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Liao H, Tian W, Yao W, Guo Q, Wang Y, Li J, Qing D, Li Y, Deng T. DBP Exposure Affects Oocyte Fertilization Via Extracellular Vesicles-Derived miR-116-5p in Ovarian Granulosa Cells Through Downregulating FOXO3a Expression. Reprod Sci 2024:10.1007/s43032-024-01559-y. [PMID: 38858331 DOI: 10.1007/s43032-024-01559-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 04/12/2024] [Indexed: 06/12/2024]
Abstract
Mono-butyl phthalate (MBP), the metabolite of dibutyl phthalate (DBP), is the most abundant phthalate metabolite found in Chinese women. Extracellular vesicles (EVs) are nanoscale lipid bilayer particles produced by extensive kinds of cells, serving a key role in intercellular communication. Extracellular vesicle miRNAs (EV-miRNAs) in follicular fluid (FF) have been evidenced to be associated with female reproductive health. The objective of this study was to investigate the associations of EV-miRNAs expressed profile with DBP exposure in FF of female participants and expose its potential mechanism in impaired oocyte development. Based on participants' FF MBP concentrations and fertilization status, we compared the miRNA expression between the FF-EVs of group A (high DBP exposure and impaired fertilization) and group B (low DBP exposure and normal fertilization). Compared with group B, miR-1246, miR-3679-5p, miR-423-5p, miR-5585-3p, miR-116-5p, miR-172-5p were upregulated, while miR-34b-3p was downregulated in group A. Target genes of the differently expressed miRNAs were predicted, and the functional analysis was performed. Furthermore, we exposed human ovarian granulosa tumor cell line (KGN) to MBP (4ug/L) to isolate the EVs from the culture medium and validated the expression levels of different miRNAs. We found that MBP exposure was significantly associated with increased levels of miR-116-5p (P = 0.01). In addition, we demonstrated that the most different miRNA, miR-116-5p regulated oocyte fertilization by inhibiting FOXO3a. Our findings suggested that EV-miRNAs in the FF might mediate MBP toxicity in oocytes.
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Affiliation(s)
- Hongmei Liao
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
| | - Wenqu Tian
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
| | - Wen Yao
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
| | - Qingchun Guo
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
| | - Yi Wang
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
| | - Juan Li
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
| | - Danyu Qing
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
| | - Yufeng Li
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
| | - Taoran Deng
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China.
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de Souza LK, Witusk JPD, Galgaro BC, Rodrigues LDS, da Cunha-Filho JSL. Total Fertilization Failure: A Single Center Analysis. Reprod Sci 2024; 31:697-703. [PMID: 37814199 DOI: 10.1007/s43032-023-01338-1] [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: 05/16/2023] [Accepted: 08/23/2023] [Indexed: 10/11/2023]
Abstract
Our main objective was to identify the male and female parameters associated with total fertilization failure (TFF) in IVF with nonmasculine indications. The present work, IRB equivalent INS 63209, is a case-control study that evaluated all cases with TFF after conventional IVF at the Center for Human Reproduction from January 2010 to December 2019 (n = 154). As a control group, we analyzed all patients who did not experience fertilization failure after conventional IVF in the same period (n = 475). We evaluated various parameters, both male and female, assessed during infertility treatment, and only cases without masculine etiology (normal seminal parameters) were included. Ages (female and male) were not different between the groups. Moreover, AMH (anti-Müllerian hormone), semen volume, preprocessing concentration and preprocessing motility were not significantly different (P > 0.05). However, the number of collected oocytes (study versus control groups, median [25-75 interquartile]: 2 [1-5] and 5 [3-8]); MII (2 [1-4] and 5 [2-7]); and postprocessing motility (85 [70-90] and 90 [80-95]) were significantly different between both groups (P < 0.05). Furthermore, a logistic regression analysis including all significant data demonstrated that the number of collected oocytes was significantly related to IVF failure. Patients with fewer than 5 oocytes had an OR of - 1.37 (- 0.938 to - 1.827) for TFF after conventional IVF. Our results showed that a lower follicular response to controlled ovarian stimulation, evidenced by a decreased number of collected oocytes, was the most important parameter associated with IVF failure in nonmasculine infertility.
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Guo H, Wu H, Yan Z, Yin M, Wu L, Li B. Novel WEE2 homozygous mutations c.1346C>T and c.949A>T identified in primary infertile women due to unexplained fertilization failure. Clin Genet 2023; 104:700-704. [PMID: 37772619 DOI: 10.1111/cge.14429] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 09/13/2023] [Accepted: 09/15/2023] [Indexed: 09/30/2023]
Abstract
The occurrence of unexplained fertilization failure can have profound psychological and financial consequences for couples struggling with infertility, and its pathogenesis remains unclear. Increasing evidence highlights genetic basis of unexplained fertilization failure occurrence. Here, we identified one novel homozygous nonsense mutation (c.949A>T), one novel homozygous missense mutation (c.1346C>T), and three reported homozygous mutations (c.585G>C, c.1006_1007insTA, c.1221G>A) in six unrelated probands, showing similar manifestations of unexplained fertilization failure. This finding expands the spectrum of WEE2 mutations, highlighting the critical role of WEE2 in fertilization process, and provides a basis for the prognostic value of testing for WEE2 mutations in primary infertile couples with unexplained fertilization failure.
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Affiliation(s)
- Haiyan Guo
- Department of Assisted Reproduction, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Haibo Wu
- Department of Assisted Reproduction, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zheng Yan
- Department of Assisted Reproduction, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Mingru Yin
- Department of Assisted Reproduction, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ling Wu
- Department of Assisted Reproduction, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Bin Li
- Department of Assisted Reproduction, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Salehi Novin M, Mehdizadeh A, Artimani T, Bakhtiari M, Mehdizadeh M, Aflatoonian R, Zandieh Z. MACS-DGC sperm preparation method resulted in high-quality sperm, top-quality embryo, and higher blastocyst rate in male factor infertile couples with high DNA fragmented sperm. HUM FERTIL 2023; 26:1408-1416. [PMID: 37469268 DOI: 10.1080/14647273.2023.2236297] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 06/15/2023] [Indexed: 07/21/2023]
Abstract
Conventional sperm selection based on motility and morphology fails to provide detailed information on sperm functional and molecular status. Magnetic-activated cell sorting (MACS) protocol aims to optimize this process by selecting apoptotic sperm cells. Phospholipase C zeta-1 (PLCz1) is a physiological stimulus for oocyte activation and early embryonic development. The purpose of this study was to examine seminal parameters, DNA fragmentation index (DFI), and PLCz1 expression levels in MACS-DGC sorted specimens (DFI > 30%) and assess early development in resulting embryos. Semen specimens from 60 patients diagnosed with male factor infertility were collected and processed by either density gradient centrifugation (DGC) or MACS-DGC protocols. Pre and post-preparation analysis was performed. PLCz1 expression was assessed using the RT-PCR method. Retrieved eggs from their partners were divided into two groups in which they were injected with different sorted sperm. The fertilization rate and embryonic development were evaluated. While sperm's progressive motility and morphology significantly improved, there was a substantial decline in DFI following MACS-DGC. Fertilization rates were almost the same between the groups, and the latter resulted in remarkably more top-quality embryos and more blastocysts. PLCz1 expression was considerably higher in the MACS-DGC group. By eliminating apoptotic cells, the MACS-DGC technique could sort highly PLCz1-expressed sperm, optimize sperm selection in individuals with elevated DFI, development of resulting embryos.
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Affiliation(s)
| | | | - Tayebe Artimani
- Endometrium & Endometriosis Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mehrdad Bakhtiari
- Department of Anatomy, Iran University of Medical Science, Tehran, Iran
| | - Mehdi Mehdizadeh
- Reproductive Sciences and Technology Research Center, Department of Anatomy, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Reza Aflatoonian
- Department of Endocrinology and Female Infertility, Reproductive Biomedicine Research Centre, Royan Institute for Reproductive Biomedicine, Tehran, Iran
| | - Zahra Zandieh
- Reproductive Sciences and Technology Research Center, Department of Anatomy, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
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Jiang Y, Jin L, Huang B, Wu L, Ren X, He H. Cumulative live birth rate and neonatal outcomes after early rescue ICSI: a propensity score matching analysis. Hum Reprod Open 2023; 2023:hoad046. [PMID: 38098746 PMCID: PMC10719215 DOI: 10.1093/hropen/hoad046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Revised: 10/08/2023] [Indexed: 12/17/2023] Open
Abstract
STUDY QUESTION Is early rescue ICSI (E-RICSI) an effective and safe technique compared to conventional ICSI? SUMMARY ANSWER Despite the higher multi-pronucleus (PN) rate compared to conventional ICSI, E-RICSI did not add extra risks to clinical and neonatal outcomes. WHAT IS KNOWN ALREADY Based on the finding that the second polar body was released in 80% of fertilized oocytes by 4 h after exposure to spermatozoa and in ∼90% of fertilized oocytes by 6 h, E-RICSI brings forward the timing of rescue ICSI to 6 h after initial insemination, and effectively prevents oocyte aging and embryo-uterus asynchrony. However, some researchers still voice concerns about the efficacy and safety of E-RICSI, and comparative studies are limited. STUDY DESIGN SIZE DURATION A retrospective cohort study was conducted on patients who underwent conventional ICSI or E-RICSI treatment between January 2015 and December 2020 at a university-affiliated hospital. Using 1:1 propensity score matching, 1496 cases entered each group. PARTICIPANTS/MATERIALS SETTING METHODS In total, 1496 couples undergoing conventional ICSI oocyte retrieval cycles and 1496 undergoing E-RICSI oocyte retrieval cycles were enrolled in this study, and basic clinical characteristics, embryologic data, clinical outcomes and neonatal data were compared between groups. The embryos in the E-RICSI group were divided into two subgroups: those fertilized by iIVF (IVF subgroup) and those fertilized by E-RICSI (E-RICSI subgroup); the embryologic data, clinical outcomes, and neonatal data for these subgroups were also compared with the conventional ICSI group. Logistic regression was used for statistical analysis with potential confounder adjustment. MAIN RESULTS AND THE ROLE OF CHANCE The 2PN rate, blastocyst formation rate, and viable blastocyst formation rate of the E-RICSI group were significantly lower compared to the conventional ICSI group (2PN rate: P < 0.001; blastocyst formation rate: P < 0.001; viable blastocyst formation rate: P = 0.004), and the multi-PN rate in the E-RICSI group was significantly higher than the conventional ICSI group (P < 0.001). However, the number of 2PN embryos, normal cleavage embryo rate, Day 3 high-quality cleavage embryo rate, and high-quality blastocyst rate were similar between groups. When considering the IVF embryos and E-RCSI embryos in the E-RICSI group independently, the 2PN rate of the conventional ICSI group was significantly lower than E-RICSI subgroup but higher than the IVF subgroup, whereas the blastocyst formation rate and viable blastocyst formation rate were higher than E-RICSI embryos but comparable to IVF embryos. As for the clinical and neonatal outcomes, the implantation rate of the E-RICSI subgroup was significantly lower than the IVF subgroup but comparable to the conventional ICSI group, while the low birthweight (LBW) rate was significantly lower compared with the conventional ICSI group but similar with the IVF subgroup. No other differences were observed among the three groups for cumulative clinical pregnancy rate, cumulative live birth rate, and the pregnancy outcomes per transfer including clinical pregnancy, ectopic pregnancy, miscarriage, and live birth, either in fresh or frozen embryo transfer cycles. Furthermore, neonatal outcomes, including cesarean section, sex ratio, LBW, preterm birth, and macrosomia, were similar among groups. LIMITATIONS REASONS FOR CAUTION This study is limited by the retrospective design, limited sample size, and short follow-up period. However, our study underlies the need for large-scale, multi-center randomized controlled trials with long-term follow-up. WIDER IMPLICATIONS OF THE FINDINGS Short-term insemination (3 h) combined with E-RICSI may be a safe and effective method to prevent the occurrence of total fertilization failure, and patients with normal or borderline sperm could be encouraged to try IVF first. STUDY FUNDING/COMPETING INTERESTS This study was supported by grants from the National Key & Development Program of China (No. 2021YFC2700603) and the National Natural Science Foundation of China (No. 81801443). The authors declare no conflicts of interest. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- Yaping Jiang
- Reproductive Medicine Center, Tongji Hospital, Tongji Medicine College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China
| | - Lei Jin
- Reproductive Medicine Center, Tongji Hospital, Tongji Medicine College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China
| | - Bo Huang
- Reproductive Medicine Center, Tongji Hospital, Tongji Medicine College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China
| | - Li Wu
- Reproductive Medicine Center, Tongji Hospital, Tongji Medicine College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China
| | - Xinling Ren
- Reproductive Medicine Center, Tongji Hospital, Tongji Medicine College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China
| | - Hui He
- Reproductive Medicine Center, Tongji Hospital, Tongji Medicine College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China
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Sciorio R, Cariati F, Fleming S, Alviggi C. Exploring the Impact of Controlled Ovarian Stimulation and Non-Invasive Oocyte Assessment in ART Treatments. Life (Basel) 2023; 13:1989. [PMID: 37895371 PMCID: PMC10608727 DOI: 10.3390/life13101989] [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: 08/14/2023] [Revised: 09/14/2023] [Accepted: 09/27/2023] [Indexed: 10/29/2023] Open
Abstract
Invasive and noninvasive features are normally applied to select developmentally competent oocytes and embryos that can increase the take-home baby rates in assisted reproductive technology. The noninvasive approach mainly applied to determine oocyte and embryo competence has been, since the early days of IVF, the morphological evaluation of the mature cumulus-oocyte complex at the time of pickup, first polar body, zona pellucida thickness, perivitelline space and cytoplasm appearance. Morphological evaluation of oocyte quality is one of the options used to predict successful fertilization, early embryo development, uterine implantation and the capacity of an embryo to generate a healthy pregnancy to term. Thus, this paper aims to provide an analytical revision of the current literature relating to the correlation between ovarian stimulation procedures and oocyte/embryo quality. In detail, several aspects of oocyte quality such as morphological features, oocyte competence and its surrounding environment will be discussed. In addition, the main noninvasive features as well as novel approaches to biomechanical parameters of oocytes that might be correlated with the competence of embryos to produce a healthy pregnancy and live birth will be illustrated.
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Affiliation(s)
- Romualdo Sciorio
- Fertility Medicine and Gynaecological Endocrinology Unit, Department Woman-Mother-Child, Lausanne University Hospital, CHUV, 1011 Lausanne, Switzerland
| | - Federica Cariati
- Department of Public Health, University of Naples Federico II, Via Pansini 5, 80131 Napoli, Italy;
| | - Steven Fleming
- Discipline of Anatomy & Histology, School of Medical Sciences, University of Sydney, Sydney, NSW 2006, Australia;
| | - Carlo Alviggi
- Fertility Unit, Maternal-Child Department, AOU Policlinico Federico II, 80131 Naples, Italy;
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy
- Endocrinology and Experimental Oncology Institute (IEOS), National Research Council, 80131 Naples, Italy
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Quintana-Vehí A, Martínez M, Zamora MJ, Rodríguez A, Vassena R, Miguel-Escalada I, Popovic M. Significant differences in efficiency between two commonly used ionophore solutions for assisted oocyte activation (AOA): a prospective comparison of ionomycin and A23187. J Assist Reprod Genet 2023; 40:1661-1668. [PMID: 37247099 PMCID: PMC10352473 DOI: 10.1007/s10815-023-02833-9] [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: 02/23/2023] [Accepted: 05/18/2023] [Indexed: 05/30/2023] Open
Abstract
PURPOSE Despite the success of ICSI in treating severe male factor infertile patients, total fertilization failure (FF) still occurs in around 1-3% of ICSI cycles. To overcome FF, the use of calcium ionophores has been proposed to induce oocyte activation and restore fertilization rates. However, assisted oocyte activation (AOA) protocols and ionophores vary between laboratories, and the morphokinetic development underlying AOA remains understudied. METHODS A prospective single-center cohort study involving 81 in vitro matured metaphase-II oocytes from 66 oocyte donation cycles artificially activated by A23187 (GM508 CultActive, Gynemed) (n=42) or ionomycin (n=39). Parthenogenesis was induced, and morphokinetic parameters (tPNa, tPNf, t2-t8, tSB, and tB) were compared between the 2 study groups and a control group comprising 39 2PN-zygotes from standard ICSI cycles. RESULTS Ionomycin treatment resulted in higher activation rates compared to A23187 (38.5% vs 23.8%, p=0.15). Importantly, none of the A23187-activated parthenotes formed blastocysts. When evaluating the morphokinetic dynamics between the two ionophores, we found that tPNa and tPNf were significantly delayed in the group treated by A23187 (11.84 vs 5.31, p=0.002 and 50.15 vs 29.69, p=0.005, respectively). t2 was significantly delayed in A23187-activated parthenotes when compared to the double heterologous control embryo group. In contrast, the morphokinetic development of ionomycin-activated parthenotes was comparable to control embryos (p>0.05). CONCLUSION Our results suggest that A23187 leads to lower oocyte activation rates and profoundly affects morphokinetic timings and preimplantation development in parthenotes. Despite our limited sample size and low parthenote competence, standardization and further optimization of AOA protocols may allow wider use and improved outcomes for FF cycles.
