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Mauchart P, Vass RA, Nagy B, Sulyok E, Bódis J, Kovács K. Oxidative Stress in Assisted Reproductive Techniques, with a Focus on an Underestimated Risk Factor. Curr Issues Mol Biol 2023; 45:1272-1286. [PMID: 36826028 PMCID: PMC9954903 DOI: 10.3390/cimb45020083] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 01/30/2023] [Accepted: 02/02/2023] [Indexed: 02/08/2023] Open
Abstract
Based on current findings, the presence of oxidative stress has a significant impact on the quality of gametes and embryos when performing assisted reproductive techniques (ART). Unfortunately, in vitro manipulation of these cells exposes them to a higher level of reactive oxygen species (ROS). The primary goal of this review is to provide a comprehensive overview of the development of oxidative stress in female and male reproductive systems, as well as in the case of the pre-implantation embryo and its environment. This review also focuses on the origins of ROS and the mechanisms of oxidative stress-induced damage during ART procedures. A well-known but underestimated hazard, light exposure-related photo-oxidation, is particularly concerning. The effect of oxidative stress on ART outcomes, as well as the various strategies for preventing it, are also discussed. We emphasize the role and significance of antioxidants and light protection including forms, functions, and mechanisms in the development of gametes and embryos in vivo and in vitro.
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Affiliation(s)
- Péter Mauchart
- National Laboratory on Human Reproduction, University of Pécs, 7624 Pécs, Hungary
- Department of Obstetrics and Gynecology, Medical School, University of Pécs, 7624 Pécs, Hungary
- MTA-PTE Human Reproduction Scientific Research Group, 7624 Pécs, Hungary
- Correspondence:
| | - Réka Anna Vass
- National Laboratory on Human Reproduction, University of Pécs, 7624 Pécs, Hungary
- Department of Obstetrics and Gynecology, Medical School, University of Pécs, 7624 Pécs, Hungary
| | - Bernadett Nagy
- National Laboratory on Human Reproduction, University of Pécs, 7624 Pécs, Hungary
- Department of Obstetrics and Gynecology, Medical School, University of Pécs, 7624 Pécs, Hungary
- MTA-PTE Human Reproduction Scientific Research Group, 7624 Pécs, Hungary
| | - Endre Sulyok
- National Laboratory on Human Reproduction, University of Pécs, 7624 Pécs, Hungary
- Department of Obstetrics and Gynecology, Medical School, University of Pécs, 7624 Pécs, Hungary
- Faculty of Health Sciences, Doctoral School of Health Sciences, University of Pécs, 7621 Pécs, Hungary
| | - József Bódis
- National Laboratory on Human Reproduction, University of Pécs, 7624 Pécs, Hungary
- Department of Obstetrics and Gynecology, Medical School, University of Pécs, 7624 Pécs, Hungary
- MTA-PTE Human Reproduction Scientific Research Group, 7624 Pécs, Hungary
- Faculty of Health Sciences, Doctoral School of Health Sciences, University of Pécs, 7621 Pécs, Hungary
| | - Kálmán Kovács
- National Laboratory on Human Reproduction, University of Pécs, 7624 Pécs, Hungary
- Department of Obstetrics and Gynecology, Medical School, University of Pécs, 7624 Pécs, Hungary
- MTA-PTE Human Reproduction Scientific Research Group, 7624 Pécs, Hungary
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Pham HH, Dang QT, Nguyen HN, Tran CT, Pham QT, Mol BW, Dang VQ. The effectiveness of Paraffin oil and Mineral oil for day-5 embryo culture in couples undergoing in vitro fertilisation. Eur J Obstet Gynecol Reprod Biol 2022; 275:59-63. [PMID: 35749967 DOI: 10.1016/j.ejogrb.2022.06.014] [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: 01/17/2022] [Revised: 06/09/2022] [Accepted: 06/16/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVE This study evaluated the effectiveness of Paraffin oil versus Mineral oil for day-5 embryo culture in couples undergoing assisted reproductive technology (ART). METHODS We performed a multi-centre, retrospective cohort study at IVFMD (My Duc Hospital) and IVFMD Phu Nhuan (My Duc Phu Nhuan Hospital) from January 2019 to September 2019. We studied couples treated by intracytoplasmic sperm injection (ICSI), using fresh, ejaculated semen and