Cytogenetic analysis of human zygotes displaying three pronuclei and one polar body after intracytoplasmic sperm injection

Observation of human embryonic behavior in vitro by high-resolution time-lapse cinematography

Assisted reproductive technology (ART) has yielded vast amounts of information and knowledge on human embryonic development in vitro; however, still images provide limited data on dynamic changes in the developing embryos. Using our high-resolution time-lapse cinematography (hR-TLC) system, we were able to describe normal human embryonic development continuously from the fertilization process to the hatched blastocyst stage in detail. Our hR-TLC observation also showed the embryonic abnormality of a third polar body (PB)-like substance likely containing a small pronucleus being extruded and resulting in single-pronucleus (1PN) formation, while our molecular biological investigations suggested the possibility that some 1PN embryos could be diploid, carrying both maternal and paternal genomes. Furthermore, in some embryos the extruded third PB-like substance was eventually re-absorbed into the ooplasm resulting in the formation of an uneven-sized, two-PN zygote. In addition, other hR-TLC observations showed that cytokinetic failure was correlated with equal-sized, multi-nucleated blastomeres that were also observed in the embryo showing early initiation of compaction. Assessment combining our hR-TLC with molecular biological techniques enables a better understanding of embryonic development and potential improvements in ART outcomes.

Diagnosis of abnormal human fertilization status based on pronuclear origin and/or centrosome number

PURPOSE

Normally fertilized zygotes generally show two pronuclei (2PN) and the extrusion of the second polar body. Conventional in vitro fertilization (c-IVF) and intracytoplasmic sperm injection (ICSI) often result in abnormal monopronuclear (1PN), tripronuclear (3PN), or other polypronuclear zygotes. In this study, we performed combined analyses of the methylation status of pronuclei (PN) and the number of centrosomes, to reveal the abnormal fertilization status in human zygotes.

METHOD

We used differences in DNA methylation status (5-methylcytosine (5mC) and 5-hydroxymethylcytosine (5hmC)) to discriminate between male and female PN in human zygotes. These results were also used to analyze the centrosome number to indicate how many sperm entered into the oocyte.

RESULT

Immunofluorescent analysis shows that all of the normal 2PN zygotes had one 5mC/5hmC double-positive PN and one 5mC-positive PN, whereas a parthenogenetically activated oocyte had only 5mC staining of the PN. All of the zygotes derived from ICSI (1PN, 3PN) had two centrosomes as did all of the 2PN zygotes derived from c-IVF. Of the 1PN zygotes derived from c-IVF, more than 50 % had staining for both 5mC and 5hmC in a single PN, and one or two centrosomes, indicating fertilization by a single sperm. Meanwhile, most of 3PN zygotes derived from c-IVF had a 5mC-positive PN and two 5mC/5hmC double-positive PNs, and had four or five centrosomes, suggesting polyspermy.

CONCLUSIONS

We have established a reliable method to identify the PN origin based on the epigenetic status of the genome and have complemented these results by counting the centrosomes of zygotes.

Association between amino acid turnover and chromosome aneuploidy during human preimplantation embryo development in vitro

This study investigated the relationship between human preimplantation embryo metabolism and aneuploidy rates during development in vitro. One hundred and eighty-eight fresh and cryopreserved embryos from 59 patients (33.9 +/- 0.6 years) were cultured for 2-5 days. The turnover of 18 amino acids was measured in spent media by high-performance liquid chromatography. Embryos were either fixed for interphase fluorescent in situ hybridization analysis of chromosomes 13, 18, 19, 21, X or Y, or were assayed for mitochondrial activity. Amino acid turnover was different (P < 0.05) between stage-matched fresh and cryopreserved embryos due to blastomere loss following warming. The proportion of embryos with aneuploid cells increased as cell division progressed from pronucleate- (23%) to late cleavage stages (50-70%). Asparagine, glycine and valine turnover was significantly different between uniformly genetically normal and uniformly abnormal embryos on Days 2-3 of culture. By Days 3-4, the profiles of serine, leucine and lysine differed between uniformly euploid versus aneuploid embryos. Gender significantly (P < 0.05) affected the metabolism of tryptophan, leucine and asparagine by cleavage-stage embryos. Pronucleate zygotes had a significantly higher proportion of active:inactive mitochondria compared with cleavage-stage embryos. Furthermore, mitochondrial activity was correlated (P < 0.05) with altered aspartate and glutamine turnover. These results demonstrate the association between the metabolism, cytogenetic composition and health of human embryos in vitro.

