada
| | - Hananel Holzer
- Department of Obstetrics and Gynecology, McGill University, Montreal, Quebec, Canada
| | - Asangla Ao
- Department of Human Genetics, McGill University, Montreal, Quebec, Canada
- * E-mail:
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Demeestere I, Moffa F, Peccatori F, Poirot C, Shalom-Paz E. Multiple approaches for individualized fertility protective therapy in cancer patients. Obstet Gynecol Int 2011; 2012:961232. [PMID: 22253632 PMCID: PMC3255296 DOI: 10.1155/2012/961232] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2011] [Accepted: 11/18/2011] [Indexed: 12/21/2022] Open
Abstract
In the last decade, fertility preservation has risen as a major field of interest, creating new interactions between oncologists and gynecologists. Various options, such as cryopreservation of ovarian tissue, have been developed and are currently routinely proposed in many centers. However, many of the options remain experimental and should be offered to patients only after adequate counseling. This paper addresses the efficiency and the potential of the different fertility preservation approaches.
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Affiliation(s)
- I. Demeestere
- Fertility Clinic, Universite Libre de Bruxelles (ULB), Hôpital Erasme, 1070 Brussels, Belgium
- Fertility Clinic, Universite Libre de Bruxelles (ULB), Campus Erasme, 1070 Brussels, Belgium
| | - F. Moffa
- Fertility Clinic, Universite Libre de Bruxelles (ULB), Hôpital Erasme, 1070 Brussels, Belgium
- Instituto Marquès, 08034 Barcelona, Spain
| | - F. Peccatori
- Department of Medicine, Division of Hematology Oncology, European Institute of Oncology, 20141 Milan, Italy
| | - C. Poirot
- UF de Biologie de la Reproduction, Groupe Hospitalier Pitié-Salpêtrière, 75651 Paris, France
| | - E. Shalom-Paz
- Department of Obstetrics and Gynecology, McGill University, Montreal, QC, Canada H3A 2T5
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Die In-vitro-Maturation in Deutschland. GYNAKOLOGISCHE ENDOKRINOLOGIE 2011. [DOI: 10.1007/s10304-011-0433-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Basatemur E, Sutcliffe A. Health of IVM children. J Assist Reprod Genet 2011; 28:489-93. [PMID: 21472419 DOI: 10.1007/s10815-011-9561-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2011] [Accepted: 03/21/2011] [Indexed: 01/19/2023] Open
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Zhang L, Yilmaz A, Chian RC, Son WY, Zhang XY, Kong D, Dahan M, Holzer H, Tan SL, Ao A. Reliable preimplantation genetic diagnosis in thawed human embryos vitrified at cleavage stages without biopsy. J Assist Reprod Genet 2011; 28:597-602. [PMID: 21437672 DOI: 10.1007/s10815-011-9556-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2010] [Accepted: 03/07/2011] [Indexed: 11/24/2022] Open
Abstract
PURPOSE To evaluate preimplantation genetic diagnosis (PGD) efficiency in thawed human embryos vitrified without biopsy. METHODS In this retrospective clinical study, 21 PGD cycles were carried out using fresh and vitrified-thawed embryos collected from 21 patients. RESULTS One hundred and ninety-nine embryos from patients with aneuploidy, single gene defects, or chromosomal translocations were vitrified at the cleavage stages; 93.5% of the embryos survived the vitrification procedure. Conclusive FISH results were obtained in 98.4% of the fresh and 99% of the frozen-thawed embryos screened for aneuploidy or chromosomal translocations. Conclusive PCR test results were obtained in 100% of the fresh and 93.9% of the frozen-thawed embryos screened for single gene defects. The overall clinical pregnancy rate per cycle was 57.1%. To date, 13 healthy children have been born. CONCLUSION Reliable genetic diagnosis can be performed in thawed human embryos vitrified without biopsy. However, further research is required to support this conclusion.
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Affiliation(s)
- Li Zhang
- MUHC Reproductive Center, Royal Victoria Hospital, and Department of Obstetrics and Gynecology, McGill University, Montreal, Quebec, Canada
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First successful pregnancy following PGD for chromosome translocation on embryos generated from in-vitro matured oocytes: a case report. Reprod Biomed Online 2010; 22:371-5. [PMID: 21324743 DOI: 10.1016/j.rbmo.2010.11.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2010] [Revised: 10/29/2010] [Accepted: 11/17/2010] [Indexed: 11/22/2022]
Abstract
As far as is known, this is the first report of a successful pregnancy outcome following preimplantation genetic diagnosis for a chromosome translocation in embryos generated from in-vitro matured oocytes. A couple presented to the study clinic where the female partner was a carrier of the reciprocal chromosome translocation 46,XX,t(1;20)(p36.1;p12.2) with three consecutive pregnancy terminations due to either fetal abnormality or unbalanced translocation products detected in the conceptus. Under routine ultrasound investigation she was diagnosed with polycystic ovaries. The patient underwent an in-vitro maturation/preimplantation genetic diagnosis cycle where the immature oocytes were matured in vitro and fertilized by intracytoplasmic sperm injection. Day-3 embryos were screened for the chromosome abnormality by fluorescent in-situ hybridization. A single embryo diagnosed as chromosomally normal/balanced was transferred on day 5 and resulted in the birth of a healthy child.
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