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Palomba S, Viganò P, Chamayou S, Donarelli Z, Costantini MP, Marci R, Piomboni P, Fino E, Montano L, Guglielmino A, Somigliana E. Diagnosis and management of infertility: NICE-adapted guidelines from the Italian Society of Human Reproduction. Reprod Biol Endocrinol 2024; 22:9. [PMID: 38183116 PMCID: PMC10768082 DOI: 10.1186/s12958-023-01179-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Accepted: 12/23/2023] [Indexed: 01/07/2024] Open
Abstract
In Italy the fertility rate is very low, and an increasing number of patients are infertile and require treatments. The Italian Law concerning the safety of patient care, and the professional liability of health professionals, indicates that health professionals must comply with the recommendations set out in the guidelines developed by public and private bodies and institutions, as well as scientific societies and technical-scientific associations of the health professions, except for specific cases. Unfortunately, no guideline for the diagnosis and the management of infertility is currently available in Italy. In 2019, the Italian Society of Human Reproduction pointed out the need to produce Italian guidelines and subsequently approved the establishment of a multidisciplinary and multiprofessional working group (MMWG) to develop such a guideline. The MMWG was representative of 5 scientific societies, one national federation of professional orders, 3 citizens' and patients' associations, 5 professions (including lawyer, biologist, doctor, midwife, and psychologist), and 3 medical specialties (including medical genetics, obstetrics and gynecology, and urology). The MMWG chose to adapt a high-quality guideline to the Italian context instead of developing one from scratch. Using the Italian version of the Appraisal of Guidelines for Research and Evaluation II scoring system, the National Institute of Clinical Excellence guidelines were selected and adapted to the Italian context. The document was improved upon by incorporating comments and suggestions where needed. This study presents the process of adaptation and discusses the pros and cons of the often-neglected choice of adapting rather than developing new guidelines.
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Affiliation(s)
- Stefano Palomba
- Department of Medical-Surgical Science and Translational Medicine, Sapienza University of Rome, Sant'Andrea Hospital, Rome, Italy.
- Unit of Gynecology, Sant'Andrea Hospital, Via di Grottarossa, 1039, Rome, Italy.
| | - Paola Viganò
- Infertility Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Sandrine Chamayou
- HERA Center, Unit of Reproductive Medicine (U.M.R.), Sant'Agata Li Battiati, Catania, Italy
| | - Zaira Donarelli
- Psychological Counselling Service, University of Palermo, Palermo, and Clinical Psychology Unit, ANDROS Day Surgery Clinic, Palermo, Italy
| | | | - Roberto Marci
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy
| | - Paola Piomboni
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
- Unit of Medically Assisted Reproduction, Siena University Hospital, Siena, Italy
| | - Egidio Fino
- Italian Society of Human Reproduction, SIRU, Rome, Italy
| | - Luigi Montano
- Unit and Service of Lifestyle Medicine in Uro-Andrology, Local Health Authority of Salerno, Salerno, Italy
| | - Antonino Guglielmino
- HERA Center, Unit of Reproductive Medicine (U.M.R.), Sant'Agata Li Battiati, Catania, Italy
| | - Edgardo Somigliana
- Infertility Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
- Department of Clinical Sciences and Community Heath, University of Milan, Milan, Italy
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Alteri A, Bosco L, Chamayou S, Casciani V, Cervi M, Cecchele A, Cho YS, Costantini MP, Dal Canto MB, De Stefani S, Fraioli A, Furlan V, Giacone F, Guarneri C, Guglielmino A, Iaccarino M, Miceli A, Minasi MG, Montano L, Notari T, Paffoni A, Palini S, Reschini M, Ruvolo G, Viganó P, Volpes A. The paradox of the Italian clinical embryologist in the national public health system: hints towards harmonization of a postgraduate educational curriculum. HUM FERTIL 2023; 26:1380-1384. [PMID: 35255778 DOI: 10.1080/14647273.2022.2045040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 12/04/2021] [Indexed: 11/04/2022]
Abstract
Clinical embryologists are highly trained laboratory professionals with multiple roles, including laboratory, clinical, biobanking and quality system management. In most European countries, clinical embryologists are trained to work in Medically Assisted Reproduction (MAR) centres without a specifically dedicated educational path. The criteria required for employment vary according to the educational structure and the public or private nature of the centre. We have herein described the educational profile required by Italian clinical embryologists to work in MAR centres of the National Health System (NHS). Public centres currently represent 36% of all the Italian MAR clinics. According to the Italian law, a future clinical embryologist must achieve a 3-4 year unpaid post-graduate specialization in a different field, choosing from Genetics, Microbiology, Clinical Pathology or Nutrition. Accesses to the above-mentioned post-graduate courses are themselves very limited. Clinical embryologists are basically trained by senior colleagues. This situation makes inevitably difficult to recruit laboratory staff in NHS centres. Moreover, it represents an emblematic example of the need for an equal training curriculum, possibly ensuring a comparable education quality, mobility of trainees and dissemination of skills for clinical embryologists all over Europe.
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Affiliation(s)
| | - Liana Bosco
- Società Italiana di Riproduzione Umana, Roma, Italy
| | | | | | - Marta Cervi
- Società Italiana di Riproduzione Umana, Roma, Italy
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Paola Viganó
- Società Italiana di Riproduzione Umana, Roma, Italy
| | - Aldo Volpes
- Società Italiana di Riproduzione Umana, Roma, Italy
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Chamayou S, Lombardi R, Ragolia C, Alecci C, Storaci G, Romano S, Guglielmino A. Comparison of clinical outcomes between conventional in vitro fertilization and intracytoplasmic sperm injection on sibling oocytes. Reprod Biomed Online 2022. [DOI: 10.1016/j.rbmo.2022.08.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/07/2022]
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Abstract
The metaphase II (MII) oocyte is the mature female gamete, produced from a complex maturation process called oogenesis that starts in the first weeks of embryogenesis in the female embryo tract, continues during puberty, and is completed at fertilization with the spermatozoon. Oogenesis is closely related to folliculogenesis. In assisted reproduction techniques, oocytes are retrieved in cumulus-oocyte complexes after ovarian stimulation. Before being used for in vitro fertilization or cryopreservation, the metaphase (MII) oocytes can be classified according to different morphological traits and by the presence/absence of the meiotic spindle. Except for a few and rare morphological characteristics that make the oocyte discarded, none of the morphological characteristics is predictive of oocyte competence in giving a viable embryo. On the other side, specific key performance indicators based on MII oocytes test the efficacy of in vitro treatments. Molecular, cellular, or genetic abnormalities in the oocytes have observable consequences on the embryo development dynamics and its genetic content. Besides what can be seen in vitro, several intrinsic and extrinsic factors related to the patient are responsible for the oocyte quality. The clinician and the patient herself must be aware of these factors to preserve the reproductive functions as much as possible. In the present review, we have revised oogenesis and the role of mature oocytes in supporting the fertilization process and early embryo development; we have also listed the oocyte morphological traits and key performance indicators related to the oocyte quality and studied the intrinsic and extrinsic factors that irreversibly impact female fertility.