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Affiliation(s)
| | - M Martínez
- Clínica EUGIN, C/ Balmes 236, 08006, Barcelona, Spain
| | - M J Zamora
- Clínica EUGIN, C/ Balmes 236, 08006, Barcelona, Spain
| | | | - R Vassena
- Eugin Group, 08006, Barcelona, Spain
| | | | - M Popovic
- Eugin Group, 08006, Barcelona, Spain
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Li M, Duan X, Zhang N, Ding F, Wang Y, Liu P, Li R. Development and validation of a conventional in vitro total fertilization failure prediction model. J Assist Reprod Genet 2023:10.1007/s10815-023-02851-7. [PMID: 37382786 PMCID: PMC10371948 DOI: 10.1007/s10815-023-02851-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 06/01/2023] [Indexed: 06/30/2023] Open
Abstract
BACKGROUND Conventional total fertilization failure (TFF) is a challenging problem for clinicians. The predictive model developed in this study aims to predict the individual probability of conventional in vitro total fertilization failure. METHODS The prediction model was developed based on 1635 patients who underwent first-attempt in vitro fertilization (IVF) cycles from January 2018 to January 2020. Total fertilization failure and normal fertilization occurred in 218 and 1417 cycles, respectively. Multivariate logistic regression analyses were used to develop the prediction model. Performance of our model was evaluated using calibration (Hosmer-Lemeshow test) and discrimination (area under the receiver operating characteristic curve [AUC]). RESULTS Thirteen risk factors for TFF were included in the prediction model, as follows: female age; female body mass index; infertility duration; number of oocytes retrieved; stimulation protocol; infertility etiology; infertility diagnosis; male age; sperm concentration; total sperm motility; normal sperm morphology percentage; swim-up sperm motility; and swim-up sperm concentration. The AUC of our model was 0.815 (95% CI: 0.783-0.846), indicating satisfactory discrimination performance. CONCLUSION Considering female and male factors (especially sperm parameters), we established a model that predicts the probability of TFF in conventional IVF procedures that will be helpful in the laboratory supporting IVF to facilitate physicians in determining optimal treatment.
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Affiliation(s)
- Ming Li
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, No. 49 North Huayuan Road, Haidian District, Beijing, 100191, China
- Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing, 100191, China
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive, Technology, Beijing, 100191, China
| | - Xiangyue Duan
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, No. 49 North Huayuan Road, Haidian District, Beijing, 100191, China
- Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing, 100191, China
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive, Technology, Beijing, 100191, China
| | - Nan Zhang
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, No. 49 North Huayuan Road, Haidian District, Beijing, 100191, China
- Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing, 100191, China
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive, Technology, Beijing, 100191, China
| | - Feng Ding
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, No. 49 North Huayuan Road, Haidian District, Beijing, 100191, China
- Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing, 100191, China
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive, Technology, Beijing, 100191, China
| | - Yuanyuan Wang
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, No. 49 North Huayuan Road, Haidian District, Beijing, 100191, China
- Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing, 100191, China
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive, Technology, Beijing, 100191, China
| | - Ping Liu
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, No. 49 North Huayuan Road, Haidian District, Beijing, 100191, China
- Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing, 100191, China
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive, Technology, Beijing, 100191, China
| | - Rong Li
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, No. 49 North Huayuan Road, Haidian District, Beijing, 100191, China.
- Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing, 100191, China.
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive, Technology, Beijing, 100191, China.
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Zhang X, Hu C, Wu L. Advances in the study of genetic factors and clinical interventions for fertilization failure. J Assist Reprod Genet 2023:10.1007/s10815-023-02810-2. [PMID: 37289376 PMCID: PMC10371943 DOI: 10.1007/s10815-023-02810-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 04/18/2023] [Indexed: 06/09/2023] Open
Abstract
Fertilization failure refers to the failure in the pronucleus formation, evaluating 16-18 h post in vitro fertilization or intracytoplasmic sperm injection. It can be caused by sperm, oocytes, and sperm-oocyte interaction and lead to great financial and physical stress to the patients. Recent advancements in genetics, molecular biology, and clinical-assisted reproductive technology have greatly enhanced research into the causes and treatment of fertilization failure. Here, we review the causes that have been reported to lead to fertilization failure in fertilization processes, including the sperm acrosome reaction, penetration of the cumulus and zona pellucida, recognition and fusion of the sperm and oocyte membranes, oocyte activation, and pronucleus formation. Additionally, we summarize the progress of corresponding treatment methods of fertilization failure. This review will provide the latest research advances in the genetic aspects of fertilization failure and will benefit both researchers and clinical practitioners in reproduction and genetics.
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Affiliation(s)
- Xiangjun Zhang
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230001, Anhui, China
| | - Congyuan Hu
- Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230001, Anhui, China
| | - Limin Wu
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230001, Anhui, China.
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Lin Y, Huang Y, Li B, Zhang T, Niu Y, Hu S, Ding Y, Yao G, Wei Z, Yao N, Yao Y, Lu Y, He Y, Zhu Q, Zhang L, Sun Y. Novel mutations in PLCZ1 lead to early embryonic arrest as a male factor. Front Cell Dev Biol 2023; 11:1193248. [PMID: 37261077 PMCID: PMC10227596 DOI: 10.3389/fcell.2023.1193248] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 05/05/2023] [Indexed: 06/02/2023] Open
Abstract
Early embryonic arrest is one of the causes of assist reproduction technology (ART) failure. We have previously reported that the first sperm-derived genetic factor, ACTL7a mutations, could lead to early embryonic arrest. However, whether there are other male genetic factors associated with early embryonic arrest remains elusive. Here, we reported bi-allelic mutations in PLCZ1, a well-known causal gene of total fertilization failure, in four infertile males. Among these mutations, p.403_404del, p.I489S, and p.W536X were newly reported in this study. Histological and Western blotting analysis of the patients' sperm indicated these variants as loss-of-function mutations. These patients manifested normal conventional semen parameters and ultra-structures in sperm heads. However, among four in vitro fertilization (IVF) cycles, 81.8% (18/22) of the oocytes were polyspermic fertilized, which was rarely reported in PLCZ1-related male patients. In the following six ICSI cycles, artificial oocyte activation (AOA) was applied and successfully rescued the fertilization failure and polyspermy phenotypes, with 31.3% (15/48) of the MII oocytes normally fertilized. However, 60.0% (9/15) of these normally fertilized zygotes were arrested at 2-5-cell stage, with one failing to cleave, indicating that PLCZ1 was not only necessary for fertilization, but also crucial for early embryonic development. However, these rescued zygotes showed a lower potential in developing into blastocysts when cultured in vitro. Thus, fresh cleavage transfer was tried and two live births were successfully achieved thereafter. In conclusion, this study provided novel mutations in PLCZ1 gene to expand the pathogenic mutational spectrum in male infertility and demonstrated that PLCZ1 was a crucial sperm-related genetic factor for early embryonic arrest. We also proposed that cleavage transfer after ICSI and AOA treatment could be a potential treatment method for male patients carrying bi-allelic mutations in PLCZ1.
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Affiliation(s)
- Yunying Lin
- Center for Reproductive Medicine Center, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai, China
| | - Yi Huang
- Center for Reproductive Medicine Center, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai, China
| | - Boyu Li
- Center for Reproductive Medicine Center, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai, China
| | - Ting Zhang
- Center for Reproductive Medicine Center, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai, China
| | - Yichao Niu
- Center for Reproductive Medicine Center, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai, China
| | - Shuanggang Hu
- Center for Reproductive Medicine Center, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai, China
| | - Ying Ding
- Center for Reproductive Medicine Center, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai, China
| | - Guangxin Yao
- Center for Reproductive Medicine Center, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai, China
| | - Zhe Wei
- Center for Reproductive Medicine Center, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai, China
| | - Ning Yao
- Center for Reproductive Medicine Center, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai, China
| | - Yejie Yao
- Center for Reproductive Medicine Center, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai, China
| | - Yao Lu
- Center for Reproductive Medicine Center, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai, China
| | - Yaqiong He
- Center for Reproductive Medicine Center, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai, China
| | - Qinling Zhu
- Center for Reproductive Medicine Center, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai, China
| | - Ling Zhang
- Center for Reproductive Medicine Center, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai, China
| | - Yun Sun
- Center for Reproductive Medicine Center, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai, China
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11
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Xie P, Aluko A, Cheung S, Goldschlag D, Davis O, Rosenwaks Z, Palermo GD. Assisted gamete treatment to pinpoint acquired meiotic maturity and overcome oocyte activation deficiency contributed by both gametes. F S Rep 2023; 4:72-76. [PMID: 36959954 PMCID: PMC10028469 DOI: 10.1016/j.xfre.2022.12.006] [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: 09/01/2022] [Revised: 12/20/2022] [Accepted: 12/21/2022] [Indexed: 12/31/2022] Open
Abstract
Objective To treat couples with total fertilization failure (TFF) based on a combined oocyte- and sperm-related oocyte activation deficiency by optimizing oocyte response to chemical activation with calcium ionophore. Design Case report. Setting Tertiary Hospital. Patients Two couples with a history of TFF after intracytoplasmic sperm injection intracytoplasmic sperm injection (ICSI). Interventions To overcome oocyte-related oocyte activation deficiency (OAD), extended in vivo/in vitro oocyte maturation was performed to enhance ooplasmic maturity; to address sperm-related OAD, assisted gamete treatment (AGT) was performed to trigger oocyte activation. Main outcome measures Treatment cycle outcomes for the 2 couples undergoing ICSI with extended oocyte maturation (EOM) and AGT. Results We identified 2 couples with TFF after ICSI because of a combined factor of OAD confirmed by phospholipase C zeta expression and genomic assessment. Initial AGT treatment alone failed to enhance fertilization, suggesting superimposed oocyte dysmaturity prohibiting oocytes from responding to chemical stimuli. To address this complex form of OAD, in couple 1, 27 oocytes out of 34 retrieved presented normal metaphase II spindles after EOM; ICSI with AGT yielded a fertilization rate of 63.0% (17/27). All 17 zygotes were cryopreserved initially. Two embryos were thawed and transferred, yielding a monochorionic diamniotic twin pregnancy. Couple 2 underwent 3 ICSI cycles with EOM and AGT; 91.4% (32/35) of oocytes displayed normal metaphase II spindle and achieved an overall fertilization rate of 43.8% (14/32). A total of 12 blastocysts were cryopreserved. A single 46XY blastocyst was thawed and transferred, resulting in a singleton pregnancy. Conclusions Our study has demonstrated the usefulness of EOM by targeting spindle presence to enhance chemical responses to AGT.
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Affiliation(s)
| | | | | | | | | | | | - Gianpiero D. Palermo
- Reprint requests: Gianpiero D. Palermo, M.D., Ph.D., The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medicine, 1305 York Avenue, Y720, New York, New York 10021.
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12
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Zhao S, Cui Y, Guo S, Liu B, Bian Y, Zhao S, Chen Z, Zhao H. Novel variants in ACTL7A and PLCZ1 are associated with male infertility and total fertilization failure. Clin Genet 2023; 103:603-608. [PMID: 36593593 DOI: 10.1111/cge.14293] [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: 11/28/2022] [Revised: 12/27/2022] [Accepted: 12/29/2022] [Indexed: 01/04/2023]
Abstract
Total fertilization failure (TFF), which refers to fertilization failure in all mature oocytes, accounting for 5%-10% of in vitro fertilization (IVF) cycles and 1%-3% of intracytoplasmic sperm injection (ICSI) cycles in human. In this study, we recruited three unrelated primary infertile men with repeated cycles of TFF and performed whole-exome sequencing to identify the potential pathogenic variants. We identified homozygous or compound-heterozygous variants of paternal-effect genes ACTL7A and PLCZ1 that followed a Mendelian recessive inheritance pattern. Novel homozygous nonsense variant in ACTL7A [c.C146G: p.S49*] was identified in case 1, who came from a consanguineous family. Ultrastructural observation of ACTL7A-mutated spermatozoa by transmission electron microscopy (TEM) indicated that apparent increased thickness of perinuclear matrix and the acrosome was detached from the nuclear envelop. Besides, two novel compound-heterozygous variants in PLCZ1 were identified in case 2 [c.1174+3A>C:p.?; c.A1274G:p.N425S] and case 3 [c.136-1G>C:p.?; c.G1358A:p.G453D]. Mutated spermatozoa from case 2 with reduced expression of PLCZ1 showed apparent acrosome detachment by TEM analysis. And ICSI with assisted oocyte activation (ICSI-AOA) treatment can partly rescue the TFF. Taken together, our findings revealed that novel biallelic variants in the paternal-effect genes ACTL7A and PLCZ1 were associated with human TFF, which expanding the spectrum of genetic causes and facilitating the genetic diagnosis of male infertility with TFF.
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Affiliation(s)
- Shuai Zhao
- Center for Reproductive Medicine, Shandong University, Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong Key Laboratory of Reproductive Medicine, Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, China
| | - Ying Cui
- Center for Reproductive Medicine, Shandong University, Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong Key Laboratory of Reproductive Medicine, Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, China
| | - Shunli Guo
- Center for Reproductive Medicine, Shandong University, Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong Key Laboratory of Reproductive Medicine, Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, China
| | - Boyang Liu
- Center for Reproductive Medicine, Shandong University, Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong Key Laboratory of Reproductive Medicine, Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, China
| | - Yuehong Bian
- Center for Reproductive Medicine, Shandong University, Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong Key Laboratory of Reproductive Medicine, Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, China
| | - Shigang Zhao
- Center for Reproductive Medicine, Shandong University, Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong Key Laboratory of Reproductive Medicine, Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, China
| | - Zijiang Chen
- Center for Reproductive Medicine, Shandong University, Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong Key Laboratory of Reproductive Medicine, Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, China
| | - Han Zhao
- Center for Reproductive Medicine, Shandong University, Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong Key Laboratory of Reproductive Medicine, Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, China
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13
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Suto A, Yano Y, Yamamoto Y, Noguchi H, Takeda A, Yamamoto S, Kagawa T, Yoshida K, Hinokio K, Kuwahara A, Yasui T, Iwasa T. Effects of activation with a Ca ionophore and roscovitine on the development of human oocytes that failed to fertilize after ICSI. THE JOURNAL OF MEDICAL INVESTIGATION 2023; 70:321-324. [PMID: 37940514 DOI: 10.2152/jmi.70.321] [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] [Indexed: 11/10/2023]
Abstract
OBJECTIVE The effects of oocyte activation with a Ca ionophore and roscovitine (Ca+R), a selective inhibitor of M-phase promoting factor, on unfertilized oocytes after intracytoplasmic sperm injection (ICSI) or testicular sperm extraction (TESE)-ICSI were evaluated. METHOD Oocytes without pronuclei at 18 hours after ICSI were judged to be unfertilized and were exposed to the Ca ionophore A23187 (5 ?M) with or without roscovitine (50 ?M). The activation rate was measured 3, 7, and 18 hours later. Oocytes with two polar bodies and two pronuclei with a sperm tail were judged to have been activated. RESULTS At 18 hours, the activation rates in the control, Ca ionophore, and Ca+R groups were 3.5% (4/112), 26.9% (7/26), and 32.1% (17/53), respectively. The activation rate of the Ca+R group was significantly higher than that of the control and similar to that of the Ca ionophore group. Among the oocytes that remained unfertilized after TESE-ICSI, the activation rates of the Ca ionophore and Ca+R groups were 22.2% (2/9) and 43.8% (7/16), respectively. CONCLUSIONS Sequential treatment with an Ca ionophore and roscovitine activates oocytes that remain unfertilized after ICSI. In TESE-ICSI, the activation rate tended to be increased by the co-administration of roscovitine with a Ca ionophore. J. Med. Invest. 70 : 321-324, August, 2023.
