Oocyte Morphology Assessment Research Articles

The Future Is Coming: Artificial Intelligence in the Treatment of Infertility Could Improve Assisted Reproduction Outcomes-The Value of Regulatory Frameworks.

Infertility is a global health issue affecting women and men of reproductive age with increasing incidence worldwide, in part due to greater awareness and better diagnosis. Assisted reproduction technologies (ART) are considered the ultimate step in the treatment of infertility. Recently, artificial intelligence (AI) has been progressively used in the many fields of medicine, integrating knowledge and computer science through machine learning algorithms. AI has the potential to improve infertility diagnosis and ART outcomes estimated as pregnancy and/or live birth rate, especially with recurrent ART failure. A broad-ranging review has been conducted, focusing on clinical AI applications up until September 2022, which could be estimated in terms of possible applications, such as ultrasound monitoring of folliculogenesis, endometrial receptivity, embryo selection based on quality and viability, and prediction of post implantation embryo development, in order to eliminate potential contributing risk factors. Oocyte morphology assessment is highly relevant in terms of successful fertilization rate, as well as during oocyte freezing for fertility preservation, and substantially valuable in oocyte donation cycles. AI has great implications in the assessment of male infertility, with computerised semen analysis systems already in use and a broad spectrum of possible AI-based applications in environmental and lifestyle evaluation to predict semen quality. In addition, considerable progress has been made in terms of harnessing AI in cases of idiopathic infertility, to improve the stratification of infertile/fertile couples based on their biological and clinical signatures. With AI as a very powerful tool of the future, our review is meant to summarise current AI applications and investigations in contemporary reproduction medicine, mainly focusing on the nonsurgical aspects of it; in addition, the authors have briefly explored the frames of reference and guiding principles for the definition and implementation of legal, regulatory, and ethical standards for AI in healthcare.

Human Oocyte Morphology and Outcomes of Infertility Treatment: a Systematic Review.

Oocyte morphology assessment is easy to implement in any laboratory with possible quality grading prior to fertilization. At present, comprehensive oocyte morphology scoring is not performed as a routine procedure. However, it may augment chances for successful treatment outcomes if a correlation with certain dysmorphisms can be proven. In order to determine a correlation between oocyte morphology and treatment outcome, we performed a systematic search in PubMed and Cochrane Controlled Trials Register following PRISMA guidelines. A total of 52 articles out of 6,755 search results met the inclusion criteria. Dark colour of the cytoplasm (observed with an incidence rate of 7%), homogeneous granularity of the cytoplasm (19%) and ovoid shape of oocytes (7%) appeared to have no influence on treatment outcome. Abnormalities such as refractile bodies (10%), fragmented first polar body (37%), dark zona pellucida (9%), enlarged perivitelline space (18%) and debris in it (21%) are likely to affect the treatment outcome to some extent. Finally, cytoplasmic vacuoles (4%), centrally located cytoplasmic granularity (12%) and clusters of smooth endoplasmic reticulum (4%) negatively impact infertility treatment outcomes. Nonetheless, morphological assessment is informative rather than predictive. Adding oocyte morphology to the artificial intelligence (AI)-driven selection process may improve the precision of the algorithms. Oocyte morphology assessment can be especially useful in oocyte donation cycles, during oocyte freezing for fertility preservation and finally, objective oocyte scoring can be important in cases of very poor treatment outcome as a tool for explanation of results to the patient.

To assess serum Anti Mullerian Hormone (AMH) level as a biomarker for oocyte quality

Introduction: Oocyte competence is a factor that affects ART outcomes. Oocyte morphology assessment and scoring are laborious, have inter-observer variations and lack consensus on parameters to be assessed. Role of anti mullerian hormone (AMH) as a biomarker for oocyte quality and competence is investigated. Aim and Objectives: To evaluate day 2/3 serum AMH as a predictor of oocyte quality, embryo quality and fertilization rate in a stimulated ART cycle. Methods: Single centre, prospective observational study. All patients undergoing IVF-ICSI between August 2018 and February 2019 included. Total Oocyte Score calculated for all oocytes. and subsequently assessed for fertilization, cleavage and day 3 embryo grading. Correlations between AMH levels and TOS, PTOS, Fertilization and Cleavage rates assessed using appropriate statistical methods. Results: Of 86 patients and 780 oocytes studied,639 underwent ICSI with fertilization rate 86% (550/639) and cleavage rate 90.7%(499/550). Embryo grades were A-50.6%, B-38.9% and C-10.5%. Mean TOS score and PTOS scores were 0.3±1.99 and 0.44±1.21.TOS was predictive of fertilization [ROC-AUC=0.598(P = 0.004)]. Mean AMH levels were 3.66 ± 3.96 ng/ml [0.69±0.21ng/ml 75th centile] and decreased with increasing age. AMH levels correlated with TOS, PTOS, fertilization and cleavage rates. The r2 values were low suggesting poor clinical significance. AMH levels were not predictive of fertilization and embryo grade. Conclusion: AMH levels show weak correlation with oocyte quality and are poor predictor of oocyte competence.

