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Liu L, Jiang X, Liu Z, Chen J, Yang C, Chen K, Yang X, Cai J, Ren J. Oocyte degeneration in a cohort adversely affects clinical outcomes in conventional IVF cycles: a propensity score matching study. Front Endocrinol (Lausanne) 2023; 14:1164371. [PMID: 37274329 PMCID: PMC10235780 DOI: 10.3389/fendo.2023.1164371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Accepted: 05/02/2023] [Indexed: 06/06/2023] Open
Abstract
Background Oocyte degeneration was mostly described in intracytoplasmic sperm injection (ICSI) cycles; there is no report showing the relationship between oocyte degeneration and clinical outcomes in conventional in vitro fertilization (IVF) cycles. This retrospective study using the propensity score (PS) matching method aimed to explore whether the presence of oocyte degeneration in conventional IVF cycles would affect the sibling embryo development potential and clinical outcomes. Methods Patients with at least one oocyte degenerated after short-term insemination and stripping were defined as the degeneration (DEG) group, while patients with no oocyte degenerated were defined as the non-degeneration (NONDEG) group. The PS matching method was used to control for potential confounding factors, and a multivariate logistic regression analysis was made to evaluate whether the presence of oocyte degeneration would affect the cumulative live birth rate (CLBR). Results After PS matching, basic characteristics were similar between the two groups, oocyte yield was significantly higher in the DEG group than the NON-DEG group (P < 0.05), mature oocyte number, 2 pronuclear (2PN) embryo number, 2PN embryo clearage rate, "slow" embryo number, "accelerated" embryo number, rate of cycles with total day 3 embryo extended culture, number of frozen embryo transfer (FET) cycles, transferred embryo stage, transferred embryo number, and live birth rate in fresh embryo transfer cycles were all similar between the two groups (P > 0.05), but the 2PN fertilization rate, available embryo number, high-quality embryo number, "normal" embryo number, frozen embryo number, blastocyst formation rate, and no available embryo cycle rate were all significantly lower in the DEG group than the NON-DEG group (P < 0.05). The cumulative live birth rate was also significantly lower in the DEG group than in the NON-DEG group (70.2% vs. 74.0%, P = 0.0019). Multivariate logistic regression analysis further demonstrated that the presence of oocyte degeneration in conventional IVF cycles adversely affects the CLBR both before (OR = 0.83, 95% CI: 0.75-0.92) and after (OR = 0.82, 95% CI: 0.72-0.93) PS matching. Conclusion Our findings together revealed that the presence of oocyte degeneration in a cohort of oocytes may adversely affect subsequent embryo development potential and clinical outcomes in conventional IVF cycles.
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Affiliation(s)
- Lanlan Liu
- Reproductive Medicine Center, The Affiliated Chenggong Hospital of Xiamen University, Xiamen, China
- Medical College, Xiamen University, Xiamen, China
| | - Xiaoming Jiang
- Reproductive Medicine Center, The Affiliated Chenggong Hospital of Xiamen University, Xiamen, China
| | - Zhenfang Liu
- Reproductive Medicine Center, The Affiliated Chenggong Hospital of Xiamen University, Xiamen, China
| | - Jinghua Chen
- Reproductive Medicine Center, The Affiliated Chenggong Hospital of Xiamen University, Xiamen, China
| | - Chao Yang
- Reproductive Medicine Center, The Affiliated Chenggong Hospital of Xiamen University, Xiamen, China
| | - Kaijie Chen
- Reproductive Medicine Center, The Affiliated Chenggong Hospital of Xiamen University, Xiamen, China
| | - Xiaolian Yang
- Reproductive Medicine Center, The Affiliated Chenggong Hospital of Xiamen University, Xiamen, China
| | - Jiali Cai
- Reproductive Medicine Center, The Affiliated Chenggong Hospital of Xiamen University, Xiamen, China
- Medical College, Xiamen University, Xiamen, China
| | - Jianzhi Ren
- Reproductive Medicine Center, The Affiliated Chenggong Hospital of Xiamen University, Xiamen, China
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Almeida GHDR, Iglesia RP, Rinaldi JDC, Murai MK, Calomeno CVAQ, da Silva Junior LN, Horvath-Pereira BDO, Pinho LBM, Miglino MA, Carreira ACO. Current Trends on Bioengineering Approaches for Ovarian Microenvironment Reconstruction. TISSUE ENGINEERING. PART B, REVIEWS 2023. [PMID: 36355603 DOI: 10.1089/ten.teb.2022.0171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Ovarian tissue has a unique microarchitecture and a complex cellular and molecular dynamics that are essential for follicular survival and development. Due to this great complexity, several factors may lead to ovarian insufficiency, and therefore to systemic metabolic disorders and female infertility. Techniques currently used in the reproductive clinic such as oocyte cryopreservation or even ovarian tissue transplant, although effective, have several limitations, which impair their wide application. In this scenario, mimetic ovarian tissue reconstruction comes as an innovative alternative to develop new methodologies for germ cells preservation and ovarian functions restoration. The ovarian extracellular matrix (ECM) is crucial for oocyte viability maintenance, once it acts actively in folliculogenesis. One of the key components of ovarian bioengineering is biomaterials application that mimics ECM and provides conditions for cell anchorage, proliferation, and differentiation. Therefore, this review aims at describing ovarian tissue engineering approaches and listing the main limitations of current methods for preservation and reestablishment of ovarian fertility. In addition, we describe the main elements that structure this study field, highlighting the main advances and the challenges to overcome to develop innovative methodologies to be applied in reproductive medicine. Impact Statement This review presents the main advances in the application of tissue bioengineering in the ovarian tissue reconstruction to develop innovative solutions for ovarian fertility reestablishment.
