Laser-assisted human embryo biopsy on the third day of development for preimplantation genetic diagnosis: two successful case reports

Effects of laser zona thinning and artificial blastocoel collapse on the cryosurviving and hatching of buffalo (Bubalus bulalis) blastocysts of different ages

The objectives of this study were to investigate whether blastocoel collapse before vitrification induced by laser improves the cryo-survivability of buffalo in-vitro-fertilized (IVF) blastocysts and whether laser assisted hatching (LAH) promotes hatchability of fresh and frozen-thawed IVF blastocysts. The expanded blastocysts were harvested on Days 6-9 and randomly allocated into five groups as follows: (1) blastocysts were vitrified and thawed without any treatment; (2) blastocysts were vitrified after 15-20 μm zona pellucida (ZP) thinning opposite to the inner cell mass, and blastocoels were also blotted in order to outflow the blastocoelic fluid before vitrification; (3) ZP thinning was made immediately after thawing; (4) fresh blastocysts underwent LAH; and (5) as a control, fresh blastocysts without treatment. Results of the present study showed that the cryosurvival rates of vitrified Day 8 and Day 9 blastocysts in Group 2 were significantly (P < 0.01) higher in Group 2 than Group 1. The hatching rates of Day 8 and Day 9 blastocysts in Group 2 and Group 3 were also significantly (P < 0.01) higher compared with Group 1. Moreover, the hatching rate of Day 9 blastocysts in Group 4 was notably (P < 0.05) higher than Group 5. In conclusion, LAH promotes the hatching rates of Day 9 fresh and Days 8-9 vitrified blastocysts, and artificial blastocoel collapse before vitrification improves the cryosurvival rate of Days 8-9 IVF buffalo blastocysts.

Epigenetic changes in preimplantation embryos subjected to laser manipulation

The advantage of using laser for assisted hatching in routine assisted reproductive technology (ART) practice is debatable. Recently, it has been shown that laser-manipulated mouse embryos had compromised genetic integrity. However, the impact of laser-assisted hatching (LAH) on the epigenetic integrity of the preimplantation embryos is not elucidated so far. Since continuous thermal stress on embryos was found to lower mRNA levels of de novo (bovine) methyl transferases in embryos, we hypothesize that thermal energy induced during LAH may alter the epigenetic signature through abnormal de novo methyl transferases (Dnmts) levels. Thus, using mouse model, we made an attempt to look into the expression of Dnmt3a and Dnmt3b in laser-manipulated embryos and their effects on global methylation. This experimental prospective study used mouse embryos from varying developmental stages (2-cell, 6-8-cell, and blastocyst) which were subjected to LAH using a 1480-nm diode laser. Two pulses of 350 μs frequency were applied to breach the zona pellucida, and then, embryos were assessed for the expression of two de novo methyl transferases (Dnmt3a and Dnmt3b) and LINE-1 (long interspersed element-1) methylation when LAH embryos developed to blastocyst stage. Results from this study have shown that blastocysts subjected to LAH at two-cell stage had significantly lower mRNA transcripts of Dnmt3a (P < 0.01) and Dnmt3b (P < 0.05) whereas LAH at six- to eight-cell and blastocyst stages did not affect the mRNA level significantly. On the other hand, LINE-1 methylation did not change significantly between LAH and control group in all the stages studied. These results suggest that two-cell-stage laser manipulation of embryos changes the mRNA level of Dnmts without affecting the global DNA methylation.

Laser assisted zona hatching does not lead to immediate impairment in human embryo quality and metabolism

Laser assisted zona hatching (LAH) is a routinely used therapeutic intervention in assisted reproductive technology for patients with poor prognosis. However, results are not conclusive in demonstrating the benefits of zona hatching in improving the pregnancy rate. Recent observations on LAH induced genetic instability in animal embryos prompted us to look into the effects of laser assisted zona hatching on the human preimplantation embryo quality and metabolic uptake using high resolution nuclear magnetic resonance (NMR) technology. This experimental prospective study included fifty embryos from twenty-five patients undergoing intra cytoplasmic sperm injection. Embryo quality assessment followed by profiling of spent media for the non-invasive evaluation of metabolites was performed using NMR spectroscopy 24 hours after laser treatment and compared with that of non-treated sibling embryos. Both cell number and embryo quality on day 3 of development did not vary significantly between the two groups at 24 hours post laser treatment interval. Time lapse monitoring of the embryos for 24 hours did not reveal blastomere fragmentation adjacent to the point of laser treatment. Similarly, principal component analysis of metabolites did not demonstrate any variation across the groups. These results suggest that laser assisted zona hatching does not affect human preimplantation embryo morphology and metabolism at least until 24 hours post laser assisted zona hatching. However, studies are required to elucidate laser induced metabolic and developmental changes at extended time periods.