Fluorescent Microscopy Analysis of Mammalian Oocyte Viability after Vitrification

The paper reports the results of a fluorescent microscopy analysis of the viability of oocytes from cattle and pigs after vitrification. Oocytes were frozen in a vitrification media containing varying concentrations of cryoprotectors in several steps with subsequent vitrification. After cryobank storage for 14 days, experimental samples were thawed and oocyte viability was analyzed by oocyte morphology assessment and fluorescent microscopy. Two different kits were used to stain oocytes, one specific for necrosis/apoptosis (Propidium iodide/Alexa Fluor 488 Annexin) and the other specific for live/dead cells (Calcein-AM/ethidium homodimer-1). Fluorescent microscopy of porcine and bovine oocytes has demonstrated that the fluorescent dye Calcein-AM should be chosen to assess oocyte viability, since Propidium iodide and ethidium homodimer-1 do not represent the oocyte cell death. Therefore, Propidium iodide and ethidium homodimer-1 cannot serve as indicators of real oocyte death.

Флуоресцентный микроскопический анализ жизнеспособности ооцитов млекопитающих после витрификации-=SUP=-*-=/SUP=-

AbstractThe paper reports the results of a fluorescent microscopy analysis of the viability of oocytes from cattle and pigs after vitrification. Oocytes were frozen in a vitrification media containing varying concentrations of cryoprotectors in several steps with subsequent vitrification. After cryobank storage for 14 days, experimental samples were thawed and oocyte viability was analyzed by oocyte morphology assessment and fluorescent microscopy. Two different kits were used to stain oocytes, one specific for necrosis/apoptosis (Propidium iodide/Alexa Fluor 488 Annexin) and the other specific for live/dead cells (Calcein-AM/ethidium homodimer-1). Fluorescent microscopy of porcine and bovine oocytes has demonstrated that the fluorescent dye Calcein-AM should be chosen to assess oocyte viability, since Propidium iodide and ethidium homodimer-1 do not represent the oocyte cell death. Therefore, Propidium iodide and ethidium homodimer-1 cannot serve as indicators of real oocyte death.

Dynamic Morphology of the Human Ooplasm and Subsequent Embryonic Development Analyzed by Time-Lapse Cinematography

It has been reported that oocyte dysmorphisms, such as the appearance of a cytoplasmic vacuole, granularity, and deformed shape, are strongly associated with poor embryonic development. In this study, we analyzed the dynamics of cytoplasmic dysmorphisms of oocytes and zygotes using time-lapse cinematography (TLC) that we had originally developed. Mature oocytes (n=1,601) were classified into two groups: good quality oocytes (GQO), which indicated oocytes without any defects; and poor quality oocytes (PQO), oocytes with one or more defect. Of the 1601 oocytes, 74.1% were GQO and the remaining were PQO, which were evaluated by three senior embryologists. The rate of unfertilized oocytes was significantly lower in PQO. GQO also showed a higher development rate to good quality embryos than PQO. The time required for embryonic development in GQO was significantly less than that in PQO (P<0.01). In the zygotes (n=144), 11.4% showed vacuole-like phenomenon (VLP) in the cytoplasm. The VLP appeared in the peripheral cytoplasm after extrusion of the second polar body and moved synchronously as the mPN and fPN migrated toward the central cytoplasm. The VLP size gradually increased and remained after the first cleavage. The rate of multinucleated blastomere (MNB) formation was significantly higher in embryos with VLP than in those without VLP. The appearance of VLP was closely associated with aberrant embryonic development, particularly MNB formation. Our results suggest that the dynamic morphology of the cytoplasm in oocytes and zygotes influences subsequent embryonic development and viability, suggesting that the assessment of oocyte morphology could be a useful parameter in the prediction of embryonic development.

Effect of oocyte morphology on embryo development and implantation

Assessment of oocyte morphology is a difficult task, since underlying mechanisms that change the appearance of the oocyte are multifactorial and complex. Significant morphological variations are known to exist among oocytes that may affect the developmental competence and implantation potential of the derived embryo. Morphological variations of the oocyte may result from intrinsic factors such as age and genetic defects or extrinsic factors such as stimulation protocols, culture conditions, and nutrition. The effect of these morphological variations of the oocyte on embryo development and implantation, however, is not conclusively defined because of methodological flaws inherent to most of the studies in the literature. This review will mainly discuss morphological markers of oocyte quality/viability in relation to the oocyte morphology and attempt to clarify whether morphological evaluation of the oocyte can be utilized for predicting the implantation potential of the derived embryo.