A preliminary concept, deduced from cytogenetic analyses, for explaining different types of multipronuclear oocytes obtained after intracytoplasmic sperm injection

Oocytes with three or more pronuclei and one or two polar bodies arising after intracytoplasmic sperm injection were analyzed cytogenetically, and the data were used to develop a general model explaining the possible origin of the abnormal pronuclear stages. The mechanisms, either separately or in variable combinations, that induce the appearance of additional pronuclei are: 1) nonextrusion of the second polar body; 2) incomplete chromatid segregation into the extruded second polar body; and 3) dispersal of the oocyte chromatids in the presence of the second polar body formation.

Separation of a pronucleus by premature cytokinesis: a mechanism for immediate diploidization of tripronuclear oocytes?

OBJECTIVE

To describe an oocyte with a peculiar combination of abnormalities in terms of cytoplasmic fragmentation and formation of pronuclei.

DESIGN

Case report.

SETTING

University-based IVF unit.

PATIENT(S)

A chromosomally normal couple undergoing the third treatment by assisted reproduction.

INTERVENTION(S)

Controlled ovarian hyperstimulation, follicular aspiration, testicular sperm extraction, intracytoplasmic sperm injection (ICSI), and oocyte fixation.

MAIN OUTCOME MEASURE(S)

Assessment of pronuclear formation and cytogenetic analysis of a tripronuclear fragmented oocyte.

RESULT(S)

The described oocyte revealed two polar body-like structures after follicular aspiration and developed three pronuclei after ICSI, accompanied by extrusion of another polar body-like globule. Moreover, the pronuclear stage had undergone a premature irregular cytokinesis, including one of the pronuclei in the smaller half of the divided cytoplasm. Cytogenetic analysis showed a triploid karyotype (23,X/23,X,ace/23,Y) commonly found in digynic ICSI zygotes.

CONCLUSION(S)

The chromosomal constitution suggests that the third globule represents another cytoplasmic fragment and no regular second polar body. Separation of a supernumerary pronucleus by premature cytokinesis might be relevant for the discussion on diploidization of triploid zygotes.

Mechanisms giving rise to triploid zygotes during assisted reproduction

OBJECTIVE

To review information on the origin of triploid zygotes as gathered from assisted reproduction techniques.

DESIGN

Identification of relevant literature by a MEDLINE search and own experience on the basis of cytogenetic studies of abnormally fertilized oocytes.

SETTING

None.

PATIENT(S)

None.

INTERVENTION(S)

None.

MAIN OUTCOME MEASURE(S)

None.

RESULT(S)

Penetration of two haploid spermatozoa or of a single diploid spermatozoon into the oocyte causes diandric triploidy. The first case can be discerned by formation of a total of three pronuclei, whereas the second process will remain undetected, because it involves a female and a single but diploid male pronucleus. Digynic triploidy after intracytoplasmic sperm injection is characterized by nonextrusion of the second polar body and formation of three pronuclei. Digyny can also result from the fertilization of diploid giant oocytes. Depending on how maturation of these gametes proceeds, three or only two pronuclei will be observed. Thus, the size of the pronuclear stage must be considered for a successful identification of the abnormality. Endoreduplication within the female pronucleus is not detectable and may represent another, albeit rare, origin of digynic triploidy.

CONCLUSION(S)

Routine inspection of the number of pronuclei is not an absolutely reliable tool for excluding the development of triploid embryos. Observations during assisted reproduction may yield valuable information on the origin of triploidy.

Can 'abnormally' fertilized zygotes give rise to viable embryos?