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Affiliation(s)
- Ayako Suto
- School of Medicine, Tokushima University, Tokushima, Japan
| | - Yuya Yano
- School of Medicine, Tokushima University, Tokushima, Japan
| | - Yuri Yamamoto
- School of Medicine, Tokushima University, Tokushima, Japan
| | - Hiroki Noguchi
- School of Medicine, Tokushima University, Tokushima, Japan
| | - Asuka Takeda
- School of Medicine, Tokushima University, Tokushima, Japan
| | - Shota Yamamoto
- School of Medicine, Tokushima University, Tokushima, Japan
- Department of Renal and Genitourinary Surgery, Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
| | | | - Kanako Yoshida
- School of Medicine, Tokushima University, Tokushima, Japan
| | - Kenji Hinokio
- School of Medicine, Tokushima University, Tokushima, Japan
| | - Akira Kuwahara
- School of Medicine, Tokushima University, Tokushima, Japan
| | | | - Takeshi Iwasa
- School of Medicine, Tokushima University, Tokushima, Japan
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14
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Chen X, Zhao H, Lv J, Dong Y, Zhao M, Sui X, Cui R, Liu B, Wu K. Calcium ionophore improves embryonic development and pregnancy outcomes in patients with previous developmental problems in ICSI cycles. BMC Pregnancy Childbirth 2022; 22:894. [PMID: 36460987 PMCID: PMC9717248 DOI: 10.1186/s12884-022-05228-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 11/17/2022] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Calcium (Ca2+) ionophores are now mainly considered as efficient treatments for fertilization failure. Recently, its application for rescuing poor embryo development was proposed but still non-routine. This study aimed to explore whether Ca2+ ionophore improves embryo development and pregnancy outcomes in patients with poor embryo development in previous intracytoplasmic sperm injection (ICSI) cycles. METHODS This study included 97 patients undergoing assisted oocyte activation (AOA) with Ca2+ ionophore (calcimycin, A23187) treatment. Preimplantation embryonic development and clinical outcomes were compared between ICSI-AOA cycles (AOA group) and previous ICSI cycles of the same patients in which poor embryo developmental potential was present (non-AOA group). Subgroups stratified by maternal age (< 35, 35-40, ≥ 40 years, respectively) were analyzed separately. RESULTS A total of 642 MII oocytes were collected in AOA group, and 689 in non-AOA group. Significantly higher day 3 good quality embryo rate (P = 0.034), good quality blastocyst formation rate (P < 0.001), and utilization rate (P < 0.001) were seen in AOA group. Similar results were seen in each subgroup. For pregnancy outcomes, there were significant differences in clinical pregnancy rate (P = 0.039) and live birth rate (P = 0.045) in total group. In subgroup aged < 35 years, biochemical (P = 0.038), clinical (P = 0.041), and ongoing pregnancy rate (P = 0.037) in AOA group were significantly higher than that in non-AOA group. No significant improvement for clinical outcomes for subgroups aged 35-40 and aged ≥40. CONCLUSION The study suggests that calcimycin could improve preimplantation development and pregnancy outcomes in patients aged < 35 years with embryo developmental problems in previous ICSI cycles.
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Affiliation(s)
- Xiaolei Chen
- grid.27255.370000 0004 1761 1174Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, 250012 Shandong China ,grid.27255.370000 0004 1761 1174Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, 250012 Shandong China ,grid.27255.370000 0004 1761 1174Shandong Key Laboratory of Reproductive Medicine, Jinan, 250012 Shandong China ,Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, 250012 Shandong China ,Shandong Technology Innovation Center for Reproductive Health, Jinan, 250012 Shandong China ,grid.27255.370000 0004 1761 1174National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, 250012 Shandong China
| | - Haibin Zhao
- grid.27255.370000 0004 1761 1174Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, 250012 Shandong China ,grid.27255.370000 0004 1761 1174Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, 250012 Shandong China ,grid.27255.370000 0004 1761 1174Shandong Key Laboratory of Reproductive Medicine, Jinan, 250012 Shandong China ,Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, 250012 Shandong China ,Shandong Technology Innovation Center for Reproductive Health, Jinan, 250012 Shandong China ,grid.27255.370000 0004 1761 1174National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, 250012 Shandong China
| | - Jiale Lv
- grid.27255.370000 0004 1761 1174Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, 250012 Shandong China ,grid.27255.370000 0004 1761 1174Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, 250012 Shandong China ,grid.27255.370000 0004 1761 1174Shandong Key Laboratory of Reproductive Medicine, Jinan, 250012 Shandong China ,Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, 250012 Shandong China ,Shandong Technology Innovation Center for Reproductive Health, Jinan, 250012 Shandong China ,grid.27255.370000 0004 1761 1174National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, 250012 Shandong China
| | - Yi Dong
- grid.27255.370000 0004 1761 1174Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, 250012 Shandong China ,grid.27255.370000 0004 1761 1174Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, 250012 Shandong China ,grid.27255.370000 0004 1761 1174Shandong Key Laboratory of Reproductive Medicine, Jinan, 250012 Shandong China ,Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, 250012 Shandong China ,Shandong Technology Innovation Center for Reproductive Health, Jinan, 250012 Shandong China ,grid.27255.370000 0004 1761 1174National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, 250012 Shandong China
| | - Maoning Zhao
- grid.27255.370000 0004 1761 1174Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, 250012 Shandong China ,grid.27255.370000 0004 1761 1174Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, 250012 Shandong China ,grid.27255.370000 0004 1761 1174Shandong Key Laboratory of Reproductive Medicine, Jinan, 250012 Shandong China ,Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, 250012 Shandong China ,Shandong Technology Innovation Center for Reproductive Health, Jinan, 250012 Shandong China ,grid.27255.370000 0004 1761 1174National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, 250012 Shandong China
| | - Xinlei Sui
- grid.27255.370000 0004 1761 1174Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, 250012 Shandong China ,grid.27255.370000 0004 1761 1174Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, 250012 Shandong China ,grid.27255.370000 0004 1761 1174Shandong Key Laboratory of Reproductive Medicine, Jinan, 250012 Shandong China ,Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, 250012 Shandong China ,Shandong Technology Innovation Center for Reproductive Health, Jinan, 250012 Shandong China ,grid.27255.370000 0004 1761 1174National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, 250012 Shandong China
| | - Ran Cui
- grid.27255.370000 0004 1761 1174Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, 250012 Shandong China ,grid.27255.370000 0004 1761 1174Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, 250012 Shandong China ,grid.27255.370000 0004 1761 1174Shandong Key Laboratory of Reproductive Medicine, Jinan, 250012 Shandong China ,Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, 250012 Shandong China ,Shandong Technology Innovation Center for Reproductive Health, Jinan, 250012 Shandong China ,grid.27255.370000 0004 1761 1174National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, 250012 Shandong China
| | - Boyang Liu
- grid.27255.370000 0004 1761 1174Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, 250012 Shandong China ,grid.27255.370000 0004 1761 1174Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, 250012 Shandong China ,grid.27255.370000 0004 1761 1174Shandong Key Laboratory of Reproductive Medicine, Jinan, 250012 Shandong China ,Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, 250012 Shandong China ,Shandong Technology Innovation Center for Reproductive Health, Jinan, 250012 Shandong China ,grid.27255.370000 0004 1761 1174National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, 250012 Shandong China
| | - Keliang Wu
- grid.27255.370000 0004 1761 1174Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, 250012 Shandong China ,grid.27255.370000 0004 1761 1174Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, 250012 Shandong China ,grid.27255.370000 0004 1761 1174Shandong Key Laboratory of Reproductive Medicine, Jinan, 250012 Shandong China ,Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, 250012 Shandong China ,Shandong Technology Innovation Center for Reproductive Health, Jinan, 250012 Shandong China ,grid.27255.370000 0004 1761 1174National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, 250012 Shandong China
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15
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Machlin JH, Shikanov A. Single-cell RNA-sequencing of retrieved human oocytes and eggs in clinical practice and for human ovarian cell atlasing. Mol Reprod Dev 2022; 89:597-607. [PMID: 36264989 PMCID: PMC9805491 DOI: 10.1002/mrd.23648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 10/06/2022] [Accepted: 10/09/2022] [Indexed: 01/18/2023]
Abstract
With the advancement of single-cell separation techniques and high-throughput sequencing platforms, single-cell RNA-sequencing (scRNA-seq) has emerged as a vital technology for understanding tissue and organ systems at cellular resolution. Through transcriptional analysis, it is possible to characterize unique or rare cell types, interpret their interactions, and reveal novel functional states or shifts in developmental stages. As such, this technology is uniquely suited for studying the cells within the human ovary. The ovary is a cellularly heterogeneous organ that houses follicles, the reproductive and endocrine unit that consists of an oocyte surrounded by hormone-producing support cells, as well as many other cell populations constituting stroma, vasculature, lymphatic, and immune components. Here we review studies that have utilized scRNA-seq technology to analyze cells from healthy human ovaries and discuss the single-cell isolation techniques used. We identified two overarching applications for scRNA-seq in the human ovary. The first applies this technology to investigate transcriptional differences in oocytes/eggs from patients undergoing in vitro fertilization treatments to ultimately improve clinical outcomes. The second utilizes scRNA-seq for the pursuit of creating a comprehensive single-cell atlas of the human ovary. The knowledge gained from these studies underscores the importance of scRNA-seq technologies in unlocking a new biological understanding of the human ovary.
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Affiliation(s)
- Jordan H. Machlin
- Program in Cellular and Molecular BiologyUniversity of MichiganAnn ArborMichiganUSA
| | - Ariella Shikanov
- Program in Cellular and Molecular BiologyUniversity of MichiganAnn ArborMichiganUSA
- Department of Biomedical EngineeringUniversity of MichiganAnn ArborMichiganUSA
- Department of Obstetrics and GynecologyUniversity of MichiganAnn ArborMichiganUSA
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16
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Zhang L, Cai H, Li W, Tian L, Shi J. Duration of infertility and assisted reproductive outcomes in non-male factor infertility: can use of ICSI turn the tide? BMC Womens Health 2022; 22:480. [DOI: 10.1186/s12905-022-02062-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 11/10/2022] [Indexed: 11/29/2022] Open
Abstract
Abstract
Background
Intracytoplasmic sperm injection (ICSI) is increasingly used among in vitro fertilization (IVF) cycles without male factor infertility. For couples with prolonged infertility duration, the preferred insemination method may vary across laboratories and clinics. We analyzed whether ICSI is effective for non-male factor infertility with long infertility duration.
Methods
Seventeen thousand four hundred seventy-seven IVF/ICSI cycles from women with non-male factor infertility were included, of these 4177 women with infertility duration ≥ 5 years were in the final analysis. Primary outcome was the live birth rate after first embryo transfer. Secondary outcomes were rates of clinical pregnancy and fertilization.
Results
A nonlinear relationship was observed between infertility duration and IVF fertilization rate, which decreased with infertility years up to the turning point (4.8 years). 4177 women with infertility ≥ 5 years were categorized by IVF (n = 3806) or ICSI (n = 371). Live birth rate after first embryo transfer was 43.02% in ICSI and 47.85% in IVF group (adjusted odds ratio (aOR), 0.91; 95% confidence interval (CI), 0.72–1.15). Fertilization rate per metaphaseII (aOR, 1.10; 95% CI, 0.86–1.40) and clinical pregnancy rate (aOR, 0.89; 95% CI, 0.71–1.13) were similar between the two groups. Sensitive analyses (women ≥ 35 years) did not show a benefit of ICSI over IVF.
Conclusions
Women with infertility exceeding 4.8 years had decreased incidence of IVF fertilization. The use of ICSI showed no significant improvement in fertilization and live birth rates for non-male factor couples with ≥ 5 years of infertility.
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Wang Q, Wan Q, Bu X, Feng Q, Li T, Lv X, Meng X, Chen M, Qian Y, Yang Y, Geng L, Zhong Z, Tang X, Ding Y. Nomogram models to predict low fertilisation rate and total fertilisation failure in patients undergoing conventional IVF cycles. BMJ Open 2022; 12:e067838. [PMID: 36428025 PMCID: PMC9703318 DOI: 10.1136/bmjopen-2022-067838] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVES To establish visualised prediction models of low fertilisation rate (LFR) and total fertilisation failure (TFF) for patients in conventional in vitro fertilisation (IVF) cycles. DESIGN A retrospective cohort study. SETTING Data from August 2017 to August 2021 were collected from the electronic records of a large obstetrics and gynaecology hospital in Sichuan, China. PARTICIPANTS A total of 11 598 eligible patients who underwent the first IVF cycles were included. All patients were randomly divided into the training group (n=8129) and the validation group (n=3469) in a 7:3 ratio. PRIMARY OUTCOME MEASURE The incidence of LFR and TFF. RESULTS Logistic regressions showed that ovarian stimulation protocol, primary infertility and initial progressive sperm motility were the independent predictors of LFR, while serum luteinising hormone and P levels before human chorionic gonadotropin injection and number of oocytes retrieved were the critical predictors of TFF. And these indicators were incorporated into the nomogram models. According to the area under the curve values, the predictive ability for LFR and TFF were 0.640 and 0.899 in the training set and 0.661 and 0.876 in the validation set, respectively. The calibration curves also showed good concordance between the actual and predicted probabilities both in the training and validation group. CONCLUSION The novel nomogram models provided effective methods for clinicians to predict LFR and TFF in traditional IVF cycles.
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Affiliation(s)
- Qiaofeng Wang
- School of Public Health, Chongqing Medical University, Chongqing, China
| | - Qi Wan
- Department of Reproductive Medicine, Chengdu Jinjiang Hospital for Women's and Children's Health, Chengdu, China
- Department of Gynecology and Obstetrics, Sichuan University, Chengdu, China
| | - Xiaoqing Bu
- School of Public Health, Chongqing Medical University, Chongqing, China
| | - Qian Feng
- Department of Gynecology, Chongqing City Hospital of Traditional Chinese Medicine, Chongqing, China
| | - Tian Li
- Department of Reproductive Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xingyu Lv
- Department of Gynecology and Obstetrics, Sichuan University, Chengdu, China
| | - Xiangqian Meng
- Department of Gynecology and Obstetrics, Sichuan University, Chengdu, China
| | - Mingxing Chen
- School of Public Health, Chongqing Medical University, Chongqing, China
| | - Yue Qian
- School of Public Health, Chongqing Medical University, Chongqing, China
| | - Yin Yang
- School of Public Health, Chongqing Medical University, Chongqing, China
| | - Lihong Geng
- Department of Gynecology and Obstetrics, Sichuan University, Chengdu, China
| | - Zhaohui Zhong
- School of Public Health, Chongqing Medical University, Chongqing, China
| | - Xiaojun Tang
- School of Public Health, Chongqing Medical University, Chongqing, China
| | - Yubin Ding
- School of Public Health, Chongqing Medical University, Chongqing, China
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18
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Iwamoto A, Van Voorhis BJ, Summers KM, Sparks A, Mancuso AC. Intracytoplasmic sperm injection vs. conventional in vitro fertilization in patients with non-male factor infertility. Fertil Steril 2022; 118:465-472. [PMID: 35835597 DOI: 10.1016/j.fertnstert.2022.06.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 06/07/2022] [Accepted: 06/10/2022] [Indexed: 01/13/2023]
Abstract
OBJECTIVE To compare the cumulative live birth rates (CLBRs) and cost effectiveness of intracytoplasmic sperm injection (ICSI) and conventional in vitro fertilization (cIVF) for non-male factor infertility. DESIGN A retrospective cohort study. SETTING Society for Assisted Reproductive Technology clinics. PATIENT(S) A total of 46,967 patients with non-male factor infertility with the first autologous oocyte retrieval cycle between January 2014 and December 2015. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) The primary outcomes were CLBR, defined as up to 1 live birth from an autologous retrieval cycle between 2014 and 2015, and linked fresh and frozen embryo transfers through 2016. The secondary outcomes included miscarriage rate, 2 pronuclei per oocyte retrieved, and the total number of transferred and frozen embryos. Analyses were performed on subsamples with and without preimplantation genetic testing for aneuploidy (PGT-A). A cost analysis was performed to determine the costs accrued by ICSI. RESULT(S) Among cycles without PGT-A in patients with non-male factor infertility, the CLBR was 60.9% for ICSI cycles vs. 64.3% for cIVF cycles, a difference that was not significantly different after adjustment for covariates (adjusted risk ratio, 0.99; 95% confidence interval, 0.99-1.00). With PGT-A, no difference in CLBR was found between ICSI and cIVF cases after adjustment (64.7% vs. 69.0%, respectively; adjusted risk ratio, 0.97; 95% confidence interval, 0.93-1.01). The patients were charged an estimated additional amount of $37,476,000 for ICSI without genetic testing and an additional amount of $7,213,500 for ICSI with PGT-A over 2 years by Society for Assisted Reproductive Technology clinics. CONCLUSION(S) In patients with non-male factor infertility, ICSI did not improve CLBR. Given the additional cost and the lack of CLBR benefit, our data show that the routine use of ICSI in patients with non-male factor infertility is not warranted.