ABBREVIATIONS

AH: assisted hatching; ART: assisted reproductive technology; DNA: deoxy-ribo nucleic acid; LAH: laser assisted hatching; MHz: megahertz; NMR: nuclear magnetic resonance; PCA: principal component analysis; PGD: preimplantation genetic diagnosis; TLM: time lapse monitoring.

Outcomes of preimplantation genetic diagnosis using either zona drilling with acidified Tyrode's solution or partial zona dissection

Objective

To review the outcomes of preimplantation genetic diagnosis (PGD) using zona drilling with acid Tyrode's solution (chemical zona pellucida drilling, chemical ZD) and those of partial zona dissection (PZD).

Methods

Clinical outcomes of seventy-one couples undergoing 85 PGD cycles from January 2005 to December 2010 were included. Blastocyst formation and the hatching rate, clinical pregnancy rate, ongoing pregnancy rate, implantation rate, and fetal gender ratio of the PZD and chemical ZD groups were compared.

Results

Application of PZD resulted in a significantly higher rate of clinical pregnancy (40.7% vs. 15.4%, p=0.022), ongoing pregnancy (35.6% vs. 11.5%, p=0.023), and implantation (18.1% vs. 5.7%, p=0.007) compared with chemical ZD. Among non-transferred embryos, the rate of blastocyst formation on day 5 (49.1% vs. 39.5%, p=0.016) and hatching on day 6 (47.2% vs. 26.5%, p<0.001) were also significantly higher in the PZD group.

Conclusion

The mechanical zona dissection method showed better outcomes than chemical ZD in terms of the blastocyst development and pregnancy rate. In this study, the fact that chemical ZD was conducted in different period from mechanical method should be considered in interpreting the result.

Laser zona drilling does not induce hsp70i transcription in blastomeres of eight-cell mouse embryos

To assess whether zona drilling with a 1,480-nm laser induces heat shock in eight-cell embryos, we measured hsp70i RNA levels in sets of single blastomeres isolated after laser treatment of mouse embryos that had or had not been heated at 43 degrees C. Unlike heating, laser zona drilling did not stimulate hsp70i expression, even in the blastomeres closest to the laser beam, corroborating the safety of this procedure for assisted reproduction.

Possible applications of a non-contact 1.48 μm wavelength diode laser in assisted reproduction technologies

Recently, one laser system has been introduced in IVF fulfilling all safety requirements, while achieving a high standard of reproducibility in terms of ablation diameter. This 1.48 microm wavelength indium-gallium-arsenic-phosphorus (InGaAsP) semiconductor laser offers a variety of laser applications to the embryologist. On the one hand, zona pellucida of oocytes or embryos can be manipulated in order to facilitate ICSI or biopsy and assist hatching, and on the other, spermatozoa may be paralysed or immobilized prior to usage. To conclude, the 1.48 microm diode laser provides a promising tool for the microdissection of subcellular targets. The diode laser stands out due to the rapidity, the simplicity and the safety of the procedure which is supported by healthy offspring after laser application.

Pregnancy after cryopreservation of donor oocytes and preimplantation genetic diagnosis of embryos in a patient with ovarian failure

OBJECTIVE

To describe the successful use of preimplantation genetic diagnosis to assess the prevalence of meiotic errors after oocyte cryopreservation in an oocyte donation cycle.

DESIGN

Case report.

SETTING

Private IVF center.

PATIENT(S)

A 42.6-year-old patient with ovarian failure.

INTERVENTION(S)

A donor oocyte IVF cycle with cryopreservation of oocytes followed by thaw, fertilization of oocytes, preimplantation genetic diagnosis for selective aneuploidy, and ET.

MAIN OUTCOME MEASURE(S)

Preimplantation genetic analysis of chromosomes 13,16,18, 21,22, X, and Y with fluorescence in-situ hybridization.

RESULT(S)

The recipient's initial serum beta-hCG level was 196 mIU/mL 15 days after oocyte retrieval. An initial ultrasound at the sixth week of gestation revealed two gestational sacs. A second ultrasound 1 week later showed a monochorionic twin in sac A and a singleton pregnancy in sac B. Fetal cardiac activity was visualized for all gestations.

CONCLUSION(S)

This case illustrates the feasibility of cryopreservation of donor oocytes combined with preimplantation genetic diagnosis for clinical use in those settings where there may be an increased risk of spindle-related abnormalities.