Conventional practice in in vitro fertilization or intracytoplasmic sperm injection is to select the best quality embryos based on their morphology and cleavage status from a cohort of fertilized oocytes in which two pronuclei were observed at the time they were checked for fertilization. However, in a small proportion of cycles, the selection is limited to embryos that appeared to be either unfertilized (displaying zero pronuclei) or abnormally fertilized (displaying one or three pronuclei) at the time they were checked for fertilization. There is a lack of consensus on whether such embryos should be transferred to the uterus. Cytogenetic analysis of embryos from oocytes with one pronucleus has shown a proportion is diploid. Transfer of such embryos has resulted in healthy births. Limited cytogenetic analysis of oocytes that divide despite the absence of pronuclei at fertilization check indicates that a proportion also have a normal cytogenetic constitution. Cytogenetic analysis of embryos from oocytes with three pronuclei has shown high rates of triploidy and chaotic cell divisions. Subsequent foetuses have extremely unfavourable outcomes. Here, we review the published literature on the cytogenetic analysis of 'unfertilized' and 'abnormally fertilized' embryos and discuss possible pathways which lead to their formation. The limited evidence indicates that oocytes with one pronucleus and oocytes that show normal onward division despite the absence of pronuclei may be considered for replacement in certain circumstances.

Numerical chromosome anomalies detected in paternally derived pronuclei of tripronuclear zygotes after intracytoplasmic sperm injection

OBJECTIVE

To investigate after intracytoplasmic sperm injection (ICSI) the paternal-derived pronuclei of zygotes with three pronuclei (3PN) for numerical-chromosome anomalies by using fluorescence in situ hybridization.

DESIGN

A total of 211 ICSI 3PN zygotes have been analyzed for numerical-chromosome anomalies in paternally derived pronuclei and compared with the group of 82 zygotes originated during IVF. In the ICSI group, 163 zygotes were evaluated for numerical-chromosome anomalies by using DNA probes for chromosomes 18, X, and Y, and 48 zygotes, for chromosomes 21, X, and Y. In the IVF group, 68 zygotes were evaluated for numerical-chromosome anomalies by using probes for chromosomes 18, X, and Y, and 14 zygotes, by using chromosomes 21, X, and Y.

SETTING AND PATIENT(S)

Tripronuclear zygotes were obtained from 74 and 176 patients participating in IVF and ICSI treatment cycles at a university hospital in Switzerland.

INTERVENTION(S)

To evaluate the frequency of numerical-chromosome anomalies in different populations of infertile patients, a total of 211 ICSI zygotes were divided into three groups of zygotes from men with oligozoospermia (n = 124), severe oligozoospermia (n = 53), and azoospermia (n = 34).

MAIN OUTCOME MEASURE(S)

Incidence of sex-chromosome aneuploidy, diploidy, and aneuploidy for chromosomes 18 or 21.

RESULT(S)

Overall incidence of numerical-chromosome anomalies in paternal-derived pronuclei after ICSI (9.5%) was significantly higher than the rate found in paternal-derived pronuclei of IVF zygotes (1.2%). Among ICSI zygotes, sex-chromosome aneuploidy (5.2%) and diploidy (2.8%) were two dominant numerical anomalies in paternal-derived pronuclei. In contrast, aneuploidy for autosomes 18 or 21 was not significantly different when comparing ICSI with IVF zygotes. Regarding different groups of infertile patients, the highest incidence of numerical-chromosome anomalies was found in zygotes originating from men with severe oligozoospermia (13.2%), followed by those originating from men with azoospermia (8.8%) and oligozoospermia (8.1%).

CONCLUSION(S)

Sex-chromosome aneuploidy and diploidy were the most frequent numerical-chromosome anomalies found in paternal pronuclei of ICSI 3PN zygotes. Surprisingly, no statistically significant difference in the incidence of numerical-chromosome anomalies was observed in the three groups of pronuclei derived from men with oligozoospermia, severe oligozoospermia, and azoospermia.

Endoreduplication of the hyperhaploid maternal complement and abnormal pronuclear formation in a human zygote obtained after intracytoplasmic sperm injection

We report the cytogenetic analysis of a tripronuclear zygote with two polar bodies observed after intracytoplasmic sperm injection. Rare previous investigations of this kind of zygote suggested a diploid or a hypotriploid chromosome constitution. In contrast, the present case turned out to be hypertriploid. Besides the haploid (23,Y) sperm chromosome set, there was a hyperdiploid endoreduplicated (end48,XX,+18,+18) maternal contribution. This zygote not only revealed a peculiar combination of different anomalies (hyperhaploidy of the female gamete, endoreduplication and abnormal pronuclear formation) but also indicates that endoreduplication may sporadically contribute to the generation of triploidy.