undergoing day-5 embryo transfer. Couples who underwent in vitro maturation (IVM) or oocyte donation cycles or couples where the woman had uterine abnormalities were excluded. From January 2019 to May 2019, we used Mineral oil (LiteOil, LifeGlobal) while Paraffin oil (Liquid Paraffin, Origio) was used from June 2019 to September 2019. The primary outcome was live birth rate after the first transfer, either from a fresh transfer or frozen embryo transfer. RESULTS Between 1st January 2019 to 30th September 2019, there were 2,312 couples undergoing ART in both centres, of which 762 (377 in the Paraffin group and 385 in the Mineral group) eligible couples were included in the study. Baseline characteristics of couples were comparable between the two groups, with mean female age 31.5 ± 4.3 versus 31.9 ± 4.7 in the Paraffin and Mineral group. Live birth after the first transfer occurred in 153 (40.6%) couples in the Paraffin group, compared to 152 (39.5%) couples in the Mineral group (risk ratio 1.02, 95% confidence interval 0.91 - 1.14). Other secondary outcomes were comparable between the two groups. CONCLUSION In day-5 embryo culture, Paraffin and Mineral oil resulted in a comparable live birth rate.
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Affiliation(s)
- Huy H Pham
- IVFMD Phu Nhuan, My Duc Phu Nhuan Hospital, Ho Chi Minh City, Viet Nam; HOPE Research Centre, My Duc Hospital, Ho Chi Minh City, Viet Nam.
| | - Quyen T Dang
- IVFMD Phu Nhuan, My Duc Phu Nhuan Hospital, Ho Chi Minh City, Viet Nam; HOPE Research Centre, My Duc Hospital, Ho Chi Minh City, Viet Nam
| | - Hue N Nguyen
- IVFMD Phu Nhuan, My Duc Phu Nhuan Hospital, Ho Chi Minh City, Viet Nam; HOPE Research Centre, My Duc Hospital, Ho Chi Minh City, Viet Nam
| | - Cam T Tran
- IVFMD, My Duc Hospital, Ho Chi Minh City, Viet Nam; HOPE Research Centre, My Duc Hospital, Ho Chi Minh City, Viet Nam
| | - Quan T Pham
- HOPE Research Centre, My Duc Hospital, Ho Chi Minh City, Viet Nam
| | - Ben W Mol
- Department of Obstetrics and Gynaecology, School of Clinical Sciences at Monash Health, Monash University, Australia; Aberdeen Centre for Women's Health Research, University of Aberdeen, Aberdeen, United Kingdom
| | - Vinh Q Dang
- IVFMD, My Duc Hospital, Ho Chi Minh City, Viet Nam; HOPE Research Centre, My Duc Hospital, Ho Chi Minh City, Viet Nam
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Agarwal A, Maldonado Rosas I, Anagnostopoulou C, Cannarella R, Boitrelle F, Munoz LV, Finelli R, Durairajanayagam D, Henkel R, Saleh R. Oxidative Stress and Assisted Reproduction: A Comprehensive Review of Its Pathophysiological Role and Strategies for Optimizing Embryo Culture Environment. Antioxidants (Basel) 2022; 11:antiox11030477. [PMID: 35326126 PMCID: PMC8944628 DOI: 10.3390/antiox11030477] [Citation(s) in RCA: 38] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 02/17/2022] [Accepted: 02/21/2022] [Indexed: 02/07/2023] Open
Abstract
Oxidative stress (OS) due to an imbalance between reactive oxygen species (ROS) and antioxidants has been established as an important factor that can negatively affect the outcomes of assisted reproductive techniques (ARTs). Excess ROS exert their pathological effects through damage to cellular lipids, organelles, and DNA, alteration of enzymatic function, and apoptosis. ROS can be produced intracellularly, from immature sperm, oocytes, and embryos. Additionally, several external factors may induce high ROS production in the ART setup, including atmospheric oxygen, CO2 incubators, consumables, visible light, temperature, humidity, volatile organic compounds, and culture media additives. Pathological amounts of ROS can also be generated during the cryopreservation-thawing process of gametes or embryos. Generally, these factors can act at any stage during ART, from gamete preparation to embryo development, till the blastocyst stage. In this review, we discuss the in vitro conditions and environmental factors responsible for the induction of OS in an ART setting. In addition, we describe the effects of OS on gametes and embryos. Furthermore, we highlight strategies to ameliorate the impact of OS during the whole human embryo culture period, from gametes to blastocyst stage.
