Predict Oocyte Quality Research Articles

Serum AMH level predicts oocytes quality better than follicular fluid AMH level

BackgroundCurrent in vitro fertilization (IVF) methods can't predict oocyte quality after oocyte retrieval. Anti-Mullerian hormones (AMH) in the follicular fluid are produced directly by granulosa cells therefore should be considered as parameter for predicting oocyte quality. The objective of this study is to develop a non-invasive method for predicting oocyte quality. MethodsThis is a prognostic study with a cross sectional design, conducted from April 2012 to June 2013 at Yasmin IVF Clinic – Dr. Cipto Mangunkusumo General Hospital Jakarta. The subjects of this study were infertile couples underwent IVF. The measurement of serum AMH and estradiol level was performed at the beginning of IVF cycles, while follicular fluid AMH, were measured on the day of oocytes retrieval. Oocyte quality was measured using Xia morphology criteria. ResultWe obtained 102 IVF patients with antagonist protocol. Serum and follicular fluid AMH, serum estradiol, number of mature oocytes, and oocytes morphological score were assessed. Serum AMH, follicular fluid AMH and serum estradiol were related to oocytes quality. Based on the multivariate analysis, we found that age and serum AMH level are the best two predictors for oocyte quality. ConclusionSerum AMH, but not the follicular AMH, can be used to predict oocytes quality.

Telomeres and Female Reproductive Aging.

Reproductive aging involves declines both in oocyte number and developmental capacity. Declining oocyte number alone cannot explain the manifestations of reproductive aging in women. We have proposed the Telomere Theory of Reproductive Aging to explain the complex phenotype found in oocytes from older women. Telomeres are TTAGGG repeats and associated proteins, which form loops at the ends of chromosomes to provide structural and genomic stability. Studies in mice and women show that telomere shortening in oocytes provides a parsimonious explanation for the effects of reproductive aging on oocyte quality. Measurement of polar body telomere length may predict oocyte quality in women undergoing ART.

Measurement of oxidative stress in the follicular fluid of infertility patients with an endometrioma.

Follicular fluid (FF) might reflect the environment during follicle and oocyte growth, and an evaluation of oxidative stress in the FF might be useful in predicting oocyte quality. In order to measure the oxidative stress (OS) in the FF from a single follicle of patients with endometrioma (EM), we evaluated whether an EM might affect the environment of follicular growth. Between December 2011 and July 2013, 26 patients with a unilateral EM (EM group) and 29 without EM (control group) were enrolled in this study. The FF was obtained during the first puncture of follicular aspiration, and was stored at -30 °C until it was assayed. A Free Radical Elective Evaluator (WISMERLL, USA) was used to perform d-ROM and BAP tests to measure oxidative stress (U.CARR) and antioxidant power (μmol/L). The d-ROM values in the EMC and control groups were 328.7 ± 97.8 and 414.9 ± 84.2, respectively, and the BAP values for the two groups were 2474.3 ± 432.0 and 2552.8 ± 435.58, respectively. These values were similar between the two groups (mean ± SD). The number of patients with a modified BAP/d-ROM ratio of <1.0 in the EM group was similar to that for the control group at 16 and 15, respectively (61.5 and 51.7 %). The oxidative stress and antioxidant potential in the FF of the patients with unilateral EM showed values similar to those without an EM. Therefore, we concluded that EMs do not affect the environment for follicle growth during ART treatment.

Analysis of correlations between zona pellucida birefringence and molecular markers of oocyte developmental competence

Background Human infertility is the incapacity of a couple to conceive after one year of unprotected sexual intercourse. Selection of the best gametes for subsequent steps of fertilization and embryo transfer was shown to be the crucial step in infertility treatment procedure [1,2]. Oocyte selection using morphological criteria has been the gold standard method in assisted reproductive technologies (ART) clinics. Zona Pellucida (ZP) , a filamentous matrix of glycosylated glycoproteins surrounding the oocyte, is one of these morphological criteria of oocyte selection. In fact, ZP thickness and birefringence was reported to be positively correlated with higher ability of the oocyte to achieve successful pregnancy, but this selection approach has limitations in terms of accuracy, objectivity and constancy. Recent studies using OMICs approaches have identified key molecular markers in somatic cells (cumulus and/or granulosa cells) and follicular fluid that quantitatively and non-invasively predict the oocyte quality for better selection, higher pregnancy rates and efficient infertility treatment. These biomarkers could be a valuable reinforcement of the morphological selection criteria widely used in IVF clinics. In this context, this study was designed to study the relationship between some molecular predictors of oocyte quality found by our group and the conventional morphological parameters of oocyte quality. We expect to find a positive correlation between the ZP birefringence and molecular markers of oocyte competence. Such integrative strategy should lead to a powerful combined approach that will precisely predict the oocyte developmental potential, allowing therefore efficient infertility treatment and elective single embryo transfer (eSET).