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Affiliation(s)
- Aya Iwamoto
- Department of Obstetrics and Gynecology, University of Iowa Hospitals and Clinics, Iowa City, Iowa.
| | - Bradley J Van Voorhis
- Department of Obstetrics and Gynecology, University of Iowa Hospitals and Clinics, Iowa City, Iowa
| | - Karen M Summers
- Department of Obstetrics and Gynecology, University of Iowa Hospitals and Clinics, Iowa City, Iowa
| | - Amy Sparks
- Department of Obstetrics and Gynecology, University of Iowa Hospitals and Clinics, Iowa City, Iowa
| | - Abigail C Mancuso
- Department of Obstetrics and Gynecology, University of Iowa Hospitals and Clinics, Iowa City, Iowa
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19
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Chen H, Li P, Du X, Zhao Y, Wang L, Tian Y, Song X, Shuai L, Bai X, Chen L. Homozygous Loss of Septin12, but not its Haploinsufficiency, Leads to Male Infertility and Fertilization Failure. Front Cell Dev Biol 2022; 10:850052. [PMID: 35547809 PMCID: PMC9082362 DOI: 10.3389/fcell.2022.850052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 04/06/2022] [Indexed: 11/23/2022] Open
Abstract
The SEPTIN12 gene has been associated with male infertility. Male Septin12+/− chimera mice were infertile, supporting the prevailing view that SEPTIN12 haploinsufficiency causes male infertility. In this study, we identified a heterozygous mutation on SEPTIN12, c.72C>A (p.Cys24Ter) in the male partner of a patient couple, who had a previous fertilization failure (FF) after intracytoplasmic sperm injection (ICSI) and became pregnant after ICSI together with artificial oocyte activation (AOA). To investigate the role of SEPTIN12 in FF and oocyte activation, we constructed Septin12 knockout mice. Surprisingly, Septin12−/− male mice, but not Septin12+/− male mice, are infertile, and have reduced sperm counts and abnormal sperm morphology. Importantly, AOA treatment enhances the 2-cell embryo rate of ICSI embryos injected with Septin12−/− sperm, indicating that FF caused by male Septin12 deficiency is overcome by AOA. Mechanistically, loss of PLCζ around the acrosome might be the reason for FF of Septin12−/− sperm. Taken together, our data indicated that homozygous knockout of Septin12, but not Septin12 haploinsufficiency, leads to male infertility and FF.
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Affiliation(s)
- Haixia Chen
- Tianjin Key Laboratory of Female Reproductive Health and Eugenics, Reproductive Medicine Center, Department of Gynecology and Obstetrics, Tianjin Medical University General Hospital, Tianjin, China
| | - Peng Li
- Tianjin Union Medical Center, State Key Laboratory of Medicinal Chemical Biology, Tianjin Key Laboratory of Protein Sciences, Frontiers Science Center for Cell Responses, National Demonstration Center for Experimental Biology Education and College of Life Sciences, Nankai University, Institute of Translational Medicine, Tianjin, China
| | - Xiaoling Du
- Tianjin Union Medical Center, State Key Laboratory of Medicinal Chemical Biology, Tianjin Key Laboratory of Protein Sciences, Frontiers Science Center for Cell Responses, National Demonstration Center for Experimental Biology Education and College of Life Sciences, Nankai University, Institute of Translational Medicine, Tianjin, China
| | - Yiding Zhao
- State Key Laboratory of Medicinal Chemical Biology and College of Pharmacy, Nankai University, Tianjin, China
| | - Lingling Wang
- Tianjin Union Medical Center, State Key Laboratory of Medicinal Chemical Biology, Tianjin Key Laboratory of Protein Sciences, Frontiers Science Center for Cell Responses, National Demonstration Center for Experimental Biology Education and College of Life Sciences, Nankai University, Institute of Translational Medicine, Tianjin, China
| | - Ye Tian
- Tianjin Key Laboratory of Female Reproductive Health and Eugenics, Reproductive Medicine Center, Department of Gynecology and Obstetrics, Tianjin Medical University General Hospital, Tianjin, China
| | - Xueru Song
- Tianjin Key Laboratory of Female Reproductive Health and Eugenics, Reproductive Medicine Center, Department of Gynecology and Obstetrics, Tianjin Medical University General Hospital, Tianjin, China
| | - Ling Shuai
- State Key Laboratory of Medicinal Chemical Biology and College of Pharmacy, Nankai University, Tianjin, China
| | - Xiaohong Bai
- Tianjin Key Laboratory of Female Reproductive Health and Eugenics, Reproductive Medicine Center, Department of Gynecology and Obstetrics, Tianjin Medical University General Hospital, Tianjin, China
| | - Lingyi Chen
- Tianjin Union Medical Center, State Key Laboratory of Medicinal Chemical Biology, Tianjin Key Laboratory of Protein Sciences, Frontiers Science Center for Cell Responses, National Demonstration Center for Experimental Biology Education and College of Life Sciences, Nankai University, Institute of Translational Medicine, Tianjin, China
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20
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Fertilization and neonatal outcomes after early rescue intracytoplasmic sperm injection: a retrospective analysis of 16,769 patients. Arch Gynecol Obstet 2022; 306:249-258. [PMID: 35380279 PMCID: PMC9300487 DOI: 10.1007/s00404-022-06445-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 02/09/2022] [Indexed: 01/04/2023]
Abstract
Purpose To evaluate the efficacy and safety of short-term insemination and early-rescue intracytoplasmic sperm injection (ICSI), an approach that rescued oocytes with unclear second polar body 6 h after initial insemination by ICSI (early R-ICSI) to avoid total or near-total fertilization failure in conventional in vitro fertilization (IVF). Methods We performed a retrospective study in 16,769 patients (short-term IVF, n = 12,094; ICSI, n = 3452; early R-ICSI, n = 1223) who received IVF/ICSI treatment in our hospital from January 2009 to October 2018. Fertilization and clinical outcomes were compared among those three groups. Results When considering the R-ICSI embryos in the early R-ICSI group independently, the rates of fertilization and day-3 cleaved embryos in 2PN oocytes were comparable, the rates of fertilization (2PN) and high-quality embryos were lower, whereas the multi-PN fertilization rate (3.27%) was significantly higher than the ICSI group (1.26%). The difference of clinical pregnancy rate between the part of transferred R-ICSI embryos (40.81%) and the ICSI group (44.73%) remained nonsignificant. Furthermore, the rate of congenital birth defects in the early R-ICSI group (0.99%) was not significantly different from those in the short-term IVF (0.76%) and ICSI groups (1.07%). Conclusion Despite the multi-PN fertilization rate, our study highlights early R-ICSI as a safe and effective alternative in assisted reproduction to decrease complete IVF fertilization failure and reduce ICSI utilization. Additional large amount and long-term follow-up studies are needed to further validate the use of early R-ICSI.
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21
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Sciorio R, Miranian D, Smith GD. Non-invasive oocyte quality assessment. Biol Reprod 2022; 106:274-290. [PMID: 35136962 DOI: 10.1093/biolre/ioac009] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 01/04/2022] [Accepted: 01/11/2022] [Indexed: 12/27/2022] Open
Abstract
Oocyte quality is perhaps the most important limiting factor in female fertility; however, the current methods of determining oocyte competence are only marginally capable of predicting a successful pregnancy. We aim to review the predictive value of non-invasive techniques for the assessment of human oocytes and their related cells and biofluids that pertain to their developmental competence. Investigation of the proteome, transcriptome, and hormonal makeup of follicular fluid, as well as cumulus-oocyte complexes are currently underway; however, prospective randomized non-selection-controlled trials of the future are needed before determining their prognostic value. The biological significance of polar body morphology and genetics are still unknown and the subject of debate. The predictive utility of zygotic viscoelasticity for embryo development has been demonstrated, but similar studies performed on oocytes have yet to be conducted. Metabolic profiling of culture media using human oocytes are also limited and may require integration of automated, high-throughput targeted metabolomic assessments in real time with microfluidic platforms. Light exposure to oocytes can be detrimental to subsequent development and utilization of time-lapse imaging and morphometrics of oocytes is wanting. Polarized light, Raman microspectroscopy, and coherent anti-Stokes Raman scattering are a few novel imaging tools that may play a more important role in future oocyte assessment. Ultimately, the integration of chemistry, genomics, microfluidics, microscopy, physics, and other biomedical engineering technologies into the basic studies of oocyte biology, and in testing and perfecting practical solutions of oocyte evaluation, are the future for non-invasive assessment of oocytes.
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Affiliation(s)
- Romualdo Sciorio
- Edinburgh Assisted Conception Programme, EFREC, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - Daniel Miranian
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, USA
| | - Gary D Smith
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, USA.,Department of Physiology, Urology, and Reproductive Sciences Program, University of Michigan, Ann Arbor, MI, USA
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22
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Giacobbe M, Conatti M, Gomes A, Bonetti TC, Monteleone PA. Effectivity of conventional in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) when male factor is absent: a perspective point of view. JBRA Assist Reprod 2022; 26:123-128. [PMID: 34812599 PMCID: PMC8769186 DOI: 10.5935/1518-0557.20210031] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 06/10/2021] [Indexed: 12/05/2022] Open
Abstract
An objective and individualized approach of in vitro fertilization techniques tends to decrease costs and improve the experience of infertile couples during treatment. The use of available technologies to diagnose and treat infertility based on scientific evidence seems to be the best practice, which is the guideline that motivates this review on the available techniques for laboratory oocyte insemination. Conventional IVF, the pioneering technique, was initially used in the treatment of tubal obstruction infertility, successfully expanding the treatment of infertile couples presenting with several other factors. However, it was less effective in cases of severe male factor infertility. Intracytoplasmic sperm injection, which was developed in 1992, proved to be the method of choice for treating couples with severe male factor infertility. Since then, it has been increasingly used regardless of the infertility factor. This review discusses the effectiveness of conventional in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) when the male factor is absent in all aspects, as technical and clinical outcomes, associated risks, adjustments for using with other technologies and costs. Finally we discuss the advantages and disadvantages of each one, with all aspects reviewed.
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Affiliation(s)
- Marcelo Giacobbe
- ART Medicina Rede de Reprodução Humana, São Paulo, SP, Brazil
- Fertilivitá Reprodução Humana, São Paulo, SP, Brazil
| | - Maiara Conatti
- Monteleone Centro de Reprodução Humana, São Paulo, SP, Brazil
| | | | - Tatiana Cs Bonetti
- Monteleone Centro de Reprodução Humana, São Paulo, SP, Brazil
- Departamento de Ginecologia. Universidade Federal de São Paulo - Escola Paulista de Medicina, São Paulo, SP, Brazil
| | - Pedro Aa Monteleone
- Monteleone Centro de Reprodução Humana, São Paulo, SP, Brazil
- Disciplina de Ginecologia - Departamento de Obstetrícia e Ginecologia. Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
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23
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Li J, Hu T, Wang Y, Fu Y, Wang F, Hu R. Development a nomogram to predict fertilisation rate of infertile males with borderline semen by using semen parameters combined with AMH and INHB. Andrologia 2021; 53:e14182. [PMID: 34270116 PMCID: PMC8519038 DOI: 10.1111/and.14182] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 06/10/2021] [Accepted: 06/19/2021] [Indexed: 11/30/2022] Open
Abstract
The sperm quality of some males is in a critical state, making it hard for clinicians to choose the suitable fertilisation methods. This study aimed to develop an intelligent nomogram for predicting fertilisation rate of infertile males with borderline semen. 160 males underwent in vitro fertilisation (IVF), 58 of whom received rescue ICSI (R‐ICSI) due to fertilisation failure (fertilisation rate of IVF ≤30%). A least absolute shrinkage and selection operator (LASSO) regression analysis identified sperm concentration, progressively motile spermatozoa (PMS), seminal plasma anti‐Müllerian hormone (spAMH), seminal plasma inhibin (spINHB), serum AMH (serAMH) and serum INHB (serINHB) as significant predictors. The nomogram was plotted by multivariable logistic regression. This nomogram‐illustrated model showed good discrimination, calibration and clinical value. The area under the receiver operating characteristic curve (AUC) of the nomogram was 0.762 (p < .001). Calibration curve and Hosmer–Lemeshow test (p = .5261) showed good consistency between the predictions of the nomogram and the actual observations, and decision curve analysis showed that the nomogram was clinically useful. This nomogram may be useful in predicting fertilisation rate, mainly focused on new biomarkers, INHB and AMH. It could assist clinicians and laboratory technicians select appropriate fertilisation methods (IVF or ICSI) for male patients with borderline semen.
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Affiliation(s)
- Jialing Li
- Ningxia Medical University, Yinchuan, China.,Key Laboratory of Fertility Preservation and Maintenance of Ministry of Education, Ningxia Medical University, Yinchuan, China
| | - Ting Hu
- Gansu Provincial Maternity and Child-care Hospital, Lanzhou, Gansu, China
| | - Yanfei Wang
- Gansu Provincial Maternity and Child-care Hospital, Lanzhou, Gansu, China
| | - Yuxing Fu
- Ningxia Medical University, Yinchuan, China.,Key Laboratory of Fertility Preservation and Maintenance of Ministry of Education, Ningxia Medical University, Yinchuan, China
| | - Feimiao Wang
- Reproductive Medicine Center, General Hospital of Ningxia Medical University, Yinchuan, China
| | - Rong Hu
- Reproductive Medicine Center, General Hospital of Ningxia Medical University, Yinchuan, China
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24
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Chua AC, Abdul Karim AK, Tan ACC, Abu MA, Ahmad MF. The outcome of intra-cytoplasmic sperm injection (ICSI): do the sperm concentration and motility matter? Horm Mol Biol Clin Investig 2021; 42:367-372. [PMID: 34118795 DOI: 10.1515/hmbci-2020-0089] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 05/08/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES The male-factor subfertility was reported to be 30% globally; thus, the intracytoplasmic sperm injection (ICSI) procedure was implemented to improve the overall in vitro fertilization (IVF) rates. Nevertheless, at least 10% of fertilization failure still occurs. Concerning this issue, we explored the association of sperm concentration and motility with the quality of embryo development and pregnancy outcome in IVF-ICSI cycles. METHODS Retrospective analysis of 109 couples with male factor were done over 14 months in a tertiary university hospital in Malaysia. The data were divided into four groups; Group I: normal sperm parameters, Group II: normal sperm concentration but reduced total sperm motility, Group III: reduced sperm concentration and motility, Group IV: reduced sperm concentration but normal sperm motility. Only fresh semen samples and fresh embryo transfers were included. The fertilization, cleavage rate, embryo quality and pregnancy outcome were assessed. RESULTS Overall, group I had the highest oocytes yield and ICSI attempted; (10.12 + 6.50), whereas the lowest was in group IV; (7.00 + 2.82). Group II revealed the highest fertilization and cleavage rates; (54.14 + 25.36), (55.16 + 26.06), thus not surprisingly resulting in the highest number of good embryos and highest clinical pregnancy rates. The lowest cleavage and pregnancy rates were seen in group IV. However, all the outcomes were not statically significant (p>0.05). CONCLUSIONS Similar fertilization rate and comparable pregnancy outcome was seen among couples with normal and reduced sperm concentration and motility.