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Affiliation(s)
- Ashok Agarwal
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH 44195, USA; (R.F.); (R.H.)
- Correspondence:
| | | | | | - Rossella Cannarella
- Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy;
- Department of Biochemistry and Molecular Biotechnology, University of Massachusetts Medical School, Worcester, MA 01605, USA
| | - Florence Boitrelle
- Reproductive Biology, Fertility Preservation, Andrology, CECOS, Poissy Hospital, 78300 Poissy, France;
- Department BREED, UVSQ, INRAE, Paris Saclay University, 78350 Jouy-en-Josas, France
| | - Lina Villar Munoz
- Citmer Reproductive Medicine, IVF LAB, Mexico City 11520, Mexico; (I.M.R.); (L.V.M.)
| | - Renata Finelli
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH 44195, USA; (R.F.); (R.H.)
| | - Damayanthi Durairajanayagam
- Faculty of Medicine, Universiti Teknologi MARA (UiTM), Sungai Buloh Campus, Jalan Hospital, Sungai Buloh 47000, Selangor, Malaysia;
| | - Ralf Henkel
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH 44195, USA; (R.F.); (R.H.)
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London W2 1NY, UK
- Department of Medical Bioscience, University of the Western Cape, Bellville, Cape Town 7530, South Africa
- LogixX Pharma, Theale RG7 4AB, UK
| | - Ramadan Saleh
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Sohag University, Sohag 82524, Egypt;
- Ajyal IVF Center, Ajyal Hospital, Sohag 82524, Egypt
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Blaschka C, Diers S, Aravina M, Geisler S, Schuler G, Tetens J. Evaluation of a small volume oil-free in vitro production system for bovine embryos. Vet Med Sci 2021; 7:868-875. [PMID: 33502126 PMCID: PMC8136954 DOI: 10.1002/vms3.428] [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: 08/17/2020] [Revised: 12/16/2020] [Accepted: 01/04/2021] [Indexed: 02/01/2023] Open
Abstract
Background: Embryos are usually produced in culture systems with an oil overlay, which conveys protection against the evaporation of water and microbial contamination. The oil can also release toxic substances and absorb essential components, such as hormones, which adversely affect the quality of the oocytes and the development of embryos in vitro. Objective: The aim of this study was to validate an oil‐free bovine in vitro production (IVP) system. Method: Cumulus–oocyte complexes collected from abattoir‐derived ovaries were matured, fertilized and cultured employing a standard system. The quantity of medium in both groups (with and without an oil overlay) and throughout all stages of IVP was maintained at a volume of 100 μl. The oil group was covered with paraffin oil. The maturation stage of oocytes was assessed using fluorescence staining after 24 hr and developmental stages of embryos were evaluated on day 8. The expanded day 8 blastocysts were assessed by live–dead staining. Results: Oocytes matured in the absence of an oil overlay had significantly higher maturation rates when compared against matured oocytes in medium with an oil overlay. Steroid concentration is higher in medium after maturation without oil cover. The developmental rate was significantly higher after culture without oil overlay. The total cell number and the live–dead ratio was not significantly different. The osmolality did not differ between both groups during maturation and slightly decreased during culture without oil. Conclusion: Based on the current study, bovine oil‐free IVP systems can be suggested as an alternative to oil‐covered medium.