Predictive value of antral follicle count and anti-Müllerian hormone for follicle and oocyte developmental competence during the early prepubertal period in a sheep model

Circulating anti-Müllerian hormone (AMH) and antral follicle count (AFC) are addressed as suitable markers of oocyte quantity and quality during adulthood. To investigate whether AFC and circulating AMH could predict follicle development and oocyte quality during the prepubertal period we used 40-day-old ewe lambs with high, intermediate and low AFC (≥30, 16-29 and≤15 follicles respectively). The analysis of the response to the exogenous FSH ovarian reserve test showed a positive correlation between AFC, AMH plasma levels, total follicle number and the number of large follicles (≥3mm) grown after exogenous FSH administration. The incorporation of abattoir-derived oocytes collected from ovaries with different AFC in an in vitro embryo production system showed that a high AFC can predict oocyte quality in prepubertal ovaries, reflecting an ovarian status suitable for follicular development. The histological quantification of the ovarian reserve evidenced that AFC was not predictive of differences in either the number of healthy follicles or the size of the primordial follicle pool in prepubertal ovaries. Further studies are needed to investigate the implication on the reproductive performance of the significant inter-individual differences found in the present study in AFC and circulating AMH in the early prepubertal period.

Comparative multiplex analysis of cytokines, chemokines and growth factors in follicular fluid of normoresponder women undergoing ovum donation with gonadotropin-releasing hormone agonist versus gonadotropin-releasing hormone antagonist protocols

BACKGROUND:Conflicting results were yielded about the superiority of gonadotropin-releasing hormone agonist (GnRH-a) versus gonadotropin-releasing hormone antagonist (GnRH-ant) protocols used in ovarian stimulation in in vitro fertilization (IVF) set-up. Reports also indicate that any single specific individual marker in follicular fluid collected at the time of oocyte retrieval bears inconclusive value as a predictor of oocyte quality.AIMS:Simultaneous analyses of large numbers of cytokines, chemokines and growth factors in ovarian follicular fluid and perifollicular vascularity in both protocols for ovarian stimulation in IVF program to address the above mentioned lacunae.SETTINGS AND DESIGNS:Normoresponder women (n = 45) were subjected to either GnRH-a (Group 1; n = 23) or GnRH-ant (Group 2; n = 22) for ovarian stimulation in IVF clinics.MATERIALS AND METHODS:The fluid samples of dominant follicles collected at oocyte retrieval from women in Group 1 (GnRH-a; n = 20) and Group 2 (GnRH-ant; n = 16) were used for simultaneous quantitative assays of 48 cytokines. Perifollicular vascularity was assessed by Doppler hemodynamics to assess the ovarian vascular response in all participants in Groups 1 and 2.RESULTS:Despite demographic and reproductive parameters studied remained comparable, higher follicular fluid concentration of interleukins, IL-3 (P < 0.01), IL12p70 (P < 0.05) and vascular endothelial growth factor (P < 0.01), P4 (P < 0.05) and pulsatility index (P < 0.04) along with a lower number of oocytes in metaphase II stage (P < 0.03) was observed in Group 2 compared with Group 1. GnRH-a protocol appeared to be superior to GnRH-ant protocol for ovarian stimulation in normoresponder women.

Unique cumulus cell microrna expression profiles predict IVF outcome and live birth

Communication between the developing oocyte and surrounding cumulus cells is crucial. Indeed, cumulus cell (CC) gene expression has been shown to predict oocyte quality. Gene regulation by microRNAs (miRNAs) is an important post-transcriptional mechanism, which may modulate CC phenotype. The aim of this study was to investigate CC miRNA expression in association with IVF outcome.

Proteomic analysis of the microenvironment of developing oocytes

We utilized a setup based on extensive pre-fractionation of proteolytic peptides and nanoflow reversed-phase LC-MS/MS to identify the (sub)proteome of human follicular fluid (FF). In this in-depth screen, 246 specific proteins were identified, the majority of which are involved in coagulation- and immune-response pathways. Our aim is to define a set of FF protein markers, which could predict oocyte quality.

Human Cumulus Cells Molecular Signature in Relation to Oocyte Nuclear Maturity Stage

The bi-directional communication between the oocyte and the surrounding cumulus cells (CCs) is crucial for the acquisition of oocyte competence. We investigated the transcriptomic profile of human CCs isolated from mature and immature oocytes under stimulated cycle. We used human Genome U133 Plus 2.0 microarrays to perform an extensive analysis of the genes expressed in human CCs obtained from patients undergoing intra-cytoplasmic sperm injection. CC samples were isolated from oocyte at germinal vesicle, stage metaphase I and stage metaphase II. For microarray analysis, we used eight chips for each CC category. Significance analysis of microarray multiclass was used to analyze the microarray data. Validation was performed by RT-qPCR using an independent cohort of CC samples. We identified differentially over-expressed genes between the three CC categories. This study revealed a specific signature of gene expression in CCs issued from MII oocyte compared with germinal vesicle and metaphase I. The CC gene expression profile, which is specific of MII mature oocyte, can be useful as predictors of oocyte quality.