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Affiliation(s)
| | - Rebeca Piatniczka Iglesia
- Department of Cell and Developmental Biology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | | | - Mikaelly Kiemy Murai
- Department of Morphological Sciences, State University of Maringa, Maringá, Brazil
| | | | | | | | - Letícia Beatriz Mazo Pinho
- Department of Surgery, Faculty of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo, Brazil
| | - Maria Angelica Miglino
- Department of Surgery, Faculty of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo, Brazil
| | - Ana Claudia Oliveira Carreira
- Department of Surgery, Faculty of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo, Brazil.,Center of Natural and Human Sciences, Federal University of ABC, Santo André, Brazil
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Siristatidis C, Tzanakaki D, Simopoulou M, Vaitsopoulou C, Tsioulou P, Stavros S, Papapanou M, Drakakis P, Bakas P, Vlahos N. Empty Zona Pellucida Only Case: A Critical Review of the Literature. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18179409. [PMID: 34501995 PMCID: PMC8430770 DOI: 10.3390/ijerph18179409] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Revised: 08/21/2021] [Accepted: 09/01/2021] [Indexed: 12/14/2022]
Abstract
The presence of empty zona pellucida (EZP) in oocytes following oocyte retrieval (OR) during an in vitro fertilization (IVF) cycle presents a major clinical and laboratory challenge in assisted reproduction. It has been attributed to several factors such as the ovarian stimulation protocol employed, the damaging of the follicles during oocyte retrieval (OR) mainly through the high aspiration pressure, during the denudation technique, and the degeneration of oolemma within the zona pellucida (ZP) through apoptosis. The role of ZP is pivotal from the early stages of follicular development up to the preimplantation embryo development and embryo hatching. Polymorphisms or alterations on the genes that encode ZP proteins may contribute to EZP. We present a critical review of the published literature hitherto on EZP and available options when encountered with the phenomenon of EZP. Concerning the former, we found that there is rare data on this phenomenon that merits documentation. The latter includes technical, genetic, and pathophysiological perspectives, along with specific treatment options. In conclusion, we identify the lack of a definitive management proposal for couples presenting with this phenomenon, we underline the need for an algorithm, and indicate the questions raised that point towards our goal for a strategy when addressing a previous finding of EZP.
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Affiliation(s)
- Charalampos Siristatidis
- Assisted Reproduction Unit, Second Department of Obstetrics and Gynecology, Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece; (D.T.); (M.S.); (C.V.); (P.T.); (P.B.); (N.V.)
- Second Department of Obstetrics and Gynecology, Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece;
- Correspondence: or ; Tel.: +0030-6932294994
| | - Despoina Tzanakaki
- Assisted Reproduction Unit, Second Department of Obstetrics and Gynecology, Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece; (D.T.); (M.S.); (C.V.); (P.T.); (P.B.); (N.V.)
| | - Mara Simopoulou
- Assisted Reproduction Unit, Second Department of Obstetrics and Gynecology, Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece; (D.T.); (M.S.); (C.V.); (P.T.); (P.B.); (N.V.)
| | - Christina Vaitsopoulou
- Assisted Reproduction Unit, Second Department of Obstetrics and Gynecology, Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece; (D.T.); (M.S.); (C.V.); (P.T.); (P.B.); (N.V.)
| | - Petroula Tsioulou
- Assisted Reproduction Unit, Second Department of Obstetrics and Gynecology, Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece; (D.T.); (M.S.); (C.V.); (P.T.); (P.B.); (N.V.)
| | - Sofoklis Stavros
- Molecular Biology of Reproduction Unit and Recurrent Abortions Unit, Assisted Reproduction Unit, First Department of Obstetrics and Gynecology, Alexandra Hospital, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece; (S.S.); (P.D.)
| | - Michail Papapanou
- Second Department of Obstetrics and Gynecology, Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece;
| | - Peter Drakakis
- Molecular Biology of Reproduction Unit and Recurrent Abortions Unit, Assisted Reproduction Unit, First Department of Obstetrics and Gynecology, Alexandra Hospital, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece; (S.S.); (P.D.)
| | - Panagiotis Bakas
- Assisted Reproduction Unit, Second Department of Obstetrics and Gynecology, Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece; (D.T.); (M.S.); (C.V.); (P.T.); (P.B.); (N.V.)