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Affiliation(s)
- Carina Blaschka
- Division of Biotechnology and Livestock Reproduction, Department of Animal Sciences, Georg-August-University, Goettingen, Germany
| | - Sophie Diers
- Division of Biotechnology and Livestock Reproduction, Department of Animal Sciences, Georg-August-University, Goettingen, Germany
| | - Mariya Aravina
- Division of Biotechnology and Livestock Reproduction, Department of Animal Sciences, Georg-August-University, Goettingen, Germany
| | - Swantje Geisler
- Division of Biotechnology and Livestock Reproduction, Department of Animal Sciences, Georg-August-University, Goettingen, Germany
| | - Gerhard Schuler
- Clinic for Veterinary Obstetrics, Gynecology and Andrology, Molecular Reproductive Medicine, Justus-Liebig-University, Giessen, Germany
| | - Jens Tetens
- Division of Biotechnology and Livestock Reproduction, Department of Animal Sciences, Georg-August-University, Goettingen, Germany
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Abstract
In vitro culture of the embryo is a useful method to treat infertility that shows embryo potential for selecting the best one to transfer and successfully implantation. However, embryo development in vitro is affected by oxidative stresses such as reactive oxygen species that may damage embryo development. Antioxidants are molecules found in fruits, vegetables, and fish that play an important role in reducing oxidative processes. In the natural environment, there is a physiological antioxidant system that protects embryos against oxidative damage. This antioxidant system does not exist in vitro. Antioxidants act as free radical scavengers and protect cells or repair damage done by free radicals. Various studies have shown that adding antioxidants into embryo culture medium improves embryo development in vitro. This review article emphasizes different aspects of various antioxidants, including types, functions and mechanisms, on the growth improvement of different species of embryos in vitro.
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Siristatidis CS, Sertedaki E, Karageorgiou V, Vaidakis D. Endometrial injection of embryo culture supernatant for subfertile women in assisted reproduction. Cochrane Database Syst Rev 2020; 8:CD013063. [PMID: 32797689 PMCID: PMC8094452 DOI: 10.1002/14651858.cd013063.pub2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Despite substantial improvements in the success of assisted reproduction techniques (ART), live birth rates may remain consistently low, and practitioners may look for innovative treatments to improve the outcomes. The injection of embryo culture supernatant in the endometrial cavity can be undertaken at various time intervals before embryo transfer. It provides an altered endometrial environment through the secretion of factors considered to facilitate implantation. It is proposed that injection of the supernatant into the endometrial cavity prior to embryo transfer will stimulate the endometrium and provide better conditions for implantation to take place. An increased implantation rate would subsequently increase rates of clinical pregnancy and live birth, but current robust evidence on the efficacy of injected embryo culture supernatant is lacking. OBJECTIVES To evaluate the effectiveness and safety of endometrial injection of embryo culture supernatant before embryo transfer in women undergoing ART. SEARCH METHODS Our search strategies were designed with the help of the Cochrane Gynaecology and Fertility Group Information Specialist. We sought to identify all published and unpublished randomised controlled trials (RCTs) meeting inclusion criteria. Searches were performed on 2 December 2019. We searched the Cochrane Gynaecology and Fertility Group Specialised Register of controlled trials, CENTRAL, MEDLINE, Embase, CINAHL, trials registries and grey literature. We made further searches in the UK National Institute for Health and Care Excellence (NICE) fertility assessment and treatment guidelines. We handsearched reference lists of relevant systematic reviews and RCTs, together with searches of PubMed and Google for any recent trials that have not yet been indexed in the major databases. We had no language or location restrictions. SELECTION CRITERIA We included RCTs testing the use of endometrial injection of embryo culture supernatant before embryo transfer during an