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Affiliation(s)
- Sandrine Chamayou
- Unit of Reproductive Medicine, HERA Center, Sant'Agata Li Battiati, Catania, Italy -
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Chamayou S, Ragolia C, Alecci C, Storaci G, Romano S, Sapienza R, Maglia E, Liprino A, Cardea C, Fichera M, Guglielmino A. More blastocysts are produced from fewer oocytes in ICSI compared to IVF - results from a sibling oocytes study and definition of a new key performance indicator. Reprod Biol Endocrinol 2021; 19:116. [PMID: 34311751 PMCID: PMC8311920 DOI: 10.1186/s12958-021-00804-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 07/16/2021] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Which fertilization method, between ICSI and IVF in split insemination treatments, has the highest clinical efficiency in producing clinically usable blastocyst? METHODS 211 infertile couples underwent split insemination treatments for a non-severe male factor. 1300 metaphase II (MII) oocytes were inseminated by conventional IVF and 1302 MII oocytes were micro-injected with the same partner's semen. Embryo development until blastocyst stage on day V and clinical outcomes were valuated trough conventional key performance indicators (KPI), and new KPIs such as blastocyst rate per used MII oocytes and the number of MII oocytes to produce one clinically usable blastocyst from ICSI and IVF procedures. RESULTS The results were globally analyzed and according to ovarian stimulation protocol, infertility indication, and female age. The conventional KPI were online with the expected values from consensus references. From global results, 2.3 MII oocyte was needed to produce one clinically usable blastocyst after ICSI compared to 2.9 MII oocytes in IVF. On the same way, more blastocysts for clinical use were produced from fewer MII oocytes in ICSI compared to IVF in all sub-groups. CONCLUSIONS In split insemination treatments, the yield of clinically usable blastocysts was always superior in ICSI compared to IVF. The new KPI "number of needed oocytes to produce one clinically usable embryo" tests the clinical efficiency of the IVF laboratory.
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Affiliation(s)
- Sandrine Chamayou
- Unità di Medicina della Riproduzione - Centro HERA, via barriera del bosco, n. 51/53, Sant'Agata Li Battiati, Catania, Italy.
| | - Carmen Ragolia
- Unità di Medicina della Riproduzione - Centro HERA, via barriera del bosco, n. 51/53, Sant'Agata Li Battiati, Catania, Italy
| | - Carmelita Alecci
- Unità di Medicina della Riproduzione - Centro HERA, via barriera del bosco, n. 51/53, Sant'Agata Li Battiati, Catania, Italy
| | - Giorgia Storaci
- Unità di Medicina della Riproduzione - Centro HERA, via barriera del bosco, n. 51/53, Sant'Agata Li Battiati, Catania, Italy
| | - Simona Romano
- Unità di Medicina della Riproduzione - Centro HERA, via barriera del bosco, n. 51/53, Sant'Agata Li Battiati, Catania, Italy
| | - Roberta Sapienza
- Unità di Medicina della Riproduzione - Centro HERA, via barriera del bosco, n. 51/53, Sant'Agata Li Battiati, Catania, Italy
| | - Elena Maglia
- Unità di Medicina della Riproduzione - Centro HERA, via barriera del bosco, n. 51/53, Sant'Agata Li Battiati, Catania, Italy
| | - Annalisa Liprino
- Unità di Medicina della Riproduzione - Centro HERA, via barriera del bosco, n. 51/53, Sant'Agata Li Battiati, Catania, Italy
| | - Clementina Cardea
- Unità di Medicina della Riproduzione - Centro HERA, via barriera del bosco, n. 51/53, Sant'Agata Li Battiati, Catania, Italy
| | - Michele Fichera
- Unit of Gynecology and Obstetrics-Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy
| | - Antonino Guglielmino
- Unità di Medicina della Riproduzione - Centro HERA, via barriera del bosco, n. 51/53, Sant'Agata Li Battiati, Catania, Italy
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Chamayou S, Sicali M, Lombardo D, Maglia E, Liprino A, Cardea C, Fichera M, Venti E, Guglielmino A. The true panel of cystic fibrosis mutations in the Sicilian population. BMC Med Genet 2020; 21:89. [PMID: 32357917 PMCID: PMC7195759 DOI: 10.1186/s12881-020-0958-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Accepted: 01/21/2020] [Indexed: 11/24/2022]
Abstract
Background The aim was to establish the true risk of having an affected child with Cystic Fibrosis (CF) in the Sicilian infertile population. Methods A longitudinal CFTR screening of 1279 Sicilian infertile patients for all CFTR mutations sequencing the entire gene by Next Generation Sequencing (NGS) was performed from patient’s blood. Results One patient out of 16 was a carrier of a CFTR mutation. Twenty-four mutations were found. Theoretically one couple out of 256 was at risk of CF transmission. Conclusions The risk of CF transmission is unexpectedly high in Sicily and with a high heterogeneity. Sequencing an entire and long gene such as CFTR makes accessible the true panel of mutations in a specific population and helps better to understand the true risk of having an affected child.
