Different morphology and proliferative ability of cumulus and granulosa cells originating from cystic follicles aspirated from stimulated in vitro fertilization patients

Molecular basis of thyrotropin and thyroid hormone action during implantation and early development

BACKGROUND

Implantation and early embryo development are finely regulated processes in which several molecules are involved. Evidence that thyroid hormones (TH: T4 and T3) might be part of this machinery is emerging. An increased demand for TH occurs during gestation, and any alteration in maternal thyroid physiology has significant implications for both maternal and fetal health. Not only overt but also subclinical hypothyroidism is associated with infertility as well as with obstetric complications, including disruptions and disorders of pregnancy, labor, delivery, and troubles in early neonatal life.

METHODS

We searched the PubMed and Google Scholar databases for articles related to TH action on ovary, endometrium, trophoblast maturation and embryo implantation. In addition, articles on the regulation of TH activity at cellular level have been reviewed. The findings are hereby summarized and critically discussed.

RESULTS

TH have been shown to influence endometrial, ovarian and placental physiology. TH receptors (TR) and thyrotropin (thyroid-stimulating hormone: TSH) receptors (TSHR) are widely expressed in the feto-maternal unit during implantation, and both the endometrium and the trophoblast might be influenced by TH either directly or through TH effects on the synthesis and activity of implantation-mediating molecules. Interestingly, due to the multiplicity of mechanisms involved in TH action (e.g. differential expression of TR isoforms, heterodimeric receptor partners, interacting cellular proteins, and regulating enzymes), the TH concentration in blood is not always predictive of their cellular availability and activity at both genomic and nongenomic level.

CONCLUSIONS

In addition to the known role of TH on the hormonal milieu of the ovarian follicle cycle, which is essential for a woman's fertility, evidence is emerging on the importance of TH signaling during implantation and early pregnancy. Based on recent observations, a local action of TH on female reproductive organs and the embryo during implantation appears to be crucial for a successful pregnancy. Furthermore, an imbalance in the spatio-temporal expression of factors involved in TH activity might induce early arrest of pregnancy in women considered as euthyroid, based on their hormonal blood concentration. In conclusion, alterations of the highly regulated local activity of TH may play a crucial, previously underestimated, role in early pregnancy and pregnancy loss. Further studies elucidating this topic should be encouraged.

Dynamics of the transcriptome in the primate ovulatory follicle

Experiments were designed to evaluate changes in the transcriptome (mRNA levels) in the ovulatory, luteinizing follicle of rhesus monkeys, using a controlled ovulation model that permits analysis of the naturally selected, dominant follicle at specific intervals (0, 12, 24 and 36 h) after exposure to an ovulatory (exogenous hCG) stimulus during the menstrual cycle. Total RNA was prepared from individual follicles (n= 4-8/timepoint), with an aliquot used for microarray analysis (Affymetrix Rhesus Macaque Genome Array) and the remainder applied to quantitative real-time PCR (q-PCR) assays. The microarray data from individual samples distinctly clustered according to timepoints, and ovulated follicles displayed markedly different expression patterns from unruptured follicles at 36 h. Between timepoint comparisons revealed profound changes in mRNA expression profiles. The dynamic pattern of mRNA expression for steroidogenic enzymes (CYP17A, CYP19A, HSD3B2, HSD11B1 and HSD11B2), steroidogenic acute regulatory protein (StAR) and gonadotrophin receptors [LH/choriogonadotrophin receptor (LHCGR), FSH receptor (FSHR)] as determined by microarray analysis correlated precisely with those from blinded q-PCR assays. Patterns of mRNA expression for epidermal-growth-factor-like factors (amphiregulin, epiregulin) and processes [hyaluronan synthase 2 (HAS2), tumor necrosis factor alpha-induced protein 6 (TNFAIP6)] implicated in cumulus-oocyte maturation/expansion were also comparable between assays. Thus, several mRNAs displayed the expected expression pattern for purported theca (e.g. CYP17A), granulosa (CYP19A, FSHR), cumulus (HAS2, TNFAIP6) cell and surface epithelium (HSD11B)-related genes in the rodent/primate pre-ovulatory follicle. This database will be of great value in analyzing molecular and cellular pathways associated with periovulatory events in the primate follicle (e.g. follicle rupture, luteinization, inflammatory response and angiogenesis), and for identifying novel gene products controlling mammalian fertility.

High rate of aneuploidy in luteinized granulosa cells obtained from follicular fluid in women who underwent controlled ovarian hyperstimulation

We performed a prospective study to detect the cell cycle changes in luteinized granulosa cells in patients undergoing controlled ovarian stimulation with GnRH analog and gonadotropin therapy. Aneuploid DNA content was observed in 37 of 70 women (52.9%), and multiple logistic regression analysis revealed that only the dose of gonadotropins used significantly predicted the ploidy status of granulosa cells, which indicates that ovarian hyperstimulation in IVF treatment might be detrimental for the DNA content of granulosa cells.