Ovarian and Follicular Metrics are Useful for Predicting Oocyte Quality in the Cheetah (Acinonyx jubatus).

Ovarian and Follicular Metrics are Useful for Predicting Oocyte Quality in the Cheetah (Acinonyx jubatus).

High bone morphogenetic protein-15 level in follicular fluid is associated with high quality oocyte and subsequent embryonic development

Bone morphogenetic protein-15 (BMP-15) has been shown to influence oocyte maturation and quality. However, no relationship has been established between BMP-15 and oocyte quality/embryonic development in humans. The aim of this study is to investigate BMP-15 level in human follicular fluid (FF) and its possible role in determining oocyte quality and developmental potential. A total of 79 oocytes and their corresponding FF from 79 women undergoing ICSI were examined. Individual oocytes were inseminated and subsequently assessed on the basis of their fertilization, cleavage and preimplantation development. BMP-15, FSH, estradiol (E(2)) and progesterone levels of FF were also analysed via the techniques of western blot or radioimmunoassay. Higher FF BMP-15 levels were observed in the fertilized and cleaved groups versus the unfertilized and uncleaved groups, respectively (P < 0.05). The best (Grade I) embryo morphology was associated with higher FF BMP-15 levels than Grade II or III embryos (P < 0.01). A significant positive correlation was found between BMP-15 and E(2) levels in the same follicle. The present study demonstrates that the BMP-15 level in FF appears to be a potential factor in predicting oocyte quality and subsequent embryo development, and is correlated with E(2) level, which may additionally be a valuable predictor of oocyte fertilization.

O-285: Oocyte aging: Does quantity predict quality?

Many women with elevated FSH and/or low antral follicle count (AFC) are discouraged from undergoing IVF. It has been argued these markers might be an indication of declining oocyte quality, and therefore adversely affect pregnancy rates. The goal of this study is to assess the ability of markers of ovarian reserve, such as AFC and basal FSH levels, to predict oocyte quality, as approximated by implantation rate (IR).

Polar body morphology and spindle imaging as predictors of oocyte quality

It has been suggested that first polar body (PBI) morphology reflects oocyte competence. Oocytes with an intact normal-sized PBI have been described as generating better day 2 embryos, higher blastocyst yield, and increased pregnancy and implantation rates. In other studies, PBI morphology was found to be unrelated to fertilization rate, embryo quality, and blastocyst formation. In a prospective analysis, the predictive value of the PBI was investigated by comparing the development of oocytes retrieved from intracytoplasmic sperm injection patients and displaying different PBI morphology, classified according to the following characteristics: normal size and smooth surface (I), fragmented (II), rough surface (III), or large size (IV). Fertilization rates were 59, 57, 64 and 60% respectively. No significant differences were found between the various groups. The proportions of high quality (grade A) day 2 embryos were also comparable among groups I–III (14, 12 and 17% respectively), while the low number of grade A embryos in group IV (two embryos) did not allow comparison with the other classes. These data do not suggest that PBI selection can contribute to identification of embryos with high developmental ability. In order to establish alternative criteria for oocyte selection, a metaphase II (MII) spindle analysis was also conducted via Polscope. In oocytes of patients of different age, spindle retardance (which reflects the high order and density of microtubules) was compared with parameters of embryo development. In aged patients, a trend was observed between low retardance and poor embryo quality, although in general the association between retardance and oocyte developmental performance did not reach statistical significance.

P04.22: Evaluation of endometrial receptivity during IVF using 3‐D power Doppler ultrasonography

Objective: to investigate the predictive role of Power Doppler follicular grading combined with leptin intrafollicular levels to predict oocyte quality. Design: prospective study Patients: ten infertile women undergoing controlled ovarian stimulation followed by ovuum pick up and embriotransfer using intracytoplasmic sperm injection (ICSI). Methods: Power Doppler ultrasound examination of follicular vascular grading, according with Pugh’s method, on the day of hCG administration and at the pick up, combined with detection of intrafollicular leptin levels, obtained by immunoenzymatic assay (ELISA). Results: Pregnancy was obtained in 4 patients (group A). In group A the twelve oocytes selected (three for patients) showed grade four vascularization. In the remaining 6 patients (group B) the eighteen oocytes selected (three for patients) showed grade four vascularization in 5 cases and grade 2–3 in 13 cases. Leptin intrafollicular levels were found elevated in one patient of group A and in five patients of group B. Conclusion: Follicular vascularity combined with low intrafollicular leptin levels seems to improve the prediction of oocyte quality. On the basis of these preliminary results a study to evaluate the possibility to set a new scoring system, using ultrasonographic and biochemical parametres, to carachterize oocyte quality prior to fertilization, has been started in our Department.