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Affiliation(s)
- Sandrine Chamayou
- Unità di Medicina della Riproduzione - Centro HERA, via Barriera del Bosco n. 51/53, 95030, Catania, Sant'Agata Li Battiati, Italy.
| | - Maria Sicali
- Unità di Medicina della Riproduzione - Centro HERA, via Barriera del Bosco n. 51/53, 95030, Catania, Sant'Agata Li Battiati, Italy
| | - Debora Lombardo
- Unità di Medicina della Riproduzione - Centro HERA, via Barriera del Bosco n. 51/53, 95030, Catania, Sant'Agata Li Battiati, Italy
| | - Elena Maglia
- Unità di Medicina della Riproduzione - Centro HERA, via Barriera del Bosco n. 51/53, 95030, Catania, Sant'Agata Li Battiati, Italy
| | - Annalisa Liprino
- Unità di Medicina della Riproduzione - Centro HERA, via Barriera del Bosco n. 51/53, 95030, Catania, Sant'Agata Li Battiati, Italy
| | - Clementina Cardea
- Unità di Medicina della Riproduzione - Centro HERA, via Barriera del Bosco n. 51/53, 95030, Catania, Sant'Agata Li Battiati, Italy
| | - Michele Fichera
- Unit of Gynecology and Obstetric - Department of general surgery and medical surgical specialties, University of Catania, Catania, Italy
| | - Ermanno Venti
- Unità di Medicina della Riproduzione - Centro HERA, via Barriera del Bosco n. 51/53, 95030, Catania, Sant'Agata Li Battiati, Italy
| | - Antonino Guglielmino
- Unità di Medicina della Riproduzione - Centro HERA, via Barriera del Bosco n. 51/53, 95030, Catania, Sant'Agata Li Battiati, Italy
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Chamayou S, Sicali M, Lombardo D, Alecci C, Ragolia C, Maglia E, Liprino A, Cardea C, Storaci G, Romano S, Guglielmino A. Universal strategy for preimplantation genetic testing for cystic fibrosis based on next-generation sequencing. J Assist Reprod Genet 2019:10.1007/s10815-019-01636-1. [PMID: 31848897 DOI: 10.1007/s10815-019-01636-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Accepted: 11/12/2019] [Indexed: 11/29/2022] Open
Abstract
PURPOSE We developed and applied a universal strategy for preimplantation genetic testing for all cystic fibrosis gene mutations (PGT-CF) based on next-generation sequencing (NGS). METHODS A molecular protocol was designed to diagnose all CF mutations at preimplantation stage. The detection of CF mutations was performed by direct gene sequencing and linkage strategy testing 38 specific SNPs located upstream and inside the gene for PGT-CF. Seventeen couples at risk of CF transmission decided to undergo PGT-CF. Trophectoderm cell biopsies were performed on days 5-6 blastocysts. PGT for aneuploidy (PGT-A) was performed from the same samples. Tested embryos were transferred on further natural cycles. RESULTS PGT was performed on 109 embryos. Fifteen CF mutations were tested. PGT-CF and PGT-A were conclusive for, respectively, 92.7% and 95.3% of the samples. A mean of 24.1 SNPs was informative per couple. After single embryo transfer on natural cycle, 81.3% of the transferred tested embryos implanted. CONCLUSIONS The present protocol based on the entire CFTR gene sequencing together with informative SNPs outside and inside the gene can be applied to diagnose all CF mutations at preimplantation stage.
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Affiliation(s)
- Sandrine Chamayou
- Unità di Medicina della Riproduzione, Centro HERA, via Barriera del Bosco n. 51/53, 95030, Sant'Agata Li Battiati, Catania, Italy.
| | - Maria Sicali
- Unità di Medicina della Riproduzione, Centro HERA, via Barriera del Bosco n. 51/53, 95030, Sant'Agata Li Battiati, Catania, Italy
| | - Debora Lombardo
- Unità di Medicina della Riproduzione, Centro HERA, via Barriera del Bosco n. 51/53, 95030, Sant'Agata Li Battiati, Catania, Italy
| | - Carmelita Alecci
- Unità di Medicina della Riproduzione, Centro HERA, via Barriera del Bosco n. 51/53, 95030, Sant'Agata Li Battiati, Catania, Italy
| | - Carmen Ragolia
- Unità di Medicina della Riproduzione, Centro HERA, via Barriera del Bosco n. 51/53, 95030, Sant'Agata Li Battiati, Catania, Italy
| | - Elena Maglia
- Unità di Medicina della Riproduzione, Centro HERA, via Barriera del Bosco n. 51/53, 95030, Sant'Agata Li Battiati, Catania, Italy
| | - Annalisa Liprino
- Unità di Medicina della Riproduzione, Centro HERA, via Barriera del Bosco n. 51/53, 95030, Sant'Agata Li Battiati, Catania, Italy
| | - Clementina Cardea
- Unità di Medicina della Riproduzione, Centro HERA, via Barriera del Bosco n. 51/53, 95030, Sant'Agata Li Battiati, Catania, Italy
| | - Giorgia Storaci
- Unità di Medicina della Riproduzione, Centro HERA, via Barriera del Bosco n. 51/53, 95030, Sant'Agata Li Battiati, Catania, Italy
| | - Simona Romano
- Unità di Medicina della Riproduzione, Centro HERA, via Barriera del Bosco n. 51/53, 95030, Sant'Agata Li Battiati, Catania, Italy
| | - Antonino Guglielmino
- Unità di Medicina della Riproduzione, Centro HERA, via Barriera del Bosco n. 51/53, 95030, Sant'Agata Li Battiati, Catania, Italy
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Chamayou S, Sicali M, Lombardo D, Alecci C, Ragolia C, Maglia E, Liprino A, Cardea C, Storaci G, Romano S, Guglielmino A. Universal strategy for preimplantation genetic testing for cystic fibrosis based on next generation sequencing. J Assist Reprod Genet 2019; 37:213-222. [PMID: 31828483 PMCID: PMC7000499 DOI: 10.1007/s10815-019-01635-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Accepted: 11/12/2019] [Indexed: 12/11/2022] Open
Abstract
Purpose We developed and applied a universal strategy for preimplantation genetic testing for all cystic fibrosis gene mutations (PGT-CF) based on next-generation sequencing (NGS). Methods A molecular protocol was designed to diagnose all CF mutations at preimplantation stage. The detection of CF mutations was performed by direct gene sequencing and linkage strategy testing 38 specific SNPs located upstream and inside the gene for PGT-CF. Seventeen couples at risk of CF transmission decided to undergo PGT-CF. Trophectoderm cell biopsies were performed on day 5–6 blastocysts. PGT for aneuploidy (PGT-A) was performed from the same samples. Tested embryos were transferred on further natural cycles. Results PGT was performed on 109 embryos. Fifteen CF mutations were tested. PGT-CF and PGT-A were conclusive for respectively 92.7% and 95.3% of the samples. A mean of 24.1 SNPs was informative per couple. After a single embryo transfer on natural cycle, 81.3% of the transferred tested embryos were implanted. Conclusions The present protocol based on the entire CFTR gene together with informative SNPs outside and inside the gene can be applied to diagnose all CF mutations at preimplantation stage. Electronic supplementary material The online version of this article (10.1007/s10815-019-01635-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Sandrine Chamayou
- Unità di Medicina della Riproduzione - Centro HERA, via Barriera del Bosco n. 51/53, Sant'Agata Li Battiati, 95030, Catania, Italy.
