O-175 Impact of female chromosomal polymorphic variants on ovarian reserve markers and fertility treatments prognosis

Study question

Could the presence of chromosomal polymorphisms in women undergoing fertility treatments influence ovarian reserve, oocyte preservation or IVF clinical outcomes?

Summary answer

Polymorphic variants of chromosomes seem to adversely influence the Anti-Müllerian Hormone (AMH) serum levels and the post-thawing oocyte survival rate.

What is known already

Infertile couples have been reported to have a higher incidence of karyotype abnormalities than the general population, which could lead to lower fertility rates. However, few studies have demonstrated the controversial relationship between these karyotype alterations in women and the specific involvement of these variants and their combinations in an IVF cycle.

Therefore, there is a growing interest in categorizing chromosomal polymorphic variants and relating them to the subsequent evolution in ART cycles.

Study design, size, duration

Retrospective evaluation of a cohort of women undergoing IVF cycles in a private fertility center. The sample included 280 cycles performed between July 2017 and December 2020. The study explored the correlation between karyotype polymorphisms and IVF outcomes in terms of: Anti-Müllerian Hormone (AMH) level, Antral Follicle Count (AFC), Oocyte Maturity (MII), Oocyte Survival after Thawing (TS), Fertilization (FZ), Useful Embryos (UE), Biochemical (BP) and Clinical Pregnancy (CP), Miscarriage (M) and Live Birth (LB) rates.

Participants/materials, setting, methods

Women with karyotype performed before an IVF cycle. Chromosome analysis was carried out according to the International System for Human Cytogenetic Nomenclature guidelines (ISCN).

Only own eggs cycles were included, and testicular sperm cycles were excluded.

The normality of the distribution of the variables was assessed using the Shapiro-Wilk test. The association between IVF cycle parameters and the presence of polymorphisms was assessed by T-Student (parametric) or U-Mann-Whitney (non-parametric).

Main results and the role of chance

From a total of 280 IVF cycles, 198 met the inclusion criteria: Control Group (CG) with normal karyotype (94) and Study Group (SG) with presence of polymorphisms (104) were analyzed. Cycles with fresh (136) and warmed (62) oocytes were included. Mean female age was 37.66 ± 3.99 (CG) and 36.61 ± 3.72 (SG). The overall outcome rates were: 75.82% MII, 81.39% TS, 72.78% FZ, 49.07% UE on day 5, 21.82% BP, 78.18% CP, 14.53% M and 63.65% LB.

Statistically significant differences were found between the presence of polymorphisms and mean AMH serum level between CG (2.36 ng/mL) and SG (1.74 ng/mL) (p = 0.04), especially when the type “qh+” was detected (1.01 ng/mL) (p = 0.02). Furthermore, statistically significant differences were found regarding oocyte thawing survival rate, which decreased in the SG (78.94%) compared to the CG (93.69%) (p = 0.02), mainly when the type “ps+” was detected (75.13%) (p < 0.01).

No statistically significant differences were found between the presence of polymorphism and the AFC (p = 0.25), MII (p = 0.10), FZ (p = 0.93) or UE (p = 0.52) rate on day 5. In the same way, from 106 embryo transfers (ET) performed, no significant differences were found for BP, CP, M and LB rates (p > 0.05).

Limitations, reasons for caution

Larger prospective studies including homogeneous cohorts are needed in order to corroborate our initial results.

Wider implications of the findings

Our findings may represent a practical tool in order to advise these patients about their reproductive success, especially, in terms of post-thawing oocyte survival prognosis. Therefore, it could be provided more personalized prognostic information before embarking on IVF treatments.

Trial registration number

Not Applicable

Development and evaluation of an interferon gamma assay for the diagnosis of tuberculosis in red deer experimentally infected with Mycobacterium bovis

BACKGROUND

Red deer (Cervus elaphus) is regarded as an epidemiologically relevant host for Mycobacterium bovis (M. bovis) and closely related members of the Mycobacterium tuberculosis complex that cause animal tuberculosis (TB). The standard antemortem screening test for the detection of TB in deer is the intradermal tuberculin skin test, but the detection of interferon-gamma (IFNγ) produced by white blood cells exposed to M. bovis antigens can be used as an alternative or supplemental assay in most TB eradication/control programs. This study aims to develop an in-house sandwich ELISA for deer IFNγ, based on the cross-reactivity of the antibodies to both cervid and bovine IFNγ, and to evaluate the potential of this assay to detect M. bovis-infected red deer in response to the in vitro stimulation of whole-blood cells with bovine purified protein derivative (bPPD), p22 protein complex derived from bPPD or using the specific tuberculous mycobacterial proteins ESAT-6/CFP-10, Rv3615c and Rv3020c. The positive control stimulant used in this study was pokeweed mitogen, which resulted in a consistent induction of IFNγ in samples from red deer, thus allowing the interpretation of the assay.

RESULTS

The percentage of animals correctly classified by this technique as M. bovis non-infected was 100%. The detection of infected animals as positive was high and ranged widely depending upon the antigen and the cut-off value applied, as well as the time after infection. Our findings indicate that this protocol may serve as a reliable assay for the antemortem diagnosis of TB from the initial stage of M. bovis-infection, and may also be adequately sensitive.

CONCLUSIONS

The suggested optimal antigens and cut-off are bPPD, p22 and the combination of ESAT-6/CFP-10 and Rv3020c with a 0.05 Δ optical density, which yielded a up to 100% correct classification of TB positive and negatve red deer under our experimental conditions. This technique will aid in TB testing of farmed and translocated deer. Future studies should evaluate the ability of this IFNγ assay to detect specific responses under field conditions.