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Affiliation(s)
- Ai Chen Chua
- Department of Obstetrics and Gynecology, Hospital Tuanku Ja'afar, Seremban, Negeri Sembilan, Malaysia
| | - Abdul Kadir Abdul Karim
- Advanced Reproductive Centre (ARC), Hospital Canselor Tuanku Muhriz (HCTM), Kuala Lumpur, Malaysia.,Department of Obstetrics & Gynecology, Faculty of Medicine, National University of Malaysia (UKM), Kuala Lumpur, Malaysia
| | - Albert Chao Chiet Tan
- Department of Obstetrics and Gynecology, Hospital Tuanku Ja'afar, Seremban, Negeri Sembilan, Malaysia
| | - Muhammad Azrai Abu
- Advanced Reproductive Centre (ARC), Hospital Canselor Tuanku Muhriz (HCTM), Kuala Lumpur, Malaysia.,Department of Obstetrics & Gynecology, Faculty of Medicine, National University of Malaysia (UKM), Kuala Lumpur, Malaysia
| | - Mohd Faizal Ahmad
- Advanced Reproductive Centre (ARC), Hospital Canselor Tuanku Muhriz (HCTM), Kuala Lumpur, Malaysia.,Department of Obstetrics & Gynecology, Faculty of Medicine, National University of Malaysia (UKM), Kuala Lumpur, Malaysia
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25
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De Munck N, El Khatib I, Abdala A, El-Damen A, Bayram A, Arnanz A, Melado L, Lawrenz B, Fatemi HM. Intracytoplasmic sperm injection is not superior to conventional IVF in couples with non-male factor infertility and preimplantation genetic testing for aneuploidies (PGT-A). Hum Reprod 2021; 35:317-327. [PMID: 32086522 DOI: 10.1093/humrep/deaa002] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Revised: 12/25/2019] [Indexed: 11/14/2022] Open
Abstract
STUDY QUESTION Does the insemination method impact the euploidy outcome in couples with non-male factor infertility? SUMMARY ANSWER Conventional IVF can be applied in cycles with preimplantation genetic testing for aneuploidies (PGT-A), as both IVF and ICSI generate equal numbers of euploid blastocysts. WHAT IS KNOWN ALREADY Ever since its introduction, the popularity of ICSI has increased tremendously, even in couples with non-male factor infertility. The use of conventional IVF is a contraindication for couples undergoing PGT to ensure monospermic fertilisation and to eliminate potential paternal contamination from extraneous sperm attached to the zona pellucida. Despite this, it has recently been shown that sperm DNA fails to amplify under the conditions used for trophectoderm biopsy samples. STUDY DESIGN, SIZE, DURATION This single-centre prospective pilot study included 30 couples between November 2018 and April 2019. PARTICIPANTS/MATERIALS, SETTING, METHOD Arab couples, with a female age between 18-40 years, body mass index ≤30 kg/m2, at least 10 cumulus oocyte complexes (COCs) following oocyte retrieval (OR) and normal semen concentration and motility (WHO) in the fresh ejaculate on the day of OR, were eligible for the study. Half of the sibling oocytes were assigned to conventional IVF, and the other half were assigned to ICSI. All embryos were cultured in a time-lapse imaging system in Global Total LP media. Blastocysts were subjected to trophectoderm biopsy on Day 5, 6 or 7 and next-generation sequencing (NGS) to determine blastocyst ploidy status. The primary objective was to determine the euploid rate in blastocysts from sibling oocytes. MAIN RESULTS AND THE ROLE OF CHANCE A total of 568 COCs were randomly allocated between IVF (n = 283; 9.4 ± 4.0) and ICSI (n = 285; 9.5 ± 4.1). While the incidence of normal fertilisation per cycle (6.1 ± 3.8 (64.0%) vs 6.3 ± 3.5 (65.4%); P = 0.609) was distributed equally between IVF and ICSI, the degeneration rate (0.1 ± 0.3 vs 0.7 ± 0.8; P = 0.0003) was significantly higher after ICSI and the incidence of abnormal fertilisation (≥3 pronuclei) was significantly higher after IVF (0.9 ± 1.2 vs 0.2 ± 0.4; P = 0.005). For all fertilised oocytes, there were no differences in the number of good-quality embryos on Day 3 (74% vs 78%; P = 0.467), nor in the blastulation rate on Day 5 (80.4% vs 70.8%; P = 0.076). The total number of blastocysts biopsied per cycle on Days 5, 6 and 7 was not significantly different between IVF or ICSI (4.0 ± 2.8 vs 3.9 ± 2.5; P = 0.774). With euploid rates of 49.8 and 44.1% (P = 0.755; OR: 1.05664 [0.75188-1.48494), respectively, there was no significant difference identified between IVF and ICSI (2.0 ± 1.8 vs 1.9 ± 1.7; P = 0.808) and all couples had at least one euploid blastocyst available for transfer. When considering only euploid blastocysts, the male/female ratio was 61/39 in IVF and 43/57 in ICSI (P = 0.063). LIMITATIONS, REASON FOR CAUTION This is a pilot study with a limited patient population of 30 couples (and 568 COCs) with a normal ovarian response. The results of our study should not be extrapolated to other patient populations. WIDER IMPLICATIONS OF THE FINDINGS It is safe to apply conventional IVF in couples with non-male factor infertility undergoing PGT-A. STUDY FUNDING/COMPETING INTEREST(S) No funding was obtained. There are no competing interests. TRIAL REGISTRATION NUMBER NCT03708991.
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Affiliation(s)
- Neelke De Munck
- IVIRMA Middle East Fertility Clinic, IVF laboratory, Abu Dhabi, United Arab Emirates
| | - Ibrahim El Khatib
- IVIRMA Middle East Fertility Clinic, IVF laboratory, Abu Dhabi, United Arab Emirates
| | - Andrea Abdala
- IVIRMA Middle East Fertility Clinic, IVF laboratory, Abu Dhabi, United Arab Emirates
| | - Ahmed El-Damen
- IVIRMA Middle East Fertility Clinic, IVF laboratory, Abu Dhabi, United Arab Emirates
| | - Aşina Bayram
- IVIRMA Middle East Fertility Clinic, IVF laboratory, Abu Dhabi, United Arab Emirates
| | - Ana Arnanz
- IVIRMA Middle East Fertility Clinic, IVF laboratory, Abu Dhabi, United Arab Emirates
| | - Laura Melado
- IVIRMA Middle East Fertility Clinic, IVF laboratory, Abu Dhabi, United Arab Emirates
| | - Barbara Lawrenz
- IVIRMA Middle East Fertility Clinic, IVF laboratory, Abu Dhabi, United Arab Emirates.,Obstetrical Department, Women's University Hospital Tuebingen, Tuebingen, Germany
| | - Human M Fatemi
- IVIRMA Middle East Fertility Clinic, IVF laboratory, Abu Dhabi, United Arab Emirates
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26
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Meng X, Melo P, Jones C, Ross C, Mounce G, Turner K, Child T, Coward K. Use of phospholipase C zeta analysis to identify candidates for artificial oocyte activation: a case series of clinical pregnancies and a proposed algorithm for patient management. Fertil Steril 2021; 114:163-174. [PMID: 32622408 DOI: 10.1016/j.fertnstert.2020.02.113] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 01/31/2020] [Accepted: 02/28/2020] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To investigate the applicability of phospholipase C zeta (PLCζ) analysis in assisting the clinical decision-making process when considering artificial oocyte activation (AOA) for infertile males in assisted reproductive technology. DESIGN Fifty-six males (43 infertile/13 fertile) were screened using our PLCζ assay. SETTING Fertility unit/university laboratory. PATIENT(S) Infertile males with abnormal sperm morphology or total fertilization failure, low fertilization rate (<50%), or repeated fertilization failure in assisted reproductive technology. INTERVENTION(S) We analyzed PLCζ levels in sperm from fertile and infertile males. Eligible patients subsequently underwent intracytoplasmic sperm injection (ICSI)/artificial oocyte activation (AOA) with calcimycin (GM508). MAIN OUTCOME MEASURE(S) PLCζ localization and level and the proportion of sperm expressing PLCζ. Thresholds of PLCζ deficiency, fertilization rates, pregnancy rates, and live birth rates of AOA and non-AOA cycles. RESULT(S) Compared with 13 fertile controls, 34 of the 43 infertile males had significantly lower levels of PLCζ and/or a significantly lower proportion of sperm exhibiting PLCζ. Of these 34 patients, 15 showed a significant PLCζ reduction in both parameters, which we termed "PLCζ deficiency." Five PLCζ-deficient patients opted for AOA; all five achieved fertilization, and four achieved clinical pregnancies and live births. The fertilization rate improved significantly from 18.6% (ICSI) to 56.8% (ICSI/AOA). The clinical pregnancy rate and live birth rate with AOA were both 40% per initiated cycle. Youden index analysis revealed that the cutoffs below which infertile males were likely to benefit from AOA were 71% for the proportion of sperm expressing PLCζ and 15.57 arbitrary units for mean PLCζ level. CONCLUSION(S) PLCζ analysis is a useful diagnostic tool to determine patient eligibility for subsequent AOA treatment.
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Affiliation(s)
- Xin Meng
- Nuffield Department of Women's and Reproductive Health, University of Oxford, Oxford, United Kingdom
| | - Pedro Melo
- The Women's Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
| | - Celine Jones
- Nuffield Department of Women's and Reproductive Health, University of Oxford, Oxford, United Kingdom
| | | | - Ginny Mounce
- Nuffield Department of Women's and Reproductive Health, University of Oxford, Oxford, United Kingdom
| | - Karen Turner
- Nuffield Department of Women's and Reproductive Health, University of Oxford, Oxford, United Kingdom; Oxford Fertility, Oxford, United Kingdom
| | - Tim Child
- Nuffield Department of Women's and Reproductive Health, University of Oxford, Oxford, United Kingdom; Oxford Fertility, Oxford, United Kingdom
| | - Kevin Coward
- Nuffield Department of Women's and Reproductive Health, University of Oxford, Oxford, United Kingdom.
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Dai J, Zhang T, Guo J, Zhou Q, Gu Y, Zhang J, Hu L, Zong Y, Song J, Zhang S, Dai C, Gong F, Lu G, Zheng W, Lin G. Homozygous pathogenic variants in ACTL9 cause fertilization failure and male infertility in humans and mice. Am J Hum Genet 2021; 108:469-481. [PMID: 33626338 DOI: 10.1016/j.ajhg.2021.02.004] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 02/02/2021] [Indexed: 12/14/2022] Open
Abstract
Total fertilization failure (TFF) can occur during in vitro fertilization (IVF) treatments, even following intracytoplasmic sperm injection (ICSI). Various male or female factors could contribute to TFF. Increasing evidence suggested that genetic variations in PLCZ1, which encodes 1-phosphatidylinositol 4,5-bisphosphate phosphodiesterase zeta-1 (PLCζ), is involved in oocyte activation and is a key male factor in TFF. In the present study, we explored the genetic variants in male individuals that led to TFF. A total of 54 couples with TFF or poor fertilization (fertilization rate < 20%) were screened, and 21 couples were determined to have a male infertility factor by the mouse oocyte activation test. Whole-exome sequencing of these 21 male individuals identified three homozygous pathogenic variants in ACTL9 (actin like 9) in three individuals. ACTL9 variations led to abnormal ultrastructure of the perinuclear theca (PT), and PLCζ was absent in the head and present in the neck of the mutant sperm, which contributed to failed normal calcium oscillations in oocytes and subsequent TFF. The key roles of ACTL9 in the PT structure and TFF after ICSI were further confirmed in an Actl9-mutated mouse model. Furthermore, assisted oocyte activation by calcium ionophore exposure successfully overcame TFF and achieved live births in a couple with an ACTL9 variant. These findings identified the role of ACTL9 in the PT structure and the correct localization of PLCζ. The results also provide a genetic marker and a therapeutic option for individuals who have undergone ICSI without successful fertilization.
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Chen W, Bai H, Li M, Xue X, Shi J. Effects of three pro-nuclei (3PN) incidence on laboratory and clinical outcomes after early rescue intracytoplasmic sperm injection (rescue-ICSI): an analysis of a 5-year period. Gynecol Endocrinol 2021; 37:137-140. [PMID: 32342711 DOI: 10.1080/09513590.2020.1757640] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
OBJECTIVES We aimed to explore the effect of three pro-nuclei (3PN) incidence on laboratory and clinical outcomes after early rescue intracytoplasmic sperm injection (rescue-ICSI). METHODS This study included 509 early rescue-ICSI cycles from February 2014 to February 2019. The patients were divided into 3PN = 0% (394 cycles) and 3PN > 0% (115 cycles) group. Main outcomes compared were good quality embryo, available embryo, implantation (IR), clinical pregnancy (CPR), abortion (AR) and live birth rates (LBR). RESULTS There were no significant differences in the basal characteristics between two groups (p > .05). We observed that 3PN = 0% and 3PN > 0% groups had similar good quality embryo (47.02 versus 46.80%; p = .917) and available embryo (83.28 versus 81.37%; p = .247) rates. Our results showed that the IR (47.26 versus 51.05%; p = .357), CPR (61.17 versus 66.08%; p = .338) and LBR (52.80 versus 50.43%; p = .656) were comparable between 3PN = 0% and 3PN > 0% groups. The 3PN = 0% group showed significantly lower AR than that in the 3PN > 0% group (11.20 versus 21.05%; p = .029; OR 2.114; 95% CI 1.069-4.178). CONCLUSIONS 3PN incidence made negative effects on the clinical outcomes after early rescue-ICSI.
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Affiliation(s)
- Wennan Chen
- The ART Center, Northwest Women and Children's Hospital, Xi'an, China
| | - Haiyan Bai
- The ART Center, Northwest Women and Children's Hospital, Xi'an, China
| | - Mingzhao Li
- The ART Center, Northwest Women and Children's Hospital, Xi'an, China
| | - Xia Xue
- The ART Center, Northwest Women and Children's Hospital, Xi'an, China
| | - Juanzi Shi
- The ART Center, Northwest Women and Children's Hospital, Xi'an, China
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Zafar MI, Lu S, Li H. Sperm-oocyte interplay: an overview of spermatozoon's role in oocyte activation and current perspectives in diagnosis and fertility treatment. Cell Biosci 2021; 11:4. [PMID: 33407934 PMCID: PMC7789549 DOI: 10.1186/s13578-020-00520-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 12/15/2020] [Indexed: 02/07/2023] Open
Abstract
The fertilizing spermatozoon is a highly specialized cell that selects from millions along the female tract until the oocyte. The paternal components influence the oocyte activation during fertilization and are fundamental for normal embryo development; however, the sperm-oocyte interplay is in a continuous debate. This review aims to analyze the available scientific information related to the role of the male gamete in the oocyte activation during fertilization, the process of the interaction of sperm factors with oocyte machinery, and the implications of any alterations in this interplay, as well as the advances and limitations of the reproductive techniques and diagnostic tests. At present, both PLCζ and PAWP are the main candidates as oocyte activated factors during fertilization. While PLCζ mechanism is via IP3, how PAWP activates the oocyte still no clear, and these findings are important to study and treat fertilization failure due to oocyte activation, especially when one of the causes is the deficiency of PLCζ in the sperm. However, no diagnostic test has been developed to establish the amount of PLCζ, the protocol to treat this type of pathologies is broad, including treatment with ionophores, sperm selection improvement, and microinjection with PLCζ protein or RNA.
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Affiliation(s)
- Mohammad Ishraq Zafar
- Institute of Reproductive Health/Center of Reproductive Medicine, Tongji Medical College, Huazhong University of Science and Technology, 13 Hang Kong Road, Wuhan, 430030, People's Republic of China
| | - Shi Lu
- Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jeifang Avenue, Wuhan, 430022, People's Republic of China
| | - Honggang Li
- Institute of Reproductive Health/Center of Reproductive Medicine, Tongji Medical College, Huazhong University of Science and Technology, 13 Hang Kong Road, Wuhan, 430030, People's Republic of China. .,Wuhan Tongji Reproductive Medicine Hospital, 128 Sanyang Road, Wuhan, 430013, People's Republic of China.
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30
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Kong P, Yin M, Tang C, Zhu X, Bukulmez O, Chen M, Teng X. Effects of Early Cumulus Cell Removal on Treatment Outcomes in Patients Undergoing In Vitro Fertilization: A Retrospective Cohort Study. Front Endocrinol (Lausanne) 2021; 12:669507. [PMID: 34025582 PMCID: PMC8138552 DOI: 10.3389/fendo.2021.669507] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 04/09/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Early cumulus cell removal combined with early rescue intracytoplasmic sperm injection (ICSI) has been widely practiced in many in vitro fertilization (IVF) centers in China in order to avoid total fertilization failure. However, uncertainty remains whether the pregnancy and neonatal outcomes are associated with early cumulus cell removal. OBJECTIVES To investigate if early cumulus cell removal alone after 4 hours co-incubation of gametes (4 h group), has detrimental effect on the pregnancy and neonatal outcomes in patients undergoing IVF, through a comparison with conventional cumulus cell removal after 20 hours of insemination (20 h group). METHODS This retrospective cohort study included 1784 patients who underwent their first fresh cleavage stage embryo transfer at the Centre for Assisted Reproduction of Shanghai First Maternity and Infant Hospital from June 2016 to December 2018 (4 h group, n=570; 20 h group, n=1214). A logistic regression analysis was performed to examine the independent association between early cumulus cell removal and pregnancy outcomes after adjustment for potential confounders. The neonatal outcomes between the two groups were compared. RESULTS When compared with the 20 h group, the 4 h group had similar pregnancy outcomes, including rates for biochemical pregnancy, clinical pregnancy, ongoing pregnancy, miscarriage, ectopic pregnancy, multiple pregnancy, live birth. There were 1073 infants delivered after embryo transfer (4 h group, n=337; 20 h group, n=736). Outcomes in both groups were similar for both singleton and twin gestations, including preterm birth rate and very preterm birth rate, mean birth weight, mean gestational age, sex ratio at birth and rate of congenital birth defects. In addition, findings pertaining to singleton gestations were also similar in the two groups for Z-scores (gestational age- and sex-adjusted birth weight), rates of small for gestational age, very small for gestational age, large for gestational age and very large for gestational age infants. CONCLUSIONS In this study early cumulus cell removal alone was not associated with adverse pregnancy and neonatal outcomes. From this perspective, early cumulus cell removal to assess for a potential early rescue ICSI is therefore considered to be a safe option in patients undergoing IVF.