| | - Maria Sicali
- Unità di Medicina della Riproduzione - Centro HERA, via Barriera del Bosco n. 51/53, Sant'Agata Li Battiati, 95030, Catania, Italy
| | - Debora Lombardo
- Unità di Medicina della Riproduzione - Centro HERA, via Barriera del Bosco n. 51/53, Sant'Agata Li Battiati, 95030, Catania, Italy
| | - Carmelita Alecci
- Unità di Medicina della Riproduzione - Centro HERA, via Barriera del Bosco n. 51/53, Sant'Agata Li Battiati, 95030, Catania, Italy
| | - Carmen Ragolia
- Unità di Medicina della Riproduzione - Centro HERA, via Barriera del Bosco n. 51/53, Sant'Agata Li Battiati, 95030, Catania, Italy
| | - Elena Maglia
- Unità di Medicina della Riproduzione - Centro HERA, via Barriera del Bosco n. 51/53, Sant'Agata Li Battiati, 95030, Catania, Italy
| | - Annalisa Liprino
- Unità di Medicina della Riproduzione - Centro HERA, via Barriera del Bosco n. 51/53, Sant'Agata Li Battiati, 95030, Catania, Italy
| | - Clementina Cardea
- Unità di Medicina della Riproduzione - Centro HERA, via Barriera del Bosco n. 51/53, Sant'Agata Li Battiati, 95030, Catania, Italy
| | - Giorgia Storaci
- Unità di Medicina della Riproduzione - Centro HERA, via Barriera del Bosco n. 51/53, Sant'Agata Li Battiati, 95030, Catania, Italy
| | - Simona Romano
- Unità di Medicina della Riproduzione - Centro HERA, via Barriera del Bosco n. 51/53, Sant'Agata Li Battiati, 95030, Catania, Italy
| | - Antonino Guglielmino
- Unità di Medicina della Riproduzione - Centro HERA, via Barriera del Bosco n. 51/53, Sant'Agata Li Battiati, 95030, Catania, Italy
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Chamayou S, Sicali M, Lombardo D, Alecci C, Guglielmino A. The decision on the embryo to transfer after Preimplantation Genetic Diagnosis for X-autosome reciprocal translocation in male carrier. Mol Cytogenet 2018; 11:63. [PMID: 30619509 PMCID: PMC6310935 DOI: 10.1186/s13039-018-0409-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Accepted: 11/26/2018] [Indexed: 01/02/2023] Open
Abstract
Background The aim of Preimplantation Genetic Diagnosis (PGD) on embryos produced in vitro is to identify the embryos without genetic or chromosomal defect from those embryos that will develop the genetic disease or are chromosomally abnormal. In case of PGD for structural chromosome indication (PGR-SR), the normal/balanced embryos are transferred in the maternal uterus. This protocol is valid and widely applied for autosomal chromosome translocation. But which embryo should be transferred after preimplantation genetic diagnosis (PGD-SR) for X-3 reciprocal translocation in male patient? Case presentation The female patient was 26 years old with normal 46,XX karyotype. The male patient had a karyotype with balanced translocation 46,Y,t(X;3)(p11.2;p14)mat, inherited from the mother. The female patient underwent two cycles of ovarian stimulation. In the first cycle, the metaphase II oocytes were vitrified, while in the second cycle they were used as fresh. ICSI was performed on vitrified/warmed and fresh oocytes. Embryos were biopsied at blastocyst stage. Chromosomal analysis was performed by Next Generation Sequencing. Eleven blastocysts were biopsied from 23 vitrified/warmed and fresh metaphase II oocytes. Two embryos were diagnosed 46,XY; two embryos were diagnosed 46,XX; four embryos were diagnosed with unbalanced translocations and three embryos were diagnosed aneuploid. We knew that the two embryos diagnosed as 46,XX inherited the balanced translocation from the father and the two embryos diagnosed as 46,XY had a normal karyotype. It was explain to the couple that the phenotype of balanced translocated female embryos cannot be predicted because of the random inactivation of X chromosome and that could also occur on the der(X). The couple asked to have a 46,XY embryo transferred. Clinical pregnancy was obtained and non invasive prenatal test confirmed PGD-SR result. Conclusions Proposing PGD-SR for gonosome-autosome reciprocal translocation implies the risk to exclude balanced translocated female embryos with a normal phenotype for transfer because the early and late normal development at post-natal stage cannot be predicted based on the only chromosomal analysis.
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Affiliation(s)
- Sandrine Chamayou
- Unità di Medicina della Riproduzione - Centro HERA, via Barriera del Bosco n 51/53 95030 Sant Agata Li Battiati, Catania, Italy
| | - Maria Sicali
- Unità di Medicina della Riproduzione - Centro HERA, via Barriera del Bosco n 51/53 95030 Sant Agata Li Battiati, Catania, Italy
| | - Debora Lombardo
- Unità di Medicina della Riproduzione - Centro HERA, via Barriera del Bosco n 51/53 95030 Sant Agata Li Battiati, Catania, Italy
| | - Carmelita Alecci
- Unità di Medicina della Riproduzione - Centro HERA, via Barriera del Bosco n 51/53 95030 Sant Agata Li Battiati, Catania, Italy
| | - Antonino Guglielmino
- Unità di Medicina della Riproduzione - Centro HERA, via Barriera del Bosco n 51/53 95030 Sant Agata Li Battiati, Catania, Italy
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Rienzi L, Bariani F, Dalla Zorza M, Albani E, Benini F, Chamayou S, Minasi MG, Parmegiani L, Restelli L, Vizziello G, Costa AN. Comprehensive protocol of traceability during IVF: the result of a multicentre failure mode and effect analysis. Hum Reprod 2018; 32:1612-1620. [PMID: 28575413 DOI: 10.1093/humrep/dex144] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Accepted: 05/16/2017] [Indexed: 11/14/2022] Open
Abstract
STUDY QUESTION Can traceability of gametes and embryos be ensured during IVF? SUMMARY ANSWER The use of a simple and comprehensive traceability system that includes the most susceptible phases during the IVF process minimizes the risk of mismatches. WHAT IS KNOWN ALREADY Mismatches in IVF are very rare but unfortunately possible with dramatic consequences for both patients and health care professionals. Traceability is thus a fundamental aspect of the treatment. A clear process of patient and cell identification involving witnessing protocols has to be in place in every unit. To identify potential failures in the traceability process and to develop strategies to mitigate the risk of mismatches, previously failure mode and effects analysis (FMEA) has been used effectively. The FMEA approach is however a subjective analysis, strictly related to specific protocols and thus the results are not always widely applicable. To reduce subjectivity and to obtain a widespread comprehensive protocol of traceability, a multicentre centrally coordinated FMEA was performed. STUDY DESIGN, SIZE, DURATION Seven representative Italian centres (three public