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What Does Intracytoplasmic Sperm Injection Change in Embryonic Development? The Spermatozoon Contribution. J Clin Med 2023; 12:jcm12020671. [PMID: 36675600 PMCID: PMC9867417 DOI: 10.3390/jcm12020671] [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: 12/13/2022] [Revised: 12/30/2022] [Accepted: 01/11/2023] [Indexed: 01/19/2023] Open
Abstract
The intracytoplasmic sperm injection (ICSI) technique was invented to solve severe male infertility due to altered sperm parameters. Nowadays, it is applied worldwide for the treatment of couple infertility. ICSI is performed with any available spermatozoon from surgery or ejaculated samples, whatever are the sperm motility, morphology or quantity. The aim of the present review was to study if embryo development and kinetics would be modified by (1) ICSI under the technical aspects, (2) the micro-injected spermatozoa in connection with male infertility. From published data, it can be seen that ICSI anticipates the zygote kinetics Furthermore, because fertilization rate is higher in ICSI compared to conventional in vitro fertilization (IVF), more blastocysts are obtained for clinical use in ICSI. Sperm and spermatozoa characteristics, such as sperm parameters, morphology and vitality, DNA content (levels of sperm DNA fragmentation, microdeletions, and chromosomal abnormalities), RNA content, epigenetics, and sperm recovery site (testicular, epididymis, and ejaculated), have an impact on fertilization and blastocyst rates and embryo kinetics in different ways. Even though ICSI is the most common solution to solve couples' infertility, the causes of male infertility are crucial in building a competent spermatozoa that will contribute to normal embryonic development and healthy offspring.
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Franasiak JM, Polyzos NP, Neves AR, Yovich JL, Ho TM, Vuong LN, Norman RJ. Intracytoplasmic sperm injection for all or for a few? Fertil Steril 2022; 117:270-284. [DOI: 10.1016/j.fertnstert.2021.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 12/02/2021] [Indexed: 11/04/2022]
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A 10-Year Perspective on the Utility of Three Adjuvants Often Used in IVF: Growth Hormone, Melatonin and DHEA. REPRODUCTIVE MEDICINE 2021. [DOI: 10.3390/reprodmed2040016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Since 2010, numerous studies reported from PIVET, a pioneer IVF facility established over 40 years ago, have explored the use of three adjuvants designed to improve laboratory and clinical outcomes in cases where a poor prognosis has been demonstrated. The adjuvants reported commenced with recombinant growth hormone (rGH), followed by dehydroepiandrosterone (DHEA) after developing a unique troche to avoid the first-pass effect and, subsequently, melatonin. The studies show that rGH is beneficial in the situation where women have poor-quality embryos in the setting of additional poor prognosis factors, such as advanced female age, a very low ovarian reserve, an insulin growth factor profile in the lowest quartile or recurrent implantation failure. The studies also imply that the adjuvants may actually reduce live birth productivity rates if used on women without poor prognosis factors; hence, further studies, which can now be better designed, should be undertaken to explore the notion of underlying adult growth hormone deficiency in some cases as well as the suggestion that DHEA can provide equivalent benefits in some poor prognosis settings. Melatonin showed no suggestive benefits in any of the studies and can be excluded from consideration in this context. Future studies should compare rGH and DHEA with a focus on those women who have poor embryo quality with additional poor prognosis factors. Such trials should be extended to 12 weeks to cover the entire period of oocyte activation.
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Chamayou S, Ragolia C, Alecci C, Storaci G, Romano S, Sapienza R, Maglia E, Liprino A, Cardea C, Fichera M, Guglielmino A. More blastocysts are produced from fewer oocytes in ICSI compared to IVF - results from a sibling oocytes study and definition of a new key performance indicator. Reprod Biol Endocrinol 2021; 19:116. [PMID: 34311751 PMCID: PMC8311920 DOI: 10.1186/s12958-021-00804-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 07/16/2021] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Which fertilization method, between ICSI and IVF in split insemination treatments, has the highest clinical efficiency in producing clinically usable blastocyst? METHODS 211 infertile couples underwent split insemination treatments for a non-severe male factor. 1300 metaphase II (MII) oocytes were inseminated by conventional IVF and 1302 MII oocytes were micro-injected with the same partner's semen. Embryo development until blastocyst stage on day V and clinical outcomes were valuated trough conventional key performance indicators (KPI), and new KPIs such as blastocyst rate per used MII oocytes and the number of MII oocytes to produce one clinically usable blastocyst from ICSI and IVF procedures. RESULTS The results were globally analyzed and according to ovarian stimulation protocol, infertility indication, and female age. The conventional KPI were online with the expected values from consensus references. From global results, 2.3 MII oocyte was needed to produce one clinically usable blastocyst after ICSI compared to 2.9 MII oocytes in IVF. On the same way, more blastocysts for clinical use were produced from fewer MII oocytes in ICSI compared to IVF in all sub-groups. CONCLUSIONS In split insemination treatments, the yield of clinically usable blastocysts was always superior in ICSI compared to IVF. The new KPI "number of needed oocytes to produce one clinically usable embryo" tests the clinical efficiency of the IVF laboratory.