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Affiliation(s)
- Pengcheng Kong
- Centre for Assisted Reproduction, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China
| | - Mingru Yin
- Department of Assisted Reproduction, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chuanling Tang
- Centre for Assisted Reproduction, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China
| | - Xiuxian Zhu
- Centre for Assisted Reproduction, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China
| | - Orhan Bukulmez
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Miaoxin Chen
- Centre for Assisted Reproduction, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China
- *Correspondence: Xiaoming Teng, ; Miaoxin Chen,
| | - Xiaoming Teng
- Centre for Assisted Reproduction, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China
- *Correspondence: Xiaoming Teng, ; Miaoxin Chen,
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31
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Diagnosis and Treatment of Male Infertility-Related Fertilization Failure. J Clin Med 2020; 9:jcm9123899. [PMID: 33271815 PMCID: PMC7761017 DOI: 10.3390/jcm9123899] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 11/26/2020] [Accepted: 11/27/2020] [Indexed: 12/22/2022] Open
Abstract
Infertility affects approximately 15% of reproductive-aged couples worldwide, of which up to 30% of the cases are caused by male factors alone. The origin of male infertility is mostly attributed to sperm abnormalities, of which many are caused by genetic defects. The development of intracytoplasmic sperm injection (ICSI) has helped to circumvent most male infertility conditions. However, there is still a challenging group of infertile males whose sperm, although having normal sperm parameters, are unable to activate the oocyte, even after ICSI treatment. While ICSI generally allows fertilization rates of 70 to 80%, total fertilization failure (FF) still occurs in 1 to 3% of ICSI cycles. Phospholipase C zeta (PLCζ) has been demonstrated to be a critical sperm oocyte activating factor (SOAF) and the absence, reduced, or altered forms of PLCζ have been shown to cause male infertility-related FF. The purpose of this review is to (i) summarize the current knowledge on PLCζ as the critical sperm factor for successful fertilization, as well as to discuss the existence of alternative sperm-induced oocyte activation mechanisms, (ii) describe the diagnostic tests available to determine the cause of FF, and (iii) summarize the beneficial effect of assisted oocyte activation (AOA) to overcome FF.
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Tian Y, Wang G, Wang J, Mu X, Chen H, Song X, Bai X. Novel compound heterozygous mutation in WEE2 is associated with fertilization failure: case report of an infertile woman and literature review. BMC WOMENS HEALTH 2020; 20:246. [PMID: 33148236 PMCID: PMC7643268 DOI: 10.1186/s12905-020-01111-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 10/26/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Fertilization failure after intracytoplasmic sperm injection continues to affect couples and the etiology is not well-understood. CASE PRESENTATION We characterized a couple with 2-year history of primary unexplained infertility. Three different assisted reproduction attempts (IVF + rescue ICSI, ICSI and ICSI-AOA) showed repeated fertilization failure for MII oocyte retrieval after controlled ovarian hyperstimulation. After whole-exome sequencing and sanger sequencing of the couple and their family members, variant pathogenicity was assessed using SIFT, PolyPhen2, Mutation Taster, and Human Splicing Finder software. We identified novel compound heterozygous mutations, c.1535 + 3A > G and c.946C > T (p. Leu316Phe), in WEE2 in the female proband. Trios analysis of the variations revealed an autosomal recessive pattern. c.1535 + 3A > G in WEE2 was predicted to break the wild-type donor site and affect splicing, and the missense mutation c.946C > T (p. Leu316Phe) of WEE2 was predicted to be pathogenic. CONCLUSION A novel compound heterozygous mutation in WEE2 was identified in an infertile female who experienced repeated fertilization failure even after ICSI-AOA. These novel mutations in WEE2 provided genetic evidence for fertilization failure.
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Affiliation(s)
- Ye Tian
- Reproductive Medicine Center, Department of Gynecology and Obstetrics, Tianjin Medical University General Hospital, 154, Anshan Road, Heping District, Tianjin, 300052, China
| | - Guojie Wang
- Reproductive Medicine Center, Department of Gynecology and Obstetrics, Tianjin Medical University General Hospital, 154, Anshan Road, Heping District, Tianjin, 300052, China
| | - Jin Wang
- Reproductive Medicine Center, Department of Gynecology and Obstetrics, Tianjin Medical University General Hospital, 154, Anshan Road, Heping District, Tianjin, 300052, China
| | - Xiaohuan Mu
- Reproductive Medicine Center, Department of Gynecology and Obstetrics, Tianjin Medical University General Hospital, 154, Anshan Road, Heping District, Tianjin, 300052, China
| | - Haixia Chen
- Reproductive Medicine Center, Department of Gynecology and Obstetrics, Tianjin Medical University General Hospital, 154, Anshan Road, Heping District, Tianjin, 300052, China
| | - Xueru Song
- Reproductive Medicine Center, Department of Gynecology and Obstetrics, Tianjin Medical University General Hospital, 154, Anshan Road, Heping District, Tianjin, 300052, China
| | - Xiaohong Bai
- Reproductive Medicine Center, Department of Gynecology and Obstetrics, Tianjin Medical University General Hospital, 154, Anshan Road, Heping District, Tianjin, 300052, China.
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Xiong F, Sun Q, Li G, Yao Z, Chen P, Wan C, Zhong H, Zeng Y. Perinatal and neonatal outcomes of pregnancies after early rescue intracytoplasmic sperm injection in women with primary infertility compared with conventional intracytoplasmic sperm injection: a retrospective 6-year study. BMC Pregnancy Childbirth 2020; 20:460. [PMID: 32787803 PMCID: PMC7425156 DOI: 10.1186/s12884-020-03155-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2019] [Accepted: 08/04/2020] [Indexed: 12/24/2022] Open
Abstract
Background Early rescue intracytoplasmic sperm injection (ICSI) has been used in clinic as appropriate currently. While the outcomes of children born after this method were not well assessed. The purpose of this study was to evaluate the effect of early rescue ICSI on women with primary infertility. Methods Fresh embryo transfer cycles after rescue (n = 214) and conventional (n = 546) ICSI were retrospectively evaluated from women with primary infertility who underwent their first assisted reproductive technology cycles at our center in 2012–2017. The conventional ICSI group was subdivided into ICSI-1 (semen suitable for in vitro fertilization, IVF) and ICSI-2 (poor semen quality) to minimize bias from differences in semen quality. Pregnancy, delivery and neonatal outcomes were compared between groups. Results There was a higher rate of polyspermy and a lower rate of top-quality embryos (TQE) on day 3 for oocytes subject to rescue ICSI compared with conventional ICSI. This reduced the total number of TQE and the number of TQE transferred in the rescue ICSI group. There was no significant difference between groups in clinical pregnancy, ongoing pregnancy, early miscarriage and live birth. For pregnant women, gestational age, route of delivery, risk of preterm birth and gestational diabetes mellitus were also comparable. Neonatal outcomes including sex ratio, birth weight, neonatal intensive care unit admission and birth defects were also similar after rescue and conventional ICSI. Moreover, no differences were observed with the different ICSI subgroups. Conclusions For women with primary infertility who have a high risk of IVF fertilization failure (FF), rescue ICSI provides a safe and efficient alternative to minimize FF after initial IVF, but results in fewer TQE on day 3.
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Affiliation(s)
- Feng Xiong
- Shenzhen Key Laboratory of Reproductive Immunology for Peri-implantation, Shenzhen Zhongshan Institute for Reproduction and Genetics, Fertility Center, Shenzhen Zhongshan Urology Hospital, Guangdong, 518045, Shenzhen, People's Republic of China
| | - Qing Sun
- Shenzhen Key Laboratory of Reproductive Immunology for Peri-implantation, Shenzhen Zhongshan Institute for Reproduction and Genetics, Fertility Center, Shenzhen Zhongshan Urology Hospital, Guangdong, 518045, Shenzhen, People's Republic of China
| | - Guangui Li
- Shenzhen Key Laboratory of Reproductive Immunology for Peri-implantation, Shenzhen Zhongshan Institute for Reproduction and Genetics, Fertility Center, Shenzhen Zhongshan Urology Hospital, Guangdong, 518045, Shenzhen, People's Republic of China
| | - Zhihong Yao
- Shenzhen Key Laboratory of Reproductive Immunology for Peri-implantation, Shenzhen Zhongshan Institute for Reproduction and Genetics, Fertility Center, Shenzhen Zhongshan Urology Hospital, Guangdong, 518045, Shenzhen, People's Republic of China
| | - Peilin Chen
- Shenzhen Key Laboratory of Reproductive Immunology for Peri-implantation, Shenzhen Zhongshan Institute for Reproduction and Genetics, Fertility Center, Shenzhen Zhongshan Urology Hospital, Guangdong, 518045, Shenzhen, People's Republic of China
| | - Caiyun Wan
- Shenzhen Key Laboratory of Reproductive Immunology for Peri-implantation, Shenzhen Zhongshan Institute for Reproduction and Genetics, Fertility Center, Shenzhen Zhongshan Urology Hospital, Guangdong, 518045, Shenzhen, People's Republic of China
| | - Huixian Zhong
- Shenzhen Key Laboratory of Reproductive Immunology for Peri-implantation, Shenzhen Zhongshan Institute for Reproduction and Genetics, Fertility Center, Shenzhen Zhongshan Urology Hospital, Guangdong, 518045, Shenzhen, People's Republic of China
| | - Yong Zeng
- Shenzhen Key Laboratory of Reproductive Immunology for Peri-implantation, Shenzhen Zhongshan Institute for Reproduction and Genetics, Fertility Center, Shenzhen Zhongshan Urology Hospital, Guangdong, 518045, Shenzhen, People's Republic of China.
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Tang L, Rao M, Yang W, Yao Y, Luo Q, Lu L, Wang L, Zhao S. Predictive value of the sperm DNA fragmentation index for low or failed IVF fertilization in men with mild-to-moderate asthenozoospermia. J Gynecol Obstet Hum Reprod 2020; 50:101868. [PMID: 32663655 DOI: 10.1016/j.jogoh.2020.101868] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Revised: 07/04/2020] [Accepted: 07/08/2020] [Indexed: 11/17/2022]
Abstract
INTRODUCTION It has been observed that there is an increased incidence of total fertilization failure (TFF) and a low fertilization rate (LFR, <25 %) during conventional in vitro fertilization (IVF) treatments involving men with poor sperm motility. These men also exhibit a high sperm DNA fragmentation index (DFI), which has adverse effects on various IVF outcomes. However, the relationship between a high DFI and an increased TFF or LFR during IVF cycles has not been elucidated. Here, we aimed to investigate the association between the sperm DFI and TFF or LFR in IVF cycles involving men with mild-to-moderate asthenozoospermia and normozoospermia. MATERIALS AND METHODS This retrospective study included 116 men diagnosed as mild-to-moderate asthenozoospermia, and 407 men with normozoospermia. The sperm DFI was assessed using the sperm chromatin dispersion (SCD) test. RESULTS Men in the asthenozoospermia group had a significantly higher incidence of cycles with a TFF or LFR (9.5 % vs 2.7 %, P = 0.01), and these were associated significantly with an increased DFI (P < 0.01). After adjustment for confounding factors, a TFF or LFR was to correlate significantly with the DFI (odds ratio: 1.188; 95 % confidence interval, 1.035-1.363; P = 0.014). Area under the receiver operating characteristic curve was 0.772. No similar relationships between the DFI and IVF outcomes were observed in the normozoospermia group. CONCLUSIONS For men with mild-to-moderate asthenozoospermia, a high sperm DFI is associated with a decreased fertilization rate and an increased risk of a TFF or LFR. Additional prospectively-designed studies are warranted to confirm our results.
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Affiliation(s)
- Li Tang
- Department of Reproduction and Genetics, First Affiliated Hospital of Kunming Medical University, Kunming Medical University, Kunming 650032, Yunnan Province, China
| | - Meng Rao
- Department of Reproduction and Genetics, First Affiliated Hospital of Kunming Medical University, Kunming Medical University, Kunming 650032, Yunnan Province, China
| | - Wenjuan Yang
- Department of Reproduction and Genetics, First Affiliated Hospital of Kunming Medical University, Kunming Medical University, Kunming 650032, Yunnan Province, China
| | - Youlin Yao
- Department of Reproduction and Genetics, First Affiliated Hospital of Kunming Medical University, Kunming Medical University, Kunming 650032, Yunnan Province, China
| | - Qirui Luo
- Chengong Campus, Yunnan University Secondary School, Kunming 650500, Yunnan Province, China
| | - Ling Lu
- Department of Reproduction and Genetics, First Affiliated Hospital of Kunming Medical University, Kunming Medical University, Kunming 650032, Yunnan Province, China
| | - Longda Wang
- Department of Reproduction and Genetics, First Affiliated Hospital of Kunming Medical University, Kunming Medical University, Kunming 650032, Yunnan Province, China
| | - Shuhua Zhao
- Department of Reproduction and Genetics, First Affiliated Hospital of Kunming Medical University, Kunming Medical University, Kunming 650032, Yunnan Province, China.
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Hatakeyama S, Araki Y, Araki Y, Ohgi S, Yanaihara A. First birth following assisted sperm fusion insemination using sperm bound to zona pellucida. J Assist Reprod Genet 2020; 37:1849-1851. [PMID: 32533429 DOI: 10.1007/s10815-020-01854-y] [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: 04/15/2020] [Accepted: 06/07/2020] [Indexed: 10/24/2022] Open
Abstract
PURPOSE To report a live birth after transfer of a vitrified-warmed blastocyst produced by assisted sperm fusion insemination (ASFI). METHODS Oocyte retrieval and in vitro fertilization (IVF) were performed on a 37-year-old woman. Six hours after IVF, an oocyte exhibited a single polar body and so was defined as an unfertilized oocyte. A motile sperm was collected from the zona pellucida of the unfertilized oocyte by an injection needle. The motile sperm was pressed onto the membrane of the unfertilized oocyte. RESULTS Two oocytes were matured and subjected to IVF. One of the 2 oocytes exhibited only one polar body and was defined as an unfertilized oocyte at 6 h after IVF; this oocyte then was subjected to ASFI. Two pronuclei were observed on the next day and cultured to the blastocyst stage. This embryo achieved blastocyst status and was vitrified on day 5. The resulting vitrified-warmed blastocyst was transferred, resulting in pregnancy and subsequent delivery of a healthy boy. CONCLUSION This report describes the first case of a successful birth following transfer of a vitrified-warmed blastocyst produced by ASFI.
