Critical reappraisal of embryo quality as a predictive parameter for pregnancy outcome: a pilot study.

AIM OF THE STUDY: Pilot study to analyse the efficacy and embryo morphology using a new human embryo culture medium (GM501) versus the conventional used medium (ISM1). METHODS: Over a four-month period, all patients at the Leuven Institute of Fertility and Embryology (LIFE) were -randomly allocated to have their embryos cultured in either the standard sequential culture medium ISM1 (control) or in a new universal medium (GM501) (study group). Primary outcome parameters were clinical pregnancy and live birth rate. The secondary outcome parameter was the correlation of embryo fragmentation rate with pregnancy outcome. RESULTS: We did not observe any differences between the ISM1 control group and GM501 study group with regard to fertilization, pregnancy, implantation rates, ongoing pregnancy, and babies born. The number of embryos with a minimal fragmentation rate (less than 30%) was significantly higher in the GM501 study group. CONCLUSION: Although a significant higher embryo fragmentation rate was seen in In vitro culture of embryos in GM501, pregnancy outcome results were comparable to those of embryos cultured in ISM1. According to our results the value of embryo morphological criteria as a parameter for pregnancy outcome should be examined and discussed again.

Blastocyst development after assisted reproduction using spermatozoa obtained after testicular stem cell transplantation in mice.

BACKGROUND: Since its introduction in 1994, testicular stem cell transplantation (TSCT) has been widely used for research. This technique may also become important for preserving fertility in pre-pubertal cancer patients. Therefore, it is necessary to investigate the safety aspects of reproduction using spermatozoa obtained after TSCT. In this study, preimplantation development of mouse embryos, using spermatozoa obtained after TSCT, was examined. METHODS: TSCT-derived spermatozoa were used for IVF and ICSI. Embryos were cultured for five days until they reached blastocyst stage and were evaluated by differential staining. RESULTS: IVF revealed significantly lower fertilization and development rates after TSCT-IVF compared to control-IVF. Blastocysts derived from TSCT-IVF had significantly lower inner cell mass numbers (ICMs) and lower ICM/trophectoderm (TE) ratios compared to control-IVF blastocysts. No differences in fertilization and development rates were observed between TSCT-ICSI and control-ICSI, and blastocyst quality in the transplanted group was similar to that of the control blastocysts. CONCLUSION: Our study showed that after TSCT-IVF, fertilization and preimplantation development were disturbed and blastocysts showed reduced ICM and ICM/TE ratio. However, after TSCT-ICSI, both fertilization and preimplantation development were normal and blastocyst formation was comparable to control-ICSI.

Recovery, survival and functional evaluation by transplantation of frozen-thawed mouse germ cells.

BACKGROUND: Establishing a successful method for testicular stem cell transplantation of frozen-thawed testicular cells would be of immense benefit to boys with childhood cancer undergoing a sterilizing treatment. In this study, we evaluated different cryopreservation protocols in a mouse model by means of testicular germ cell transplantation (TGCT), in order to establish an optimal freezing protocol. METHODS AND RESULTS: In a first series of experiments, we compared an uncontrolled protocol with 1.5 mol/l dimethyl sulphoxide (DMSO) versus a controlled long protocol (cooling to -80 degrees C) and observed a better viability with the latter protocol (36% versus 48%, P < 0.05). We then compared survival after two thawing methods (37 degrees C water versus ice water) in either a DMSO- or an ethylene glycol (EG)-based protocol, and found no difference. In order to evaluate the functional capacity of the cryopreserved testicular suspension, TGCT was performed with both fresh and frozen-thawed suspensions. In 90% of the successfully injected testes, spermatogenesis was reinitiated using fresh suspensions. In contrast, this figure was only 12.5 and 22.7% after cryopreservation, for the short controlled EG protocol and the uncontrolled DMSO protocol, respectively. CONCLUSION: Reinitiation of spermatogenesis is possible after cryopreservation of testicular germ cell suspensions. Although cell survival was acceptable, our results after TGCT show that our protocols need further improvement.

Reproductive capacity of sperm obtained after germ cell transplantation in a mouse model.

BACKGROUND: The testicular stem cell transplantation technique has become an established research model in the mouse. This technique may also become useful for clinical applications. Therefore, it is necessary to investigate whether sperm obtained after testicular stem cell transplantation retain their full functional capacity and whether they are able to produce normally-developing embryos. This study aimed at evaluating the fertilizing and developmental abilities of sperm obtained after stem cell transplantation. METHODS: First, transplanted male mice were mated with females in order to evaluate in-vivo conception. Subsequently, functionality of sperm obtained after testicular germ cell transplantation was investigated by performing both IVF and ICSI. RESULTS: After in-vivo conception we found that in the control group 90% of the mice with a copulating plug became pregnant. In the experimental group only 35% of the mice with a copulating plug became pregnant (P = 0.006). After IVF, fertilization and blastocyst developmental rates were significantly lower in the transplanted group (P < 0.0001). Fertilization and blastocyst developmental rates after ICSI were comparable with control sperm. CONCLUSIONS: Our study showed that in the mouse, sperm obtained after stem cell transplantation are able to fertilize oocytes on the basis of assisted reproduction. It is recommended to further investigate this method in the human, as well as to investigate the post-implantation development of the embryo.