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Affiliation(s)
- Sandrine Chamayou
- Unità di Medicina della Riproduzione - Centro HERA, via barriera del bosco, n. 51/53, Sant'Agata Li Battiati, Catania, Italy.
| | - Carmen Ragolia
- Unità di Medicina della Riproduzione - Centro HERA, via barriera del bosco, n. 51/53, Sant'Agata Li Battiati, Catania, Italy
| | - Carmelita Alecci
- Unità di Medicina della Riproduzione - Centro HERA, via barriera del bosco, n. 51/53, Sant'Agata Li Battiati, Catania, Italy
| | - Giorgia Storaci
- Unità di Medicina della Riproduzione - Centro HERA, via barriera del bosco, n. 51/53, Sant'Agata Li Battiati, Catania, Italy
| | - Simona Romano
- Unità di Medicina della Riproduzione - Centro HERA, via barriera del bosco, n. 51/53, Sant'Agata Li Battiati, Catania, Italy
| | - Roberta Sapienza
- Unità di Medicina della Riproduzione - Centro HERA, via barriera del bosco, n. 51/53, Sant'Agata Li Battiati, Catania, Italy
| | - Elena Maglia
- Unità di Medicina della Riproduzione - Centro HERA, via barriera del bosco, n. 51/53, Sant'Agata Li Battiati, Catania, Italy
| | - Annalisa Liprino
- Unità di Medicina della Riproduzione - Centro HERA, via barriera del bosco, n. 51/53, Sant'Agata Li Battiati, Catania, Italy
| | - Clementina Cardea
- Unità di Medicina della Riproduzione - Centro HERA, via barriera del bosco, n. 51/53, Sant'Agata Li Battiati, Catania, Italy
| | - Michele Fichera
- Unit of Gynecology and Obstetrics-Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy
| | - Antonino Guglielmino
- Unità di Medicina della Riproduzione - Centro HERA, via barriera del bosco, n. 51/53, Sant'Agata Li Battiati, Catania, Italy
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Prevalence of pathogenic copy number variants among children conceived by donor oocyte. Sci Rep 2021; 11:6752. [PMID: 33762699 PMCID: PMC7991411 DOI: 10.1038/s41598-021-86242-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 03/09/2021] [Indexed: 11/30/2022] Open
Abstract
Development of assisted reproductive technologies to address infertility has favored the birth of many children in the last years. The majority of children born with these treatments are healthy, but some concerns remain on the safety of these medical procedures. We have retrospectively analyzed both the fertilization method and the microarray results in all those children born between 2010 and 2019 with multiple congenital anomalies, developmental delay and/or autistic spectrum disorder (n = 486) referred for array study in our center. This analysis showed a significant excess of pathogenic copy number variants among those patients conceived after in vitro fertilization with donor oocyte with respect to those patients conceived by natural fertilization (p = 0.0001). On the other hand, no significant excess of pathogenic copy number variants was observed among patients born by autologous oocyte in vitro fertilization. Further studies are necessary to confirm these results and in order to identify the factors that may contribute to an increased risk of genomic rearrangements, as well as consider the screening for genomic alterations after oocyte donation in prenatal diagnosis.