and four private) were selected. The study had a duration of 21 months (from April 2015 to December 2016) and was centrally coordinated by a team of experts: a risk analysis specialist, an expert embryologist and a specialist in human factor. Principal investigators of each centre were first instructed about proactive risk assessment and FMEA methodology. A multidisciplinary team to perform the FMEA analysis was then formed in each centre. After mapping the traceability process, each team identified the possible causes of mistakes in their protocol. A risk priority number (RPN) for each identified potential failure mode was calculated. The results of the FMEA analyses were centrally investigated and consistent corrective measures suggested. The teams performed new FMEA analyses after the recommended implementations. PARTICIPANTS/MATERIALS, SETTING, METHODS In each centre, this study involved: the laboratory director, the Quality Control & Quality Assurance responsible, Embryologist(s), Gynaecologist(s), Nurse(s) and Administration. The FMEA analyses were performed according to the Joint Commission International. MAIN RESULTS AND THE ROLE OF CHANCE The FMEA teams identified seven main process phases: oocyte collection, sperm collection, gamete processing, insemination, embryo culture, embryo transfer and gamete/embryo cryopreservation. A mean of 19.3 (SD ± 5.8) associated process steps and 41.9 (SD ± 12.4) possible failure modes were recognized per centre. A RPN ≥15 was calculated in a mean of 6.4 steps (range 2-12, SD ± 3.60). A total of 293 failure modes were centrally analysed 45 of which were considered at medium/high risk. After consistent corrective measures implementation and re-evaluation, a significant reduction in the RPNs in all centres (RPN <15 for all steps) was observed. A simple and comprehensive traceability system was designed as the result of the seven FMEA analyses. LIMITATIONS, REASONS FOR CAUTION The validity of FMEA is in general questionable due to the subjectivity of the judgments. The design of this study has however minimized this risk by introducing external experts for the analysis of the FMEA results. Specific situations such as sperm/oocyte donation, import/export and pre-implantation genetic testing were not taken into consideration. Finally, this study is only limited to the analysis of failure modes that may lead to mismatches, other possible procedural mistakes are not accounted for. WIDER IMPLICATIONS OF THE FINDINGS Every single IVF centre should have a clear and reliable protocol for identification of patients and traceability of cells during manipulation. The results of this study can support IVF groups in better recognizing critical steps in their protocols, understanding identification and witnessing process, and in turn enhancing safety by introducing validated corrective measures. STUDY FUNDING/COMPETING INTEREST(S) This study was designed by the Italian Society of Embryology Reproduction and Research (SIERR) and funded by the Italian National Transplant Centre (CNT) of the Italian National Institute of Health (ISS). The authors have no conflicts of interest. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- L Rienzi
- GENERA Centre for Reproductive Medicine, Clinica Valle Giulia, Via de Notaris 2B, 00197 Rome, Italy
| | - F Bariani
- Italian National Transplant Centre (CNT), Italian National Institute of Health (ISS), Via Giano della Bella, 34 - 00162 Rome, Italy
| | - M Dalla Zorza
- Aulss 2 Marca Trevigiana, Medicina Trasfusionale, Piazza Ospedale 1, 31100 Treviso, Italy
| | - E Albani
- Humanitas Fertility Center, Humanitas Research Hospital, Via Manzoni 56 20089 Rozzano (Milan), Italy
| | - F Benini
- Demetra, IVF Centre, Via Giulio Caccini, 18 - 50141 Florence, Italy
| | - S Chamayou
- Unità di Medicina della Riproduzione, HERA Centre, Via Barriera del Bosco, n. 51/53, ex n. 9, 95030 Sant'Agata Li Battiati (Catania), Italy
| | - M G Minasi
- European Hospital, Reproductive Medicine, Via Portuense 700, 00149 Rome, Italy
| | - L Parmegiani
- GynePro Medical Centers, Reproductive Medicine Unit, Via T. Cremona 8, 40137 Bologna, Italy
| | - L Restelli
- Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Infertility Unit, Via Manfredo Fanti 6, 20122 Milan, Italy
| | - G Vizziello
- Momo' FertiLife, IVF Center, via Cala dell'Arciprete 2, 76011 Bisceglie, Italy
| | - A Nanni Costa
- Italian National Transplant Centre (CNT), Italian National Institute of Health (ISS), Via Giano della Bella, 34 - 00162 Rome, Italy
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Chamayou S, Sicali M, Alecci C, Ragolia C, Liprino A, Nibali D, Storaci G, Cardea A, Guglielmino A. The accumulation of vitrified oocytes is a strategy to increase the number of euploid available blastocysts for transfer after preimplantation genetic testing. J Assist Reprod Genet 2017; 34:479-486. [PMID: 28070710 PMCID: PMC5401691 DOI: 10.1007/s10815-016-0868-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Accepted: 12/23/2016] [Indexed: 10/26/2022] Open
Abstract
PURPOSE In a preimplantation genetic diagnosis for aneuploidy (PGD-A) program, the more embryos available for biopsy, consequently increases the chances of obtaining euploid embryos to transfer. The aim was to increase the number of viable euploid blastocysts in patients undergoing PGD-A using fresh oocytes together with previously accumulated vitrified oocytes. METHODS Sixty-nine patients with normal ovarian reserve underwent PGD-A for repeated implantation failure or recurrent pregnancy loss indication. After several cycles of ovarian stimulation, 591 accumulated vitrified oocytes and 463 fresh oocytes were micro-injected with the same partner's semen sample. PGD-A was completed on 134 blastocysts from vitrified/warmed oocytes and 130 blastocysts from fresh oocytes. RESULTS A mean of 9.6% euploid blastocyst per micro-injected vitrified/warmed oocytes and 11.4% euploid blastocyst per micro-injected fresh oocyte were obtained (p > 0.05). The euploidy and aneuploidy rates were comparable in blastocysts obtained from micro-injected vitrified/warmed oocytes and fresh oocytes (42.5 versus 40.8% and 57.5 versus 59.2%, p > 0.05). Implantation rates of euploid blastocysts were comparable between the two sources of oocytes (56.0% from vitrified/warmed oocytes versus 60.9% from fresh oocytes, p > 0.05). CONCLUSIONS Oocyte vitrification and warming do not generate aneuploidy in blastocysts. The number of viable euploid embryos for transfer can be increased by using accumulated vitrified oocytes together with fresh oocytes in ICSI. TRIAL REGISTRATION NCT02820415 ClinicalTrials.gov.