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Affiliation(s)
- Shota Hatakeyama
- Yanaihara Women's Clinic, 1-26-29 Ofuna, Kamakura, Kanagawa, 247-0056, Japan. .,Graduate School of Health Science, Gunma Paz University, 1-7-1 Tonyamachi, Takasaki, Gunma, 370-0006, Japan.
| | - Yasuyuki Araki
- Graduate School of Health Science, Gunma Paz University, 1-7-1 Tonyamachi, Takasaki, Gunma, 370-0006, Japan
| | - Yasuhisa Araki
- Graduate School of Health Science, Gunma Paz University, 1-7-1 Tonyamachi, Takasaki, Gunma, 370-0006, Japan
| | - Shirei Ohgi
- Yanaihara Women's Clinic, 1-26-29 Ofuna, Kamakura, Kanagawa, 247-0056, Japan
| | - Atsushi Yanaihara
- Yanaihara Women's Clinic, 1-26-29 Ofuna, Kamakura, Kanagawa, 247-0056, Japan
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Kashir J. Increasing associations between defects in phospholipase C zeta and conditions of male infertility: not just ICSI failure? J Assist Reprod Genet 2020; 37:1273-1293. [PMID: 32285298 PMCID: PMC7311621 DOI: 10.1007/s10815-020-01748-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 03/12/2020] [Indexed: 12/12/2022] Open
Abstract
PURPOSE Oocyte activation is a fundamental event at mammalian fertilization. In mammals, this process is initiated by a series of characteristic calcium (Ca2+) oscillations, induced by a sperm-specific phospholipase C (PLC) termed PLCzeta (PLCζ). Dysfunction/reduction/deletion of PLCζ is associated with forms of male infertility where the sperm is unable to initiate Ca2+ oscillations and oocyte activation, specifically in cases of fertilization failure. This review article aims to systematically summarize recent advancements and controversies in the field to update expanding clinical associations between PLCζ and various male factor conditions. This article also discusses how such associations may potentially underlie defective embryogenesis and recurrent implantation failure following fertility treatments, alongside potential diagnostic and therapeutic PLCζ approaches, aiming to direct future research efforts to utilize such knowledge clinically. METHODS An extensive literature search was performed using literature databases (PubMed/MEDLINE/Web of Knowledge) focusing on phospholipase C zeta (PLCzeta; PLCζ), oocyte activation, and calcium oscillations, as well as specific male factor conditions. RESULTS AND DISCUSSION Defective PLCζ or PLCζ-induced Ca2+ release can be linked to multiple forms of male infertility including abnormal sperm parameters and morphology, sperm DNA fragmentation and oxidation, and abnormal embryogenesis/pregnancies. Such sperm exhibit absent/reduced levels, and abnormal localization patterns of PLCζ within the sperm head. CONCLUSIONS Defective PLCζ and abnormal patterns of Ca2+ release are increasingly suspected a significant causative factor underlying abnormalities or insufficiencies in Ca2+ oscillation-driven early embryogenic events. Such cases could potentially strongly benefit from relevant therapeutic and diagnostic applications of PLCζ, or even alternative mechanisms, following further focused research efforts.
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Affiliation(s)
- Junaid Kashir
- College of Medicine, Alfaisal University, Riyadh, Kingdom of Saudi Arabia. .,School of Biosciences, Cardiff University, Cardiff, UK. .,Department of Comparative Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, Kingdom of Saudi Arabia.
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Chu K, He Y, Wang L, Ji Y, Hao M, Pang W, Liu Y, Sun N, Yang F, Li W. Novel ZP1 pathogenic variants identified in an infertile patient and a successful live birth following ICSI treatment. Clin Genet 2020; 97:787-788. [PMID: 31909477 DOI: 10.1111/cge.13693] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 12/08/2019] [Accepted: 12/12/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Kun Chu
- Center for Reproductive Medicine, Changzheng Hosptial, Second Military Medical University, Shanghai, China
| | - Yi He
- Center for Reproductive Medicine, Changzheng Hosptial, Second Military Medical University, Shanghai, China
| | - Liang Wang
- Center for Reproductive Medicine, Changzheng Hosptial, Second Military Medical University, Shanghai, China
| | - Yixuan Ji
- Center for Reproductive Medicine, Changzheng Hosptial, Second Military Medical University, Shanghai, China
| | - Min Hao
- Center for Reproductive Medicine, Changzheng Hosptial, Second Military Medical University, Shanghai, China
| | - Wenjuan Pang
- Center for Reproductive Medicine, Changzheng Hosptial, Second Military Medical University, Shanghai, China
| | - Yan Liu
- Center for Reproductive Medicine, Changzheng Hosptial, Second Military Medical University, Shanghai, China
| | - Ningxia Sun
- Center for Reproductive Medicine, Changzheng Hosptial, Second Military Medical University, Shanghai, China
| | - Fu Yang
- Department of Medical Genetics, Second Military Medical University, Shanghai, China
| | - Wen Li
- Center for Reproductive Medicine, Changzheng Hosptial, Second Military Medical University, Shanghai, China
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Mao GH, Huang XH, Geng XJ, Li Q, Zhang Y, Dou Q. Correlation between sperm mitochondrial ND5 and ND6 gene variations and total fertilisation failure. Arch Med Sci 2020; 16:692-698. [PMID: 32399119 PMCID: PMC7212212 DOI: 10.5114/aoms.2020.94658] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2017] [Accepted: 08/10/2017] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION The purpose of this study was to investigate the correlation between sperm mitochondrial NADH dehydrogenase subunit 5 (ND5) and NADH dehydrogenase subunit 6 (ND6) gene variations and total fertilisation failure (TFF). MATERIAL AND METHODS A total of 232 sperm samples at the fresh in vitro fertilisation (IVF) cycle or the half-intracytoplasmic sperm injection (ICSI) cycle were collected for this retrospective controlled study on Han Chinese people between July 2011 and April 2014. Of the 232 total samples, 45 were from the IVF-TFF group and 187 were from couples with normal fertilisation (fertilisation rate > 50%). The mitochondrial ND5 and ND6 gene variations and sperm haplotypes were confirmed using nested PCR and DNA sequencing. RESULTS Ten homozygous variations were newly discovered, namely C12417T, T12441A, C12543A, C13650A, C13765A, T13769C, C13775T, A13776G, C13785A and C13845T. The gene variation rates of six sites, C12417T, C13650A, C13765A, T13769C, C13785A and C13845T, in the TFF group were significantly higher than those in the control group (p < 0.05). There were 231 heterozygous variations discovered; however, only nine heterozygous sites (12441, 12561, 12735, 13164, 13743, 13812, 13928, 14172 and 14368) had significantly higher gene variation rates than those in the control group (p < 0.05). In addition, the results showed that haplogroup C did not affect TFF (p > 0.05), and the fertilisation failure rates of haplogroup R and haplogroup D4a were both higher than those in the control group (p < 0.05). CONCLUSIONS Our results suggested that the ND5 and ND6 gene variations are correlated with TFF. Furthermore, this study indicated that haplogroup R and haplogroup D4a might be risk factors for TFF.
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Affiliation(s)
- Gen-Hong Mao
- Reproductive Medical Center, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - Xiao-Hui Huang
- Reproductive Medical Center, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - Xu-Jing Geng
- Reproductive Medical Center, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - Qian Li
- Reproductive Medical Center, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - Yu Zhang
- Reproductive Medical Center, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - Qian Dou
- Reproductive Medical Center, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
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Transcriptome profiling of human oocytes experiencing recurrent total fertilization failure. Sci Rep 2018; 8:17890. [PMID: 30559372 PMCID: PMC6297154 DOI: 10.1038/s41598-018-36275-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Accepted: 11/16/2018] [Indexed: 11/24/2022] Open
Abstract
There exist some patients who face recurrent total fertilization failure during assisted reproduction treatment, but the pathological mechanism underlying is elusive. Here, by using sc-RNA-seq method, the transcriptome profiles of ten abnormally fertilized zygotes were assessed, including five zygotes from one patient with recurrent Poly-PN zygotes, and five zygotes from a patient with pronuclear fusion failure. Four zygotes with three pronuclear (Tri-PN) were collected from four different patients as controls. After that, we identified 951 and 1697 significantly differentially expressed genes (SDEGs) in Poly-PN and PN arrest zygotes, respectively as compared with the control group. KEGG analyses indicated down regulated genes in the Poly-PN group included oocyte meiosis related genes, such as PPP2R1B, YWHAZ, MAD2L1, SPDYC, SKP1 and CDC27, together with genes associated with RNA processing, such as SF3B1, LOC645691, MAGOHB, PHF5A, PRPF18, DDX5, THOC1 and BAT1. In contrast, down regulated genes in the PN arrest group, included cell cycle genes, such as E2F4, DBF4, YWHAB, SKP2, CDC23, SMC3, CDC25A, CCND3, BUB1B, MDM2, CCNA2 and CDC7, together with homologous recombination related genes, such as NBN, XRCC3, SHFM1, RAD54B and RAD51. Thus, our work provides a better understanding of transcriptome profiles underlying RTFF, although it based on a limited number of patients.
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Semen parameters on the day of oocyte retrieval predict low fertilization during conventional insemination IVF cycles. J Assist Reprod Genet 2018; 36:291-298. [PMID: 30415469 DOI: 10.1007/s10815-018-1336-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Accepted: 10/12/2018] [Indexed: 10/27/2022] Open
Abstract
PURPOSE Poor fertilization during conventional IVF is difficult to predict in the absence of abnormal semen parameters; large-scale studies are lacking. The purpose of this study is to evaluate factors associated with low fertilization rates in conventional insemination IVF cycles. METHODS A retrospective cohort study evaluating demographic, reproductive evaluation, and IVF cycle characteristics to identify predictors of low fertilization (defined as 2PN/MII ≤ 30% per cycle). Participants were included if they were undergoing their first IVF cycle utilizing fresh autologous oocytes and conventional insemination with male partner's sperm (with normal pretreatment semen analysis). They were randomly divided into a training set and a validation set; validation modeling with logistic regression and binary distribution was utilized to identify covariates associated with low fertilization. RESULTS Postprocessing sperm concentration of less than 40 million/ml and postprocessing sperm motility < 50% on the day of retrieval were the strongest predictors of low fertilization in the training dataset. Next, in the validation set, cycles with either low postprocessing concentration (≤ 40 million/ml) or low postprocessing progressive motility (≤ 50%) were 2.9-times (95% CI 1.4, 6.2) more likely to have low fertilization than cycles without either risk factor. Furthermore, cycles with low postprocessing concentration and progressive motility were 13.4 times (95% CI 4.01, 45.06) more likely to have low fertilization than cycles without either risk factor. CONCLUSIONS Postprocessing concentration and progressive motility on the day of oocyte retrieval are predictive of low fertilization in conventional IVF cycles with normal pretreatment diagnostic semen analysis parameters.
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Liu X, Liu G, Liu J, Zhu P, Wang J, Wang Y, Wang W, Li N, Wang X, Zhang C, Shen X, Liu F. iTRAQ-based analysis of sperm proteome from normozoospermic men achieving the rescue-ICSI pregnancy after the IVF failure. Clin Proteomics 2018; 15:27. [PMID: 30166971 PMCID: PMC6102933 DOI: 10.1186/s12014-018-9203-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Accepted: 08/14/2018] [Indexed: 12/17/2022] Open
Abstract
Background In the assisted reproduction, the infertile molecules of spermatozoa from normozoospermic men who underwent the unexplained failure of in vitro fertilization (IVF) due to the lack of sperm binding to the normal zona pellucida, and then achieved pregnancy with the rescue intracytoplasmic sperm injection (R-ICSI) remain unclear. More works are still necessary to explore this male infertile mechanism.
Methods Normozoospermicmen with the IVF pregnancy and normozoospermic men with the R-ICSI pregnancy after the conventional IVF failure were collected. iTRAQ-based proteomic approach were performed to reveal the new infertile causes between the IVF pregnancy men and the R-ICSI pregnancy men. To validate the confidence of proteome data, the individual samples were analyzed by western blot and immunofluorescence. Further, the spontaneous acrosome reactions were measured to evaluate the sperm quality. Results Compared with IVF pregnancy group, 56 sperm proteins were differentially expressed in the R-ICSI pregnancy group. Bioinformatic analyses (PANTHER, DAVID, PubMed and STRING) indicated these altered sperm proteins were involved in various molecular functions: reproduction, chromosome organization, and sperm-oocyte interaction. Moreover, the confidence of proteome data was confirmed by western blot and immunofluorescence using the individual samples, which were consistent with our proteomic data. Additionally, an increased rate of the spontaneous acrosome reaction rate was found in the R-ICSI pregnancy group. Conclusions The sealtered sperm proteins and the increased spontaneous acrosome reaction rate might account for this unexplained male infertility in the R-ICSI pregnancy patients. The present proteomic results will throw light on the better understanding of the unexplained infertile mechanisms underlying these normozoospermic man who achieved R-ICSI pregnancy after IVF failure. Electronic supplementary material The online version of this article (10.1186/s12014-018-9203-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Xin Liu
- 1Central Laboratory, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, 264000 Shandong People's Republic of China
| | - Gensheng Liu
- Reproductive Center, Tianjin Aiwei Hospital, Tianjin, 300011 People's Republic of China
| | - Juan Liu
- 1Central Laboratory, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, 264000 Shandong People's Republic of China
| | - Peng Zhu
- 1Central Laboratory, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, 264000 Shandong People's Republic of China
| | - Jiahui Wang
- 1Central Laboratory, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, 264000 Shandong People's Republic of China
| | - Yanwei Wang
- 1Central Laboratory, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, 264000 Shandong People's Republic of China
| | - Wenting Wang
- 1Central Laboratory, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, 264000 Shandong People's Republic of China
| | - Ning Li
- 1Central Laboratory, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, 264000 Shandong People's Republic of China
| | - Xuebo Wang
- 3Department of Clinical Laboratory, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, 264000 Shandong People's Republic of China
| | - Chenglin Zhang
- 1Central Laboratory, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, 264000 Shandong People's Republic of China
| | - Xiaofang Shen
- 1Central Laboratory, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, 264000 Shandong People's Republic of China.,Reproductive Center, Beijing BaoDao Obstetrics and Gynecology Hospital, Beijing, 100000 People's Republic of China
| | - Fujun Liu
- 1Central Laboratory, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, 264000 Shandong People's Republic of China
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He Y, Liu H, Zheng H, Li L, Fu X, Liu J. Effect of early cumulus cells removal and early rescue ICSI on pregnancy outcomes in high-risk patients of fertilization failure. Gynecol Endocrinol 2018; 34:689-693. [PMID: 29448847 DOI: 10.1080/09513590.2018.1433159] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE The objective of this retrospective study was to evaluate clinical outcomes of early cumulus cells removal and early rescue intracytoplasmic sperm injection (ICSI) in high-risk patients of fertilization failure during human in vitro fertilization (IVF). METHODS A total of 5,518 patients were enrolled between January 2014 to December 2016. Of which 505 couples performed short insemination with >30% fertilization rate were included in short-term IVF group, 102 patients detected total fertilization failure (TFF) were treated with early rescue ICSI (R-ICSI group), and 4911 couples underwent conventional IVF with overnight co-incubation of gametes (traditional IVF group). The clinical outcomes were analyzed among the three groups. RESULTS The embryo implantation rates (40.34%, 39.78% and 42.42% for traditional, short-term IVF and R-ICSI groups, respectively) were comparable in the three groups. The clinical pregnancy rates among traditional IVF group, short-term IVF group and R-ICSI group were 57.95%, 57.03% and 60.78%, respectively, and the difference among three groups didn't reach significance. CONCLUSION The present study indicated that short insemination had no detrimental effects on clinical outcomes in human IVF and could prevent the occurrence of TFF combined with early rescue ICSI for high-risk patients of fertilization failure, which attained acceptable pregnancy outcomes.
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Affiliation(s)
- Yuxia He
- a Department of Reproductive Medicine , the Third Affiliated Hospital of Guangzhou Medical University , Guangzhou , Guangdong , China
- b Key Laboratory of Reproductive Medicine of Guangdong Province , Guangzhou , Guangdong , China
- c Key Laboratory for Major Obstetric Diseases of Guangdong Province , Guangzhou , Guangdong , China
- d Key Laboratory of Reproduction and Genetics of Guangdong Higher Education Institutes , Guangzhou , Guangdong , China
| | - Haiying Liu
- a Department of Reproductive Medicine , the Third Affiliated Hospital of Guangzhou Medical University , Guangzhou , Guangdong , China
| | - Haiyan Zheng
- a Department of Reproductive Medicine , the Third Affiliated Hospital of Guangzhou Medical University , Guangzhou , Guangdong , China
| | - Li Li
- a Department of Reproductive Medicine , the Third Affiliated Hospital of Guangzhou Medical University , Guangzhou , Guangdong , China
| | - Xin Fu
- a Department of Reproductive Medicine , the Third Affiliated Hospital of Guangzhou Medical University , Guangzhou , Guangdong , China
| | - Jianqiao Liu
- a Department of Reproductive Medicine , the Third Affiliated Hospital of Guangzhou Medical University , Guangzhou , Guangdong , China
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Dai C, Hu L, Gong F, Tan Y, Cai S, Zhang S, Dai J, Lu C, Chen J, Chen Y, Lu G, Du J, Lin G. ZP2 pathogenic variants cause in vitro fertilization failure and female infertility. Genet Med 2018; 21:431-440. [PMID: 29895852 DOI: 10.1038/s41436-018-0064-y] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Accepted: 05/03/2018] [Indexed: 12/30/2022] Open
Abstract
PURPOSE The oocyte-borne genetic causes leading to fertilization failure are largely unknown. We aimed to identify novel human pathogenic variants (PV) and genes causing fertilization failure. METHODS We performed exome sequencing for a consanguineous family with a recessive inheritance pattern of female infertility characterized by oocytes with a thin zona pellucida (ZP) and fertilization failure in routine in vitro fertilization. Subsequent PV screening of ZP2 was performed in additional eight unrelated infertile women whose oocytes exhibited abnormal ZP and similar fertilization failure. Expression of ZP proteins was assessed in mutant oocytes by immunostaining, and functional studies of the wild-type and mutant proteins were carried out in CHO-K1 cells. RESULTS Two homozygous s PV (c.1695-2A>G, and c.1691_1694dup (p.C566Wfs*5), respectively) of ZP2 were identified in the affected women from two unrelated consanguineous families. All oocytes carrying PV were surrounded by a thin ZP that was defective for sperm-binding. Immunostaining indicated a lack of ZP2 protein in the thin ZP. Studies in CHO cells showed that both PV resulted in a truncated ZP2 protein, which might be intracellularly sequestered and prematurely interacted with other ZP proteins. CONCLUSION We identified loss-of-function PV of ZP2 causing a structurally abnormal and dysfunctional ZP, resulting in fertilization failure and female infertility.