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Elimination of stress factors by continuous embryo culture and its influence on in vitro fertilization outcomes. Reprod Biol 2020; 20:512-519. [PMID: 32912714 DOI: 10.1016/j.repbio.2020.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 07/25/2020] [Accepted: 08/15/2020] [Indexed: 11/20/2022]
Abstract
Recently, infertility has become one of the most important endemic conditions, affecting approximately 15-20 % of couples worldwide. Among others, the careerist lifestyle, the increasing maternal age and the parallel increment in the aneuploidy rate of embryos play a crucial role in this phenomenon. In this study, embryological parameters and pregnancy outcomes were investigated in IVF cycles using either sequential embryo culture or a single step culture system. By sequential media, oocytes/embryos are needlessly exposed to the potentially negative effects of light exposure, temperature decrement and altered oxygen tension. In comparison with sequential media, single step media induced 1.28, 1.21 and 1.21-fold increments in implantation, biochemical pregnancy and clinical pregnancy rates, respectively. Pregnancy outcomes showed strong maternal age-dependency, so the difference between the two investigated culture systems was equalized by the increasing maternal ages (35-44 years) and the supposed incidence of embryo aneuploidy. Nevertheless, the significant enlargements in the outcomes of the younger ages (25-34) induced by the single step cultures suggest that, beside the resultant maternal aneuploidy, aneuploidy (reduced pregnancy rates) may evolve from exposure to the mentioned environmental stress factors.
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Zhang Y, Fang Z, Lu H, Li Y, Baloch Z, Liu Y, Yang S, Lu Z, Ding C. A blastocyst biopsy approach for preimplantation genetic diagnosis technique that affects the expression of SNAP-α in mice. Reprod Biol 2020; 20:417-423. [PMID: 32471803 DOI: 10.1016/j.repbio.2020.03.010] [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: 01/08/2020] [Revised: 03/27/2020] [Accepted: 03/28/2020] [Indexed: 11/17/2022]
Abstract
Preimplantation genetic diagnosis (PGD) is a technique that is commonly used during assisted reproduction in the clinics to eliminate genetically abnormal embryos before implantation. The blastomere biopsy technique has risks related to the embryo, but blastocyst biopsy has not been systematically evaluated in relation to effects after birth, and the resulting offspring have not been followed up on. We designed a series of experiments to evaluate the risk of blastocyst biopsy on the resulting progeny. Mice were divided into a PGD group and a control group. The former was the progeny of mice that underwent blastocyst biopsy and the latter was delivered through a normal pregnancy without blastocyst biopsy. Each group consisted of 15 animals. We found no effects of blastocyst biopsy on reproductive capacities and weight gain. As for neurobehavioral evaluation between both groups, there were no significant differences in tail suspension test, sucrose preference test, the open field test and the elevated plus maze. Western blotting, immunohistochemistry and quantitative RT-PCR results showed that the expression levels of MBP, PRDX5 and UCHL1 in the PGD group were not significantly different compared to the control group, but SNAP-α expression in the PGD group was lower than that in control group. In summary, we concluded that blastocyst biopsy had no adverse effect on the general growth and behavior in mice. However, blastocyst biopsy effected the expression of SNAP-α. Therefore, the safety of blastocyst biopsy requires further evaluation.
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Affiliation(s)
- Yingting Zhang
- College of Veterinary Medicine, South China Agricultural University, Guangzhou, 510642, China; Guangdong Laboratory of Lingnan Modern Agriculture, Guangzhou, 510642, China
| | - Zhihao Fang
- College of Veterinary Medicine, South China Agricultural University, Guangzhou, 510642, China; Guangdong Laboratory of Lingnan Modern Agriculture, Guangzhou, 510642, China
| | - Hongyu Lu
- College of Veterinary Medicine, South China Agricultural University, Guangzhou, 510642, China; Guangdong Laboratory of Lingnan Modern Agriculture, Guangzhou, 510642, China
| | - Yaqing Li
- College of Veterinary Medicine, South China Agricultural University, Guangzhou, 510642, China; Guangdong Laboratory of Lingnan Modern Agriculture, Guangzhou, 510642, China
| | - Zulqarnain Baloch
- College of Veterinary Medicine, South China Agricultural University, Guangzhou, 510642, China; Guangdong Laboratory of Lingnan Modern Agriculture, Guangzhou, 510642, China
| | - Yongxiang Liu
- Key Laboratory of Reproductive Medicine of Guangdong Province, the First Affiliated Hospital and School of Life Sciences, Sun Yat-sen University, Guangzhou, 510275, China
| | - Shihua Yang
- College of Veterinary Medicine, South China Agricultural University, Guangzhou, 510642, China; Guangdong Laboratory of Lingnan Modern Agriculture, Guangzhou, 510642, China.
| | - Zhonghua Lu
- Brain Cognition and Brain Disease Institute, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518000, China.
| | - Chenhui Ding
- Key Laboratory of Reproductive Medicine of Guangdong Province, the First Affiliated Hospital and School of Life Sciences, Sun Yat-sen University, Guangzhou, 510275, China.