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Affiliation(s)
- Sandrine Chamayou
- Unità di Medicina della Riproduzione-Centro HERA, via Barriera del Bosco n. 51/53, 95030, Sant'Agata Li Battiati, Catania, Italy.
| | - Maria Sicali
- Unità di Medicina della Riproduzione-Centro HERA, via Barriera del Bosco n. 51/53, 95030, Sant'Agata Li Battiati, Catania, Italy
| | - Carmelita Alecci
- Unità di Medicina della Riproduzione-Centro HERA, via Barriera del Bosco n. 51/53, 95030, Sant'Agata Li Battiati, Catania, Italy
| | - Carmen Ragolia
- Unità di Medicina della Riproduzione-Centro HERA, via Barriera del Bosco n. 51/53, 95030, Sant'Agata Li Battiati, Catania, Italy
| | - Annalisa Liprino
- Unità di Medicina della Riproduzione-Centro HERA, via Barriera del Bosco n. 51/53, 95030, Sant'Agata Li Battiati, Catania, Italy
| | - Daniela Nibali
- Unità di Medicina della Riproduzione-Centro HERA, via Barriera del Bosco n. 51/53, 95030, Sant'Agata Li Battiati, Catania, Italy
| | - Giorgia Storaci
- Unità di Medicina della Riproduzione-Centro HERA, via Barriera del Bosco n. 51/53, 95030, Sant'Agata Li Battiati, Catania, Italy
| | - Antonietta Cardea
- Unità di Medicina della Riproduzione-Centro HERA, via Barriera del Bosco n. 51/53, 95030, Sant'Agata Li Battiati, Catania, Italy
| | - Antonino Guglielmino
- Unità di Medicina della Riproduzione-Centro HERA, via Barriera del Bosco n. 51/53, 95030, Sant'Agata Li Battiati, Catania, Italy
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Bonaventura G, Chamayou S, Liprino A, Guglielmino A, Fichera M, Caruso M, Barcellona ML. Different Tissue-Derived Stem Cells: A Comparison of Neural Differentiation Capability. PLoS One 2015; 10:e0140790. [PMID: 26517263 PMCID: PMC4627815 DOI: 10.1371/journal.pone.0140790] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Accepted: 09/30/2015] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Stem cells are capable of self-renewal and differentiation into a wide range of cell types with multiple clinical and therapeutic applications. Stem cells are providing hope for many diseases that currently lack effective therapeutic methods, including strokes, Huntington's disease, Alzheimer's and Parkinson's disease. However, the paucity of suitable cell types for cell replacement therapy in patients suffering from neurological disorders has hampered the development of this promising therapeutic approach. AIM The innovative aspect of this study has been to evaluate the neural differentiation capability of different tissue-derived stem cells coming from different tissue sources such as bone marrow, umbilical cord blood, human endometrium and amniotic fluid, cultured under the same supplemented media neuro-transcription factor conditions, testing the expression of neural markers such as GFAP, Nestin and Neurofilaments using the immunofluorescence staining assay and some typical clusters of differentiation such as CD34, CD90, CD105 and CD133 by using the cytofluorimetric test assay. RESULTS Amniotic fluid derived stem cells showed a more primitive phenotype compared to the differentiating potential demonstrated by the other stem cell sources, representing a realistic possibility in the field of regenerative cell therapy suitable for neurodegenerative diseases.
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Affiliation(s)
- Gabriele Bonaventura
- Department of Pharmaceutical Science, Biochemistry Section, University of Catania, Catania, Italy
- Institute of Neurological Sciences, Italian National Research Council, Catania, Italy
| | - Sandrine Chamayou
- Unità di Medicina della Riproduzione, Fondazione Hera, Sant’Agata Li Battiati (CT), Italy
| | - Annalisa Liprino
- Department of Obstetrics and Gynecology and Radiological Sciences (OGiRA), University of Catania, Catania, Italy
| | - Antonino Guglielmino
- Unità di Medicina della Riproduzione, Fondazione Hera, Sant’Agata Li Battiati (CT), Italy
| | - Michele Fichera
- Department of Obstetrics and Gynecology and Radiological Sciences (OGiRA), University of Catania, Catania, Italy
| | - Massimo Caruso
- Department of Clinic and Molecular Biomedicine, University of Catania, Catania, Italy
| | - Maria Luisa Barcellona
- Department of Pharmaceutical Science, Biochemistry Section, University of Catania, Catania, Italy
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Chamayou S, Romano S, Alecci C, Storaci G, Ragolia C, Palagiano A, Guglielmino A. Oocyte vitrification modifies nucleolar remodeling and zygote kinetics-a sibling study. J Assist Reprod Genet 2015; 32:581-6. [PMID: 25701142 PMCID: PMC4380896 DOI: 10.1007/s10815-015-0446-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2014] [Accepted: 01/29/2015] [Indexed: 01/13/2023] Open
Abstract
Purpose Oocyte vitrification does not affect embryo quality after oocyte warming, making this method effective in the preservation of female fertility. Morphokinetic parameters can be used to predict the competence of an embryo produced from fresh oocytes. Our aim was to study the effect of oocyte vitrification on zygote-embryo kinetics (pl). Methods The embryo-kinetics of fresh and sibling vitrified/warmed oocytes were compared to determine the consequences of oocyte preservation on the timing of embryo development. A 44-hours time-lapse analysis, from the time of ICSI (t0), of 179 fertilized fresh oocytes was compared to 168 fertilized sibling vitrified/warmed oocytes. Results Oocyte vitrification accelerated pronuclear disappearance, one-cell stage timing and modified nucleoli activity by increasing their number and decreasing their diameter at the zygote stage. In contrast, embryo kinetics during cleavage were similar to those observed for fresh sibling oocytes based on the parameters examined in this study. Conclusions At the zygote stage, oocyte vitrification induces changes in pronuclei stability, probably due to pronuclei envelop instability as well as modifications in nucleoli functionality. Therefore, the predictive morphokinetic parameters on embryo competence found from fresh oocytes must be revised when applied on embryos from vitrified/warmed oocytes.