ART cycle, compared with the non-use of this intervention, the use of placebo or the use of any other similar drug. DATA COLLECTION AND ANALYSIS Two review authors independently selected studies, assessed risk of bias, extracted data from studies and attempted to contact the authors where data were missing. We pooled studies using a fixed-effect model. Our primary outcomes were live birth/ongoing pregnancy and miscarriage. We performed statistical analysis using Review Manager 5. We assessed evidence quality using GRADE methods. MAIN RESULTS We found five RCTs suitable for inclusion in the review (526 women analysed). We made two comparisons: embryo culture supernatant use versus standard care or no intervention; and embryo culture supernatant use versus culture medium. All studies were published as full-text articles. Data derived from the reports or through direct communication with investigators were available for the final meta-analysis performed. The GRADE evidence quality of studies ranged from very low-quality to moderate-quality. Factors reducing evidence quality included high risk of bias due to lack of blinding, unclear risk of publication bias and selective outcome reporting, serious inconsistency among study outcomes, and serious imprecision due to wide confidence intervals (CIs) and low numbers of events. Comparison 1. Endometrial injection of embryo culture supernatant before embryo transfer versus standard care or no intervention: One study reported live birth only and two reported the composite outcome live birth and ongoing pregnancy. We are uncertain whether endometrial injection of embryo culture supernatant before embryo transfer during an ART cycle improves live birth/ongoing pregnancy rates compared to no intervention (odds ratio (OR) 1.11, 95% CI 0.73 to 1.70; 3 RCTs; n = 340, I2 = 84%; very low-quality evidence). Results suggest that if the chance of live birth/ongoing pregnancy following placebo or no treatment is assumed to be 42%, the chance following the endometrial injection of embryo culture supernatant before embryo transfer would vary between 22% and 81%. We are also uncertain whether the endometrial injection of embryo culture supernatant could decrease miscarriage rates, compared to no intervention (OR 0.89, 95% CI 0.44 to 1.78, 4 RCTs, n = 430, I2 = 58%, very low-quality evidence). Results suggest that if the chance of miscarriage following placebo or no treatment is assumed to be 9%, the chance following injection of embryo culture supernatant would vary between 3% and 30%. Concerning the secondary outcomes, we are uncertain whether the injection of embryo culture supernatant prior to embryo transfer could increase clinical pregnancy rates (OR 1.13, 95% CI 0.80 to 1.61; 5 RCTs; n = 526, I2 = 0%; very low-quality evidence), decrease ectopic pregnancy rates (OR 0.32, 95% CI 0.01 to 8.24; n = 250; 2 RCTs; I2 = 41%; very low-quality evidence), decrease multiple pregnancy rates (OR 0.70, 95% CI 0.26 to 1.83; 2 RCTs; n = 150; I2 = 63%; very low-quality evidence), or decrease preterm delivery rates (OR 0.63, 95% CI 0.17 to 2.42; 1 RCT; n = 90; I2 = 0%; very low-quality evidence), compared to no intervention. Finally, there may have been little or no difference in foetal abnormality rates between the two groups (OR 3.10, 95% CI 0.12 to 79.23; 1 RCT; n = 60; I2 = 0%; low-quality evidence). Comparison 2. Endometrial injection of embryo culture supernatant versus endometrial injection of culture medium before embryo transfer We are uncertain whether the use of embryo culture supernatant improves clinical pregnancy rates, compared to the use of culture medium (OR 1.09, 95% CI 0.48 to 2.46; n = 96; 1 RCT; very low-quality evidence). No study reported live birth/ongoing pregnancy, miscarriage, ectopic or multiple pregnancy, preterm delivery or foetal abnormalities. AUTHORS' CONCLUSIONS We are uncertain whether the addition of endometrial injection of embryo culture supernatant before embryo transfer as a routine method for the treatment of women undergoing ART can improve pregnancy outcomes. This conclusion is based on current available data from five RCTs, with evidence quality ranging from very low to moderate across studies. Further large well-designed RCTs reporting on live births and adverse clinical outcomes are still required to clarify the exact role of endometrial injection of embryo culture supernatant before embryo transfer.