In utero and lactational exposure of Long-Evans rats to ammonium perchlorate (AP) disrupts ovarian follicle maturation

Ammonium perchlorate (AP) is a powerful oxidizer manufactured almost exclusively for the aerospace industry. AP salts are also used in airbags, flares, fertilizers, enamels and paints. As a result of widespread industrial use, AP has become a persistent environmental contaminant of drinking water in several U.S. states. AP ion disrupts the trapping of iodide as well as facilitates the discharge of unorganified iodide from the thyroid gland. Such disturbances in thyroid hormone concentrations during critical periods of development are then known to cause profound reproductive and developmental defects, since thyroid hormones modulate both follicular development and steroidogenesis and affect estrogen metabolism and receptor. This study was designed (1) to determine whether exposure to a low or high concentration of AP (LAP, HAP) exerts detrimental effects on follicle maturation in the Long-Evans hooded rat and (2) to determine whether the modulatory effects of AP can be ameliorated by levo-thyroxine sodium (T4) supplementation. Animals were treated via deionized drinking water on GD 7-21 with LAP (0.4 mg/kg/day) or HAP (4.0 mg/kg/day). Half of each group was also given T4 supplements via drinking water on GD 7-21. Female pups were sacrificed on postnatal days 24/25, and the ovaries were excised, fixed for histology and analyzed. The analysis included a count, measurement and classification of preantral and antral follicles in the greatest cross-sectional area of the ovary. The results indicated that treatment with the HAP significantly reduced the number of preantral follicles <50,000 microm2 and the total number of antral follicles in the <50,000, 50-100,000 and >100,000 microm2 size classes. In ovaries treated with the LAP, we observed no significant decrease in preantral follicles of any size class and only a significant reduction in the largest antral follicles. T4 only circumvented the effect on the number of small preantral and antral follicles; however, a significant diminution in the antral follicle number persisted in the mid-sized (HAP) and large (LAP, HAP)-sized classes. These data support the hypothesis that AP reduces the number of preantral and antral follicles in certain size classes in rats exposed during a critical period of development, and that T4 can attenuate the effects of AP on small preantral and antral follicles, but not on medium or large antral follicles. (T35ES007292 & ES08342.).

Maturational and developmental competence of cumulus-free immature human oocytes derived from stimulated and intracytoplasmic sperm injection cycles

The present experiments compared the maturational and developmental competence of immature oocytes derived from stimulated cycles, following culture in a newly designed in-vitro maturation medium (IVM-medium) or in standard tissue culture medium (TCM-199; control). The results indicated that maturation and fertilization rates were comparable when the cumulus-free M-I stage oocytes were matured in the IVM-medium (78.6%) or the control medium (70.8%). However, there was a significant difference in blastocyst development (P < 0.05) when M-I oocytes were matured in these two media (19.6 versus 7.7%). Both maturation and early embryonic development rates of GV-stage oocytes were significantly higher (P < 0.01) in the IVM-medium (maturation: 75.7%; blastocyst: 12.9%) compared with control (maturation 55.7%; blastocyst: 0.0%). Moreover, embryos developed to the blastocyst stage at a higher rate in both media if GV-stage oocytes had matured within 24 h compared with 48 h of culture. These results demonstrate that immature human oocytes derived from stimulated ovaries can achieve maturation and early embryonic development in vitro, especially in the new IVM-medium, which may allow additional embryos to be produced for clinical use at embryo transfer.

The abnormally large follicle during controlled ovarian hyperstimulation: management and outcome of the cycle

OBJECTIVE

To investigate if the presence of an abnormally large follicle during controlled ovarian hyperstimulation (COH) under pituitary suppression has any effect on the outcome of the cycle.

DESIGN

Prospective, observational.

SETTING

The reproductive endocrinology unit of a university hospital.

PATIENTS

One hundred fifty patients undergoing COH for assisted reproductive techniques during a 6-month period (August 1990 to January 1991).

INTERVENTIONS

Transvaginal follicular aspiration and IVF-uterine ET.

RESULTS

A total of 19 cycles had abnormally large follicles identified on day 8 of the stimulation cycle after normal baseline ultrasound. Gonadotropins were continued and hCG injection was indicated when two or more follicles of the main cohort achieved a diameter of 20 to 22 mm. Twenty preovulatory oocytes were retrieved from 22 large follicles. Two were transferred for GIFT and 18 were inseminated in vitro, resulting in a 72.0% fertilization rate. The mean number of oocytes retrieved per patient was 10.9, 71.4% of which were mature with a fertilization rate of 67.7%. All these figures were comparable with the results obtained in the 131 patients of the control group undergoing IVF. No evidence of premature luteinization was observed in the study group, based on plasma P levels (x 0.83 ng/mL [conversion factor to SI unit, 3.180], range 0.31 to 1.40 ng/mL). The clinical pregnancy rate for the group with abnormally large follicles did not differ from the control group (27.8% versus 28.2%, respectively).

CONCLUSIONS

The presence of an abnormally large follicle during COH under pituitary suppression does not affect the outcome of the cycle. Moreover, under these conditions, continuous gonadotropin stimulation of a follicle to diameters considerably larger than the standard ones does not have a detrimental effect on the oocyte contained in it, suggesting that oocyte aging is an independent process from follicular growth once LH surge is prevented.