Fesahat Farzaneh, Kalantar Seyed Mehdi, Sheikhha Mohammad Hasan, Saeedi Hojjatollah, Montazeri Fatemeh, Firouzabadi Razieh Dehghani, Khalili Mohammad Ali
Genetics Department, Shahid Sadoughi University of Medical Sciences, Yazd, 8916189165, Iran; Department of Reproductive Biology, Yazd Institute for Reproductive Sciences, Shahid Sadoughi University of Medical Sciences, Yazd, 8916877391, Iran.
Embryology Department, Omid Fertility Clinic, Tehran, Iran.
Eur J Med Genet. 2018 Apr;61(4):235-241. doi: 10.1016/j.ejmg.2017.12.006. Epub 2017 Dec 8.
Aneuploidy is of great relevance to embryo selection, as it represents one of the important causes of implantation failure. Furthermore, immature oocytes, retrieved during gonadotrophin-stimulated IVF cycles, are generally discarded in clinics; whereas, there was no detectable comprehensive evidence on higher rates of aneuploidy based on maturity status on the day of oocyte retrieval. As well, the correlation between embryo morphology on aneuploidy remains unclear. The aim was to evaluate the developmental and genetic integrity of human preimplantation embryos from rescue in-vitro matured MII stage oocytes as well as in vivo matured oocytes. 541 rescue in-vitro matured oocytes as case as well as 659 in-vivo matured oocytes as control were used for the developmental assay. Finally, 121 cleaved embryos with good quality were analyzed by FISH technique for the detection of chromosomes X, Y, 13, 15, 16, 18, 21 and 22. The fertilization rates were 61.62% and 61.76% in case and control groups, respectively. Also, embryo formation rates of 89.1% vs. 92.2% were recorded for case and control groups, respectively. Good quality embryos on day 3 were 62.54% in case and 68.36% in control groups. There were insignificant differences in fertilization, embryo formation and quality between the groups. Total abnormality in 35 of the 60 embryos was 58.5% in case and 62.3% in control (p < 0.05). There were significant differences between aneuploidy rates of embryos using only sex chromosome preimplantation genetic screening (PGS) and sex chromosome in combination with autosomal chromosomes PGS in case (58.5% vs 28.3%, p = 0.000) and control groups (62.3% vs 21.3%; p = 0.000). The results demonstrated that a high proportion of good quality embryos were aneuploid in both patient groups with no obvious increase in aneuploidies as a result of rescue IVM application. Furthermore, the morphological characteristics of embryos do not completely consistent with chromosomal content. Despite the Rescue IVM is currently not a routine procedure in association with IVF, our finding suggested a viable option for young infertile women facing cancellation of their IVF treatment due to ovarian over-response or resistance factors as well as patients with low functional ovarian reserve considering good quality of embryos from rescue IVM-MII oocytes.
非整倍体与胚胎选择密切相关,因为它是植入失败的重要原因之一。此外,在促性腺激素刺激的体外受精周期中获取的未成熟卵母细胞,在临床上通常会被丢弃;然而,目前尚无基于卵母细胞采集当天成熟状态的非整倍体率升高的全面可检测证据。同样,胚胎形态与非整倍体之间的相关性仍不清楚。本研究旨在评估来自挽救性体外成熟的MII期卵母细胞以及体内成熟卵母细胞的人类植入前胚胎的发育和遗传完整性。将541个挽救性体外成熟卵母细胞作为病例组,659个体内成熟卵母细胞作为对照组用于发育分析。最后,采用荧光原位杂交技术对121个优质卵裂胚胎进行分析,检测X、Y、13、15、16、18、21和22号染色体。病例组和对照组的受精率分别为61.62%和61.76%。病例组和对照组的胚胎形成率分别为89.1%和92.2%。病例组和对照组第3天的优质胚胎率分别为62.54%和68.36%。两组之间在受精、胚胎形成和质量方面无显著差异。60个胚胎中有35个存在总异常,病例组为58.5%,对照组为62.3%(p<0.05)。仅使用性染色体植入前基因筛查(PGS)与性染色体联合常染色体PGS的胚胎非整倍体率在病例组(58.5%对28.3%,p=0.000)和对照组(62.3%对21.3%;p=0.000)之间存在显著差异。结果表明,两组患者中高质量胚胎的非整倍体比例都很高,挽救性体外成熟技术的应用并未导致非整倍体明显增加。此外,胚胎的形态特征与染色体含量并不完全一致。尽管挽救性体外成熟目前并非与体外受精相关的常规程序,但我们的研究结果表明,对于因卵巢过度反应或抵抗因素而面临体外受精治疗取消的年轻不孕女性,以及考虑到挽救性体外成熟MII期卵母细胞可产生优质胚胎的卵巢储备功能低下患者,这是一个可行的选择。