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Affiliation(s)
- Charalampos S Siristatidis
- Assisted Reproduction Unit, 2nd Department of Obstetrics and Gynaecology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Vasilios Karageorgiou
- Second Department of Psychiatry, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Dennis Vaidakis
- Obstetrics and Gynaecology Department, Larnaca General Hospital, Larnaca, Cyprus
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Guerzoni LPB, Rose JC, Gehlen DB, Jans A, Haraszti T, Wessling M, Kuehne AJC, De Laporte L. Cell Encapsulation in Soft, Anisometric Poly(ethylene) Glycol Microgels Using a Novel Radical-Free Microfluidic System. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2019; 15:e1900692. [PMID: 30993907 DOI: 10.1002/smll.201900692] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Revised: 04/04/2019] [Indexed: 06/09/2023]
Abstract
Complex 3D artificial tissue constructs are extensively investigated for tissue regeneration. Frequently, materials and cells are delivered separately without benefitting from the synergistic effect of combined administration. Cell delivery inside a material construct provides the cells with a supportive environment by presenting biochemical, mechanical, and structural signals to direct cell behavior. Conversely, the cell/material interaction is poorly understood at the micron scale and new systems are required to investigate the effect of micron-scale features on cell functionality. Consequently, cells are encapsulated in microgels to avoid diffusion limitations of nutrients and waste and facilitate analysis techniques of single or collective cells. However, up to now, the production of soft cell-loaded microgels by microfluidics is limited to spherical microgels. Here, a novel method is presented to produce monodisperse, anisometric poly(ethylene) glycol microgels to study cells inside an anisometric architecture. These microgels can potentially direct cell growth and can be injected as rod-shaped mini-tissues that further assemble into organized macroscopic and macroporous structures post-injection. Their aspect ratios are adjusted with flow parameters, while mechanical and biochemical properties are altered by modifying the precursors. Encapsulated primary fibroblasts are viable and spread and migrate across the 3D microgel structure.
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Affiliation(s)
- Luis P B Guerzoni
- DWI-Leibniz Institute for Interactive Materials, Forckenbeckstrasse 50, 52074, Aachen, Germany
| | - Jonas C Rose
- DWI-Leibniz Institute for Interactive Materials, Forckenbeckstrasse 50, 52074, Aachen, Germany
| | - David B Gehlen
- DWI-Leibniz Institute for Interactive Materials, Forckenbeckstrasse 50, 52074, Aachen, Germany
| | - Alexander Jans
- DWI-Leibniz Institute for Interactive Materials, Forckenbeckstrasse 50, 52074, Aachen, Germany
| | - Tamàs Haraszti
- DWI-Leibniz Institute for Interactive Materials, Forckenbeckstrasse 50, 52074, Aachen, Germany
| | - Matthias Wessling
- DWI-Leibniz Institute for Interactive Materials, Forckenbeckstrasse 50, 52074, Aachen, Germany
- AVT.CVT, Forckenbeckstrasse 51, 52074, Aachen, Germany
| | - Alexander J C Kuehne
- DWI-Leibniz Institute for Interactive Materials, Forckenbeckstrasse 50, 52074, Aachen, Germany
- Institute of Organic and Macromolecular Chemistry, Ulm University, Albert-Einstein-Allee 11, 89081, Ulm, Germany
| | - Laura De Laporte
- DWI-Leibniz Institute for Interactive Materials, Forckenbeckstrasse 50, 52074, Aachen, Germany
- Institute for Technical and Macromolecular Chemistry, RWTH Aachen, Worringerweg 1-2, 52074, Aachen, Germany
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