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Yovich JL, Casper R, Chapman M, Tesarik J, Anderson RA. Regulating ART: time for a re-think in the light of increasing efficacy, safety and efficiency. Reprod Biomed Online 2019; 38:483-486. [PMID: 30704951 DOI: 10.1016/j.rbmo.2019.01.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Affiliation(s)
- John L Yovich
- PIVET Medical Centre, Perth, Australia; Curtin University, Perth, Australia.
| | - Robert Casper
- Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Canada
| | - Michael Chapman
- Royal Hospital for Women, University of New South Wales, NSW Australia
| | | | - Richard A Anderson
- MRC Centre for Reproductive Health, University of Edinburgh, Edinburgh, UK
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Yovich JL, Ye Y, Regan SLP, Keane KN. The Evolving Concept of Poor-Prognosis for Women Undertaking IVF and the Notion of Growth Hormone as an Adjuvant; A Single-Center Viewpoint. Front Endocrinol (Lausanne) 2019; 10:808. [PMID: 31824425 PMCID: PMC6882284 DOI: 10.3389/fendo.2019.00808] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 11/04/2019] [Indexed: 01/28/2023] Open
Abstract
IVF is currently regarded as a successful new technology with the number of IVF children currently well over 8 million worldwide. This has been achieved by an explosive plethora of facilities. However, from its earliest history, IVF has been beset by poor-prognosis on a treatment cycle basis, an aspect which has been a constant feature for the majority of treatments to this stage. The 2019 Australian and New Zealand Assisted Reproduction Database (ANZARD) report shows that IVF clinics have live birth productivity rates (from combined initiated fresh and frozen cycles) ranging from 9.3 to 33.2%. Over the past 40 years there have been a number of innovations which have steadily moved the success rates forward, but progress is held back by an intransigent group of women who can be classified as being poor-prognosis from one or more adverse factors, namely advanced age (>40 years), poor ovarian response (POR) to ovarian stimulation, inability to generate high quality blastocyst-stage embryos, recurrent implantation failure, or recurrent early pregnancy losses. A number of strategies are variously applied including the use of recombinant growth hormone (GH) adjuvant therapy. Our retrospective studies at PIVET over the past decade show a 6.2-fold chance of live birth for fresh cycle embryo transfers following GH injections of 1-1.5 IU daily given for 3-6 weeks in the lead-up to the trigger for ovum pick-up. We have also recently reported the live birth rates from frozen embryo transfers utilizing those blastocyst embryos generated under GH influence and showed the live birth rate was 2.7-fold higher in a carefully matched poor-prognosis group. This experience has been compared to the total 42 GH studies reported since the year 2000, the majority matching those of PIVET with significant increases in both oocyte and embryo utilization rates but only ~50% are followed by elevated live birth rates. We argue that this discrepancy relates to failure in addressing other causes of poor-prognosis along with the wastage of transferring more than a single embryo in the fresh cycle, when ANZARD data indicates a significantly higher chance of live birth from frozen embryo transfers.
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Affiliation(s)
- John L. Yovich
- PIVET Medical Centre, Perth, WA, Australia
- Department of Pharmacy and Biomedical Sciences, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
- *Correspondence: John L. Yovich
| | - Yun Ye
- PIVET Medical Centre, Perth, WA, Australia
- Zhongshan People's Hospital, Zhongshan, China
| | - Sheena L. P. Regan
- PIVET Medical Centre, Perth, WA, Australia
- Department of Pharmacy and Biomedical Sciences, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
| | - Kevin Noel Keane
- PIVET Medical Centre, Perth, WA, Australia
- Department of Pharmacy and Biomedical Sciences, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
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Mariappen U, Keane KN, Hinchliffe PM, Dhaliwal SS, Yovich JL. Neither male age nor semen parameters influence clinical pregnancy or live birth outcomes from IVF. Reprod Biol 2018; 18:324-329. [DOI: 10.1016/j.repbio.2018.11.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 11/08/2018] [Accepted: 11/10/2018] [Indexed: 12/14/2022]
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