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Affiliation(s)
- S Chamayou
- Unità Di Medicina della Riproduzione - Istituto HERA, via Barriera del Bosco n. 51/53, 95030, Sant'Agata Li Battiati, Catania, Italy,
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Ciray HN, Campbell A, Agerholm IE, Aguilar J, Chamayou S, Esbert M, Sayed S. Proposed guidelines on the nomenclature and annotation of dynamic human embryo monitoring by a time-lapse user group. Hum Reprod 2014; 29:2650-60. [DOI: 10.1093/humrep/deu278] [Citation(s) in RCA: 156] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
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Chamayou S, Alecci C, Storaci G, Ragolia CC, Guglielmino A. Oocyte vitrification modifies nucleoli activity, a time-lapse monitoring analysis. Reprod Biomed Online 2014. [DOI: 10.1016/s1472-6483(14)50005-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Chamayou S, Storaci G, Alecci C, Ragolia C, Guglielmino A. PP-16 EMBRYO DEVELOPMENT: EXACT KINETIC AND TRACEABILITY OF CELLULAR ABNORMALITIES MONITORED BY TIME-LAPSE CULTURE. Reprod Biomed Online 2012. [DOI: 10.1016/s1472-6483(12)60148-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Chamayou S, Bonaventura G, Alecci C, Tibullo D, Di Raimondo F, Guglielmino A, Barcellona ML. Consequences of metaphase II oocyte cryopreservation on mRNA content. Cryobiology 2011; 62:130-4. [PMID: 21272569 DOI: 10.1016/j.cryobiol.2011.01.014] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2010] [Revised: 12/17/2010] [Accepted: 01/19/2011] [Indexed: 11/19/2022]
Abstract
INTRODUCTION We studied the consequences of freezing/thawing processes on mRNA contents in MII oocytes after slow-freezing/rapid thawing (SF/RT) and vitrification/warming (V/W) protocols, and compared the results to fresh MII oocytes. We quantified the nuclear transcript mRNA responsible for the translation of proteins belonging either to trans-regulatory protein family or to functional structural proteins such as proteins involved in DNA structural organization (NAP1L1, TOP1, H1F0H1), chromosomal structure maintenance (SMC, SCC3, RAD21, SMC1A, SMC1B, STAG3, REC8), mitochondrial energetic pathways (ATP5GJ, SDHC), cell cycle regulation and processes (CLTA, MAPK6, CKS2) and staminal cell potency-development competence stage (DPPA3, OCT4, FOXJ2). MATERIAL AND METHODS Surplus MII oocytes were donated from patients in IVF cycles and divided in three groups of 15 oocytes. Group 1 was comprised of non-cryopreserved oocytes and Groups 2 and 3 underwent SF/RT and V/W procedures, respectively. RESULTS There was an overall decrease of mRNA extracted from cryopreserved oocytes compared to control group. Only 39.4% of mRNA content were preserved after SF/RT while 63.3% of mRNA content were maintained after V/W. CONCLUSIONS Oocyte cryopreservation is associated with molecular injury associated with the decrease of stored mRNA. However the V/W protocol is more conservative than SF/RT resulting in a level of mRNA sufficient to maintain biologic functions in the subsequent fertilized oocyte.
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Affiliation(s)
- S Chamayou
- Unità di Medicina della Riproduzione--Fondazione Hera, Via Barriera del Bosco n. 51/53, Sant'Agata Li Battiali (CT), Italy.
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Bern O, Strassburger D, Komarovsky D, Kasterstein E, Komsky A, Maslansky B, Raziel A, Ben-Ami I, Friedler S, Gidoni Y, Ron-El R, Barblett H, Shah T, Pinkus C, Mehmet D, Rebollar-Lazaro I, Dupont C, Sermondade N, Hafhouf E, Levy R, Cedrin-Durnerin I, Hugues JN, Poncelet C, Sifer C, Remohi Gimenez J, Cobo Cabal A, de los Santos MJ, Bellver J, Mifsud A, Romero JLL, Chamayou S, Bonaventura G, Alecci C, Tibullo D, Guglielmino A, Barcellona ML, Murakami M, Egashira A, Araki Y, Kuramoto T. SELECTED ORAL COMMUNICATION SESSION, SESSION 31: EMBRYOLOGY - CRYOPRESERVATION, Tuesday 5 July 2011 10:00 - 11:30. Hum Reprod 2011. [DOI: 10.1093/humrep/26.s1.31] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Tamburino L, Guglielmino A, Venti E, Chamayou S. Molecular analysis of mutations and polymorphisms in the CFTR gene in male infertility. Reprod Biomed Online 2008; 17:27-35. [DOI: 10.1016/s1472-6483(10)60289-1] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Chamayou S, Ragolia C, Alecci C, Storaci G, Maglia E, Russo E, Guglielmino A. Meiotic spindle presence and oocyte morphology do not predict clinical ICSI outcomes: a study of 967 transferred embryos. Reprod Biomed Online 2007; 13:661-7. [PMID: 17169176 DOI: 10.1016/s1472-6483(10)60656-6] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
With a view to correlating oocyte morphology and meiotic spindle presence to clinical intracytoplasmic sperm injection (ICSI) outcomes, 967 oocytes that led to 967 transferred embryos in 404 embryo transfers were studied. No relationship was found between oocyte morphology (ooplasm texture, perivitelline space largeness, perivitelline space granulation absence/presence and the first polar body shape) or meiotic spindle presence or absence and clinical pregnancy per transfer and implantation rates after ICSI. It was concluded that oocyte morphology and meiotic spindle presence or absence can only predict fertilization, cleavage rates and embryo quality, as previously described in the literature, but do not help in daily ICSI practice in the choice of the metaphase II oocyte that will lead to the embryo that starts clinical pregnancy.
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Affiliation(s)
- S Chamayou
- Unità di Medicina della Riproduzione - FOUDATION HERA, Viale Marco Polo 39/A, 95126 Catania, Italy.
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Chamayou S, Alecci C, Ragolia C, Storaci G, Maglia E, Russo E, Guglielmino A. Comparison of in-vitro outcomes from cryopreserved oocytes and sibling fresh oocytes. Reprod Biomed Online 2006; 12:730-6. [PMID: 16792849 DOI: 10.1016/s1472-6483(10)61085-1] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
In Italy, the restrictive IVF law generalizes the indication for oocyte freezing for surplus oocytes in 78.5% of in-vitro assisted reproductive cycles. With a view to understanding better what the prospects for intracytoplasmic sperm injection (ICSI) on frozen-thawed oocytes might be, the consequences of freeze-thaw procedures on fertilization, cleavage rates and embryo quality obtained from frozen-thawed oocytes were studied and compared with the results obtained from sibling fresh oocytes. Eleven IVF and 29 ICSI on 76 and 169 fresh oocytes were performed and the corresponding 40 ICSI on 221 sibling frozen-thawed oocytes. There was no difference in terms of fertilization rate between fresh and sibling frozen-thawed oocytes. The cleavage rate (98.0 and 94.4% with fresh oocytes in IVF and ICSI; 77.3% with frozen-thawed oocytes in ICSI; P < 0.001) and embryo quality (grade I embryos over total embryos: 36.7 and 22.2% with fresh oocytes in IVF and ICSI; 12.1% with frozen-thawed oocytes in ICSI; respectively P < 0.001 and P < 0.05) were statistically lower after oocyte cryopreservation. The significant decrease in meiotic spindle retrieval rate before freezing (62.4%) and after thawing procedures (43.4%; P < 0.001) suggests that cryoconservation induces irreversible damage to microtubule repolymerization. The consequences of oocyte cryopreservation procedures on embryo development are reviewed.