- Second Department of Obstetrics and Gynecology, Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece;
| | - Nikolaos Vlahos
- Assisted Reproduction Unit, Second Department of Obstetrics and Gynecology, Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece; (D.T.); (M.S.); (C.V.); (P.T.); (P.B.); (N.V.)
- Second Department of Obstetrics and Gynecology, Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece;
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Atzmon Y, Michaeli M, Aslih N, Ruzov O, Rotfarb N, Shoshan-Karchovsky E, Shalom-Paz E. Degenerative Oocytes in the Aspirated Cohort Are Not Due to the Aspirating Needle: a Prospective Randomized Pilot Study with Sibling Oocytes. Reprod Sci 2020; 28:1882-1889. [PMID: 33171516 DOI: 10.1007/s43032-020-00384-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 11/01/2020] [Indexed: 11/25/2022]
Abstract
The aim of this study is to compare two different needles (17G vs. 20-17G variable diameter) used for OPU and to assess whether the different stress forces along the needle affect the presence of degenerative oocytes, oocyte quality, and embryo morphokinetics. Prospective, randomized study enrolled women undergoing in vitro fertilization (IVF) intracytoplasmic sperm injection (ICSI) from August 2016 through August 2018 in an IVF unit at a tertiary care medical center. Ovaries were randomly aspirated using either a 20-17G needle or a 17G needle. The embryologist was blinded to the aspirating needle and sibling oocytes were separated according to needle used for fertilization and further evaluation. Oocytes were scored negatively if one of the following parameters was abnormal immediately after OPU: polar body shape, zona pellucida, cytoplasm, perivitelline space, or vacuoles. The presence of degenerative oocytes was noted at OPU. A total of 580 oocytes from 43 women were evaluated, 293 in the 17G needle group and 287 in the 20-17G group. Oocyte scoring was comparable between the two different needles (- 1.99 ± 1.9 vs. - 1.88 ± 1.69; P = 0.13), as were embryo quality and pregnancy rate. Cohorts with degenerative oocytes had lower oocyte scores (- 2.11 ± 1.81 vs. - 1.60 ± 1.50; P = 0.001) and poorer performance and fertilization rates (62.5% vs. 78.5%; P < 0.001) than did cohorts with no degenerative oocytes. Cycles with degenerative oocytes in the cohort at OPU demonstrated poorer oocyte quality and decreased fertilization, regardless of the needle used. 1.5.2016 NIH number NCT02749773.
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Affiliation(s)
- Yuval Atzmon
- IVF Unit, Department of Obstetrics and Gynecology, Hillel Yaffe Medical Center, Hadera, Israel, Ruth and Bruce Rappaport School of Medicine, Technion, Haifa, Israel.
| | - Mediea Michaeli
- IVF Unit, Department of Obstetrics and Gynecology, Hillel Yaffe Medical Center, Hadera, Israel, Ruth and Bruce Rappaport School of Medicine, Technion, Haifa, Israel
| | - Nardin Aslih
- IVF Unit, Department of Obstetrics and Gynecology, Hillel Yaffe Medical Center, Hadera, Israel, Ruth and Bruce Rappaport School of Medicine, Technion, Haifa, Israel
| | - Olga Ruzov
- IVF Unit, Department of Obstetrics and Gynecology, Hillel Yaffe Medical Center, Hadera, Israel, Ruth and Bruce Rappaport School of Medicine, Technion, Haifa, Israel
| | - Nechami Rotfarb
- IVF Unit, Department of Obstetrics and Gynecology, Hillel Yaffe Medical Center, Hadera, Israel, Ruth and Bruce Rappaport School of Medicine, Technion, Haifa, Israel
| | - Ester Shoshan-Karchovsky
- IVF Unit, Department of Obstetrics and Gynecology, Hillel Yaffe Medical Center, Hadera, Israel, Ruth and Bruce Rappaport School of Medicine, Technion, Haifa, Israel
| | - Einat Shalom-Paz
- IVF Unit, Department of Obstetrics and Gynecology, Hillel Yaffe Medical Center, Hadera, Israel, Ruth and Bruce Rappaport School of Medicine, Technion, Haifa, Israel
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