Effects of repeated comparative intradermal tuberculin testing on test results: a longitudinal study in TB-free red deer

BACKGROUND

Diagnosing tuberculosis (TB) in farmed red deer (Cervus elaphus) is challenging and might require combining cellular and humoral diagnostic tests. Repeated skin-testing with mycobacterial purified protein derivatives (PPDs) might sensitize or desensitize the subjects to both kinds of diagnostic tools. We evaluated the effect of repeated (every 6 months) comparative tuberculin skin testing on skin test and ELISA responsiveness in farmed red deer hinds from a TB-free herd. Eighteen 8-month old hinds were inoculated with bovine and avian PPDs and the mitogen phytohaemagglutinin (PHA), as positive control and concurrently tested by ELISA for antibodies against avian (avian PPD, aPPD and protoplasmatic antigen 3, PPA3) and bovine antigens (bPPD and MPB70). Blood serum was also sampled three weeks after each skin testing round and tested for antibodies against aPPD and bPPD, in order to detect eventual antibody level boosts. Testing took place every six months from winter 2012 until winter 2015.

RESULTS

The skin test response to both PPDs peaked during the second and third test round, returning to standard values thereafter. Individual variability was particularly high at the first year and early second year testing rounds (first intradermal test and blood sampling; first winter). The antibody response to avian antigens increased through time, while no such increase was recorded for bovine antigens. The antibody boost three weeks after skin testing was more marked for avian PPD. However, there was no consistent trend in the boosting response through time.

CONCLUSION

Repeated comparative skin testing at six month intervals did not cause progressive increments in skin test responsiveness or antibody production. Specifically, we observed no loss of the skin test response to bPPD and also no progressive loss of the boosting effect in the ELISA responses. However, we recorded increases through time in the antibody levels against avian mycobacterial antigens, possibly due to the progressive exposure to MAP or to other cross-reacting environmental mycobacteria. These findings should be taken into account in designing and interpreting TB testing schemes in farmed deer.

Clinical pharmacokinetics and tolerability of dotarizine in healthy subjects after single and multiple oral administration

Dotarizine is a new diphenylmethylpiperazine derivative with Ca2+ channel blocking properties and inhibitory effects on 5-HT2A and 5-HT2C receptors. Previous pilot studies in healthy volunteers demonstrated a good tolerability after single and multiple dosing. Dotarizine appeared to be rapidly and extensively metabolized to an active compound (FI-6020). We aimed to study the physiologic, subjective and psychomotor acute effects of oral dotarizine after single dose administration, to evaluate the tolerability and safety after multiple dosing over 2 weeks, and to study the pharmacokinetic parameters and linearity after single and multiple administration. Two different studies were carried out in 2 groups of 8 healthy male volunteers. Oral single doses of dotarizine 50, 100 and 200 mg were administered in a randomized, double-blind, crossover, placebo-controlled trial. Oral doses of 50 mg twice daily were administered in an open trial over 14 days. Drug effect assessments included vital signs, collection of adverse events, ECG and blood and urine safety evaluations, subjective effects, psychomotor performance tasks and blood sampling. Dotarizine and its metabolite were determined by gas chromatography with N-P detector. The results showed a good tolerability of dotarizine after single oral doses as well as multiple oral doses over 14 days. No clinically relevant adverse events were reported during the study. The highest single dose (200 mg) produced a slight increase in sedation-related symptoms as well as a slight impairment in psychomotor performance tasks. Dotarizine and its major metabolite proved linear kinetics at single doses. The administration of oral doses of dotarizine 50 mg b.i.d. reached the steady state after the 7th day of treatment. The pharmacokinetic parameters remained similar from day 7 to day 14. The terminal elimination half-life of dotarizine and its metabolite appeared to be between 7 and 12 h.

Effect of ebrotidine on the density of antral G-cells in the gastric mucosa in the rat

Two groups of male rats were treated orally for 60 days with ebrotidine and cimetidine, used as reference standard, respectively. The dose used of both drugs was 500 mg/kg. A third group, used as control, received 10 ml/kg of an aqueous agar suspension. After receiving the last dose, the animals were killed by inhalation of CO2 in a sealed chamber and the stomachs were removed for histological preparation. The purpose of this study was to count antral G-cells throughout the gastric mucosa by light microscope. A PAP system-associated antigastrin immunohistochemical method was used for cell identification. Cell density, with respect to their location in the gastric mucosa and the treatments given, was calculated using image analysis techniques. The results showed that ebrotidine did not cause any significant differences in the density of the population of these cells compared with the control group, while cimetidine induced a significant proliferation of antral G-cells.

Subacute toxicity and maximum tolerable dose of sertaconazole in repeated administration studies

28-Day oral and dermal subacute toxicity studies of 7-chloro-3-[1-(2,4-dichlorophenyl)-2-(1H-imidazol-1-yl) ethoxy-methyl] benzo [b] thiophene (sertaconazole, FI-7045, CAS 99592-32-2), were carried out. The oral studies included the evaluation of subacute toxicity in rat (dose levels of 50, 150 and 300 mg/kg) and maximum tolerable dose in repeated administration in ferrets (consecutive dose levels in accordance with a geometric progression of 50, 75, 112.5, 168 and 250 mg/kg), which were the animal species intended for chronic toxicity studies. The dermal studies included the evaluation of subacute toxicity in rats and rabbits (1 ml/kg of a 2% cream). The results, in general, have shown low toxic effects, which can be summarized as a slight non-significant hepatomegalia in the rat with increased gamma-GTP and alkaline phosphatase values and a high urinary pH value; no histopathological changes were observed. These effects are characteristic of azole derivatives and are therefore common to other antifungals with this chemical group.