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Affiliation(s)
- S Chamayou
- Unità di Medicina della Riproduzione - Fondazione HERA, Viale Marco Polo 39/A, 95126 Catania, Italy.
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Tamburino L, Guglielmino A, Venti E, Chamayou S. 14 Screening for CFTR gene mutations and analysis of the TG12-T5 haplotype in infertile patients. J Cyst Fibros 2006. [DOI: 10.1016/s1569-1993(06)80015-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Chamayou S, Alecci C, Ragolia C, Giambona A, Siciliano S, Maggio A, Fichera M, Guglielmino A. Successful application of preimplantation genetic diagnosis for beta-thalassaemia and sickle cell anaemia in Italy. Hum Reprod 2002; 17:1158-65. [PMID: 11980733 DOI: 10.1093/humrep/17.5.1158] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND In Italy, the autosomal recessive diseases beta-thalassaemia and sickle cell anaemia are so widespread that in some regions they can be defined as 'social diseases'. In this study, nine clinical applications of preimplantation genetic diagnosis (PGD) were performed for beta-thalassaemia and sickle cell anaemia on seven Sicilian couples and carriers of beta-globin gene mutations. METHODS AND RESULTS The studied mutations were: Cd39, HbS, IVS1 nt1, IVS1 nt6 and IVS1 nt110. ICSI was performed with partner's sperm on 131 out of 147 retrieved oocytes, and this resulted in 72 zygotes; 32 embryos were successfully biopsied on day 3. The biopsied blastomeres were lysed and the beta-globin alleles amplified by nested PCR. The mutation diagnosis was performed by restriction enzyme digestion and reverse dot-blot. The amplification efficacy was 97.2%. The genotype study of non-transferred and surplus embryos showed that the allele drop-out rate was 8.6%. Seventeen embryos were transferred in utero on day 4. All couples received an embryo transfer; of the four pregnancies obtained, three resulted in live births and one miscarried at 11 weeks. Prenatal diagnosis at the 11th week and miscarriage material analysis confirmed the PGD results. CONCLUSIONS These studies represent the first successful application of PGD for beta-thalassaemia and sickle cell anaemia in Italy.
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Affiliation(s)
- S Chamayou
- Unità di Medicina della Riproduzione, Associazione HERA, Catania, Italy.
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Labbé JP, Chamayou S, Benyamin Y. Interaction of 75-106 actin peptide with myosin subfragment-1 and its trypsin modified derivative. Biochim Biophys Acta 1999; 1427:105-11. [PMID: 10082991 DOI: 10.1016/s0304-4165(99)00011-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
To explore the role of a hydrophobic domain of actin in the interaction with a myosin chain we have synthesized a peptide corresponding to residues 75-106 of native actin monomer and studied by fluorescence and ELISA the interaction (13+/-2.6x10(-6) M) with both S-1 and (27 kDa-50 kDa-20 kDa) S-1 trypsin derivative of myosin. The loop corresponding to 96-103 actin residues binds to the S-1 only in the absence of Mg-ATP and under similar conditions but not to the trypsin derivative S-1. Biotinylated C74-K95 and I85-K95 peptide fragments were purified after actin proteolysis with trypsin. The C74-K95 peptide interacted with both S-1 and the S-1 trypsin derivative with an apparent Kd(app) of 6+/-1.2x10(-6) M in the presence or absence of nucleotides. Although peptide fragment I85-K95 binds to S-1 with a Kd(app) of 12+/-2.4x10(-6) M, this fragment did not bind to the trypsin S-1 derivative. We concluded that the actin 85-95 sequence should be a potential binding site to S-1 depending of the conformational state of the intact 70 kDa segment of S-1.
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Affiliation(s)
- J P Labbé
- Institut de Génétique Humaine (IGH), UPR 1142 (CNRS), 141 rue de la Cardonille, 34096, Montpellier Cedex 5, France.
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Chamayou S, Guglielmino A, Giambona A, Siciliano S, Di Stefano G, Scibilia G, Humeau C, Maggio A, Di Leo S. Attitude of potential users in Sicily towards preimplantation genetic diagnosis for beta-thalassaemia and aneuploidies. Hum Reprod 1998; 13:1936-44. [PMID: 9740453 DOI: 10.1093/humrep/13.7.1936] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
This study aims to report the willingness of different populations of high-risk couples to undergo preimplantation genetic diagnosis (PGD) for beta-thalassaemia as an alternative to prenatal genetic diagnosis (PND), and the willingness of infertile couples to undergo PGD for aneuploidies. An information sheet and questionnaire presenting PGD and PND procedures were distributed to four population types: 54 high-risk couples for beta-thalassaemia coming for their first PND (population A); 51 similar couples coming for their second or further PND without previous experience of therapeutic abortion (population B-na); 50 similar couples coming for their second or further PND with previous experience of therapeutic abortion for beta-thalassaemia-affected fetus (population B-ab); and 74 infertile couples undergoing routine in-vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) (population C). Favourable first impressions towards PGD compared with PND were observed in all four populations in the following proportions: 79.6% population A; 76.5% population B-na; 92.0% population B-ab; and 96.0% population C. Willingness to undergo PGD for beta-thalassaemia was as follows: 44.4% population A; 47.1% population B-na; and 72.0% population B-ab. We conclude that previous experience of PND for beta-thalassaemia is a crucial point in the willingness to accept the PGD procedure, and that couples belonging to population B-ab are the most suitable to undergo PGD for beta-thalassaemia. Some 96.0% of infertile couples in population C were ready to undergo PGD for aneuploidies.
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Affiliation(s)
- S Chamayou
- Université Montpellier I, Laboratoire de Biologie de la Reproduction, Hôpital Arnaud de Villeneuve, France
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