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Affiliation(s)
- Can Dai
- Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, China
| | - Liang Hu
- Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, China.,Institute of Reproductive and Stem Cell Engineering, School of Basic Medicine, Central South University, Changsha, China.,Key Laboratory of Stem Cells and Reproductive Engineering, Ministry of Health, Changsha, China.,National Engineering and Research Center of Human Stem Cell, Changsha, China
| | - Fei Gong
- Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, China.,Institute of Reproductive and Stem Cell Engineering, School of Basic Medicine, Central South University, Changsha, China.,Key Laboratory of Stem Cells and Reproductive Engineering, Ministry of Health, Changsha, China
| | - Yueqiu Tan
- Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, China.,Institute of Reproductive and Stem Cell Engineering, School of Basic Medicine, Central South University, Changsha, China.,Key Laboratory of Stem Cells and Reproductive Engineering, Ministry of Health, Changsha, China
| | - Sufen Cai
- Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, China.,Institute of Reproductive and Stem Cell Engineering, School of Basic Medicine, Central South University, Changsha, China
| | - Shuoping Zhang
- Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, China.,Institute of Reproductive and Stem Cell Engineering, School of Basic Medicine, Central South University, Changsha, China
| | - Jing Dai
- Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, China.,Institute of Reproductive and Stem Cell Engineering, School of Basic Medicine, Central South University, Changsha, China
| | - Changfu Lu
- Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, China.,Institute of Reproductive and Stem Cell Engineering, School of Basic Medicine, Central South University, Changsha, China.,Key Laboratory of Stem Cells and Reproductive Engineering, Ministry of Health, Changsha, China
| | - Jing Chen
- Institute of Reproductive and Stem Cell Engineering, School of Basic Medicine, Central South University, Changsha, China
| | - Yongzhe Chen
- Institute of Reproductive and Stem Cell Engineering, School of Basic Medicine, Central South University, Changsha, China
| | - Guangxiu Lu
- Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, China.,Key Laboratory of Stem Cells and Reproductive Engineering, Ministry of Health, Changsha, China.,National Engineering and Research Center of Human Stem Cell, Changsha, China
| | - Juan Du
- Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, China. .,Institute of Reproductive and Stem Cell Engineering, School of Basic Medicine, Central South University, Changsha, China. .,Key Laboratory of Stem Cells and Reproductive Engineering, Ministry of Health, Changsha, China.
| | - Ge Lin
- Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, China. .,Institute of Reproductive and Stem Cell Engineering, School of Basic Medicine, Central South University, Changsha, China. .,Key Laboratory of Stem Cells and Reproductive Engineering, Ministry of Health, Changsha, China. .,National Engineering and Research Center of Human Stem Cell, Changsha, China.
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Swann K. The role of Ca 2+ in oocyte activation during In Vitro fertilization: Insights into potential therapies for rescuing failed fertilization. BIOCHIMICA ET BIOPHYSICA ACTA-MOLECULAR CELL RESEARCH 2018; 1865:1830-1837. [PMID: 29746897 DOI: 10.1016/j.bbamcr.2018.05.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 04/30/2018] [Accepted: 05/02/2018] [Indexed: 12/21/2022]
Abstract
At fertilization the mature mammalian oocyte is activated to begin development by a sperm-induced series of increases in the cytosolic free Ca2+ concentration. These so called Ca2+ oscillations, or repetitive Ca2+ spikes, are also seen after intracytoplasmic sperm injection (ICSI) and are primarily triggered by a sperm protein called phospholipase Czeta (PLCζ). Whilst ICSI is generally an effective way to fertilizing human oocytes, there are cases where oocyte activation fails to occur after sperm injection. Many such cases appear to be associated with a PLCζ deficiency. Some IVF clinics are now attempting to rescue such cases of failed fertilization by using artificial means of oocyte activation such as the application of Ca2+ ionophores. This review presents the scientific background for these therapies and also considers ways to improve artificial oocyte activation after failed fertilization.
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Affiliation(s)
- Karl Swann
- School of Biosciences, Cardiff University, Sir Martin Evans Building, Museum Avenue, Cardiff CF10 3AX, UK.
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Mutational analysis of IZUMO1R in women with fertilization failure and polyspermy after in vitro fertilization. J Assist Reprod Genet 2017; 35:539-544. [PMID: 29243140 DOI: 10.1007/s10815-017-1101-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Accepted: 12/05/2017] [Indexed: 12/29/2022] Open
Abstract
PURPOSE The etiology of fertilization failure and polyspermy during assisted reproductive technology (ART) remains elusive. The aim of this study was to determine whether mutations in the IZUMO1 receptor (IZUMO1R) gene, which is essential for mammalian fertilization, contribute to the pathogenesis of fertilization failure or polyspermy in humans. METHODS We recruited 215 female subjects with fertilization failure/poor fertilization, 330 females with polyspermy, and 300 matched controls. All subjects underwent IVF treatment. Peripheral blood DNA of cases was extracted and screened for mutations in IZUMO1R gene. RESULTS Four rare single nucleotide polymorphisms (SNPs) of the IZUMO1R were identified among specimens from patients with fertilization failure and polyspermy but were absent in the 300 control subjects. These included a missense SNP (rs76779571 in exon 4), which was found in two fertilization failure patients, and a nonsynonymous SNP (rs61742524 in exon 1) and two synonymous SNPs (rs76781645 in exon 1 and rs377369966 in intron 2), which were found among three polyspermy cases. CONCLUSIONS The variations in IZUMO1R might play a role in the pathogenesis of fertilization failure and polyspermy, and the putative functions and effects of these rare variants require further studies.
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The Vienna consensus: report of an expert meeting on the development of ART laboratory performance indicators. Reprod Biomed Online 2017; 35:494-510. [PMID: 28784335 DOI: 10.1016/j.rbmo.2017.06.015] [Citation(s) in RCA: 159] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Accepted: 06/21/2017] [Indexed: 11/19/2022]
Abstract
This proceedings report presents the outcomes from an international workshop supported by the European Society of Human Reproduction and Embryology (ESHRE) and Alpha Scientists in Reproductive Medicine, designed to establish consensus on definitions and recommended values for Indicators for the assisted reproductive technology (ART) laboratory. Minimum performance-level values ('competency') and aspirational ('benchmark') values were recommended for a total of 19 Indicators, including 12 Key Performance Indicators (KPIs), five Performance Indicators (PIs), and two Reference Indicators (RIs).
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The Vienna consensus: report of an expert meeting on the development of art laboratory performance indicators. Hum Reprod Open 2017; 2017:hox011. [PMID: 31486806 PMCID: PMC6276649 DOI: 10.1093/hropen/hox011] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Revised: 06/15/2017] [Accepted: 08/03/2017] [Indexed: 12/19/2022] Open
Abstract
STUDY QUESTION What are appropriate performance indicators (PIs) for ART laboratories for use in monitoring ‘fresh’ IVF and ICSI cycles? SUMMARY ANSWER Minimum performance (competence) levels and aspirational (benchmark) values were recommended for a total of 19 indicators, including 12 key PIs (KPIs), five PIs and two reference indicators (RIs). WHAT IS ALREADY KNOWN PIs are necessary for systematic monitoring of the laboratory and an important element within the Quality Management System. However, there are no established PIs for ART laboratories and there is very little evidence on the topic. STUDY DESIGN, SIZE, DURATION This is the report of a 2-day consensus meeting of expert professionals. As a starting point for the discussion, two surveys were organized to collect information on indicators used in IVF laboratories. During the meeting, the results of the surveys, scientific evidence (where available), and personal clinical experience where integrated into presentations by experts on specific topics. After presentation, each proposed indicator was discussed until consensus was reached within the panel. PARTICIPANTS/MATERIALS, SETTING, METHODS Expert professionals representing different countries and settings convened in the consensus meeting. MAIN RESULTS AND THE ROLE OF CHANCE The paper is divided in two parts: the workshop report and the recommendations of the expert panel. The second part reflects the discussion on each of the indicators, with the agreed definition, competence level and benchmark value for each of the 19 indicators, including 12 KPIs, 5 PIs and 2 RIs. LIMITATIONS, REASONS FOR CAUTION The KPIs are mainly based on expert opinion. Future research may warrant an update of the recommended KPIs, their definition and the competence level and benchmark values. WIDER IMPLICATIONS OF THE FINDINGS Based on the information presented, each ART laboratory should select its own set of KPIs founded on laboratory organization, and processes. STUDY FUNDING/COMPETING INTEREST(S) The consensus meeting and writing of the paper was supported by funds from ESHRE and Alpha. Alpha gratefully acknowledges the following organizations for their financial support, through the provision of unrestricted educational grants: Global Fertility Alliance, Merck, Origio and Vitrolife. There are no conflicts of interest to disclose,
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Affiliation(s)
| | - Alpha Scientists in Reproductive Medicine
- ALPHA Scientists in Reproductive Medicine, 19 Mayis Mah. 19 Mayis Cad. Nova Baran Center No:4 34360 Sisli, Istanbul, Turkey
- Correspondence address. E-mail: (G.C.)/ (Z.P.)
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48
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Khalili MA, Halvaei I, Ghazali S, Razi MH. Performing ICSI with commercial microinjection pipettes enhanced pregnancy rates. Turk J Med Sci 2017; 47:801-805. [PMID: 28618725 DOI: 10.3906/sag-1512-69] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2015] [Accepted: 11/14/2016] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND/AIM Many technical factors can affect intracytoplasmic sperm injection (ICSI) outcomes. The role of the injection micropipette could be of vital importance in ICSI programs. The main goal was to compare ICSI pregnancy outcomes between commercial and home-made injection micropipettes in a large population with male factor infertility. MATERIALS AND METHODS Five-hundred and eleven ICSI cycles with severe male factor were included in this retrospective study. ICSI cycles were divided into two groups: A (home-made micropipettes, n = 267) and B (commercial micropipettes, n = 244). Rates of fertilization, embryo formation, and chemical and clinical pregnancies were compared between the groups. The independent samples t-test, chi-square test, and Fisher's exact test were used, whenever appropriate, for statistical analysis. RESULTS A total of 3621 MII oocytes were retrieved, of which 2003 were fertilized. The rate of normal fertilization was significantly higher in group A (57.9%) compared to group B (52.5%). However, the rate of embryo formation showed an increase in group B compared to group A (90.4% and 85.9%, respectively, P = 0.002). In addition, the clinical pregnancy outcomes improved in group B. CONCLUSION Our findings indicate that clinical pregnancy improves when commercial injection micropipettes are used in ICSI programs.
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Affiliation(s)
- Mohammad Ali Khalili
- Research and Clinical Center for Infertility, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Iman Halvaei
- Department of Anatomical Sciences, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Shahin Ghazali
- Sanandaj Branch, Islamic Azad University, Sanandaj, Iran
| | - Mohammad Hossein Razi
- Research and Clinical Center for Infertility, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Jeve YB, Potdar N, Blower JA, Gelbaya T. Strategies to improve fertilisation rates with assisted conception: a systematic review. HUM FERTIL 2017; 21:229-247. [PMID: 28545312 DOI: 10.1080/14647273.2017.1324182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Successful fertilisation is one of the key steps determining success of assisted conception. Various factors including sperm or oocyte pathology and environmental factors have a significant impact on fertilisation rates. This systematic review is aimed to evaluate the existing evidence about factors affecting fertilisation and strategies to improve fertilisation rates. A literature search was performed using Ovid MEDLINE ® (Jan 1950-April 2016), EMBASE (Jan 1950-April 2016), Ovid OLDMEDLINE ®, Pre-MEDLINE (Jan 1950-April 2016) and the Cochrane Library. Relevant key words were used to combine sets of results and a total 243 papers were screened. Only qualitative analysis was performed, as there was major heterogeneity in study design and methodology for quantitative synthesis. Factors affecting fertilisation were divided into sperm- and oocyte-related factors. The methods to improve fertilisation rates were grouped together based on the approach used to improve fertilisation rates. Optimising laboratory condition and procedural effects in techniques is associated with improved fertilisation rates. Various techniques are described to improve fertilisation rates including assisted oocyte activation, physiological intracytoplasmic sperm injection (PICSI) and intracytoplasmic morphologically selected sperm injection (IMSI). This review highlights the promising strategies under research to enhance fertilisation rates. Adequately powered multicentre randomised trials are required to evaluate these techniques before considering clinical application.
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Affiliation(s)
- Yadava Bapurao Jeve
- a Leicester Fertility Centre , University Hospitals of Leicester , Leicester , UK
| | - Neelam Potdar
- a Leicester Fertility Centre , University Hospitals of Leicester , Leicester , UK.,b Reproductive Sciences Section , University of Leicester , Leicester , UK
| | - Jane A Blower
- a Leicester Fertility Centre , University Hospitals of Leicester , Leicester , UK
| | - Tarek Gelbaya
- a Leicester Fertility Centre , University Hospitals of Leicester , Leicester , UK
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Gat I, Orvieto R. "This is where it all started" - the pivotal role of PLCζ within the sophisticated process of mammalian reproduction: a systemic review. Basic Clin Androl 2017; 27:9. [PMID: 28533904 PMCID: PMC5438850 DOI: 10.1186/s12610-017-0054-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Accepted: 03/26/2017] [Indexed: 12/14/2022] Open
Abstract
Mammalian reproduction is one of the most complex and fascinating biological phenomenon, which aims to transfer maternal and paternal genetic material to the next generation. At the end of oogenesis and spermatogenesis, both haploid gametes contain a single set of chromosomes ready to form the zygote, the first cell of the newly developing individual. The mature oocyte and spermatozoa remain in a quiescent state, during which the oocyte is characterized by nuclear and cytoplasmic arrest, while the spermatozoa necessitates further maturation within the epididymis and female reproductive track prior to egg fertilization. Either in vivo or in vitro, the sperm initiates a series of irreversible biochemical and physiological modifications in the oocyte. The earliest detected signal after fertilization is cytosolic Ca2+ oscillations, a prerequisite step for embryo development. These oscillations trigger the release of the oocyte from the second meiosis arrest towards embryogenesis, also known as “oocyte activation”. Phospholipase C zeta (PLCζ) is a unique sperm-soluble protein responsible for triggering the InsP3/Ca2+ pathway within the oocyte, leading to Ca2+ oscillations and consequently to embryo development. The specific structure of PLCζ (compared to other PLCs) enables its specialized activity via the preserved X and Y catalytic domains, as well as distinct features such as rapid onset, high sensitivity to Ca2+ and cession of oscillations upon zygote formation. The emerging discoveries of PLCζ have stimulated studies focusing on the possible clinical applications of this protein in male infertility evaluation and management during IVF/ICSI. Fertilization failure is attributed to lack of oocyte second meiosis resumption, suggesting that ICSI failure may be related to impaired PLCζ activity. Microinjection of recombinant human PLCζ to human oocytes after ICSI fertilization failure may trigger Ca2+ oscillations and achieve successful fertilization, offering new hope for couples traditionally referred to sperm donation. However, more studies are still required prior to the routine implementation of this approach in the clinic. Directions for future studies are discussed.
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Affiliation(s)
- Itai Gat
- IVF Unit, Department of Obstetrics and Gynecology, Sheba Medical Center, Tel Hashomer, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Pinchas Borenstein Talpiot Medical Leadership Program, Sheba Medical Center, Tel Hashomer, Israel
| | - Raoul Orvieto
- IVF Unit, Department of Obstetrics and Gynecology, Sheba Medical Center, Tel Hashomer, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,The Tarnesby-Tarnowski Chair for Family Planning and Fertility Regulation, Sackler Faculty of Medicine, Tel Aviv, Israel
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