LIF and sIL-2R plasma concentrations in IVF patients on the day of embryo transfer: predictive markers of IVF outcome.

Successful implantation is still the limiting step in IVF. We hypothesized that maternal plasma concentrations of certain cytokines at the time of embryo transfer could predict the likelihood of successful implantation and pregnancy. sIL-2R, IL-6, LIF, and MMP2 concentrations were measured in plasma from 160 IVF patients (natural and stimulated IVF cycles) on the morning of the embryo transfer (ET0) and 14 days later (ET+14). Patients were ultimately subdivided into four groups depending on the IVF treatment outcome (pregnancy failure, biochemical pregnancy, first-trimester miscarriage and normal term delivery). In natural and stimulated IVF cycles at ET0, sIL-2R concentrations were threefold higher in biochemical pregnancies than in pregnancy failures (P=0.020), and in natural cycles only, 2.5-fold higher in normal term deliveries than in pregnancy failures (P=0.023). Conversely, in natural and stimulated IVF cycles at ET0, LIF concentrations were one third lower in biochemical pregnancies/first-trimester miscarriages compared with pregnancy failures (P=0.042). We suggest that high sIL-2R and low LIF concentrations in maternal plasma on the morning of the embryo transfer might be associated with increased risks of early pregnancy loss, while a basal level of sIL-2R is necessary for normal term delivery outcome. Both cytokine measurements might therefore be useful in the management of IVF patients, and modulation of their concentrations could be investigated as a therapeutic alternative for women with abnormal concentrations at the time of embryo transfer.

Quantitative morphometrical characterization of human pronuclear zygotes.

BACKGROUND: Identification of embryos with high implantation potential remains a challenge in in vitro fertilization (IVF). Subjective pronuclear (PN) zygote scoring systems have been developed for that purpose. The aim of this work was to provide a software tool that enables objective measuring of morphological characteristics of the human PN zygote. METHODS: A computer program was created to analyse zygote images semi-automatically, providing precise morphological measurements. The accuracy of this approach was first validated by comparing zygotes from two different IVF centres with computer-assisted measurements or subjective scoring. Computer-assisted measurement and subjective scoring were then compared for their ability to classify zygotes with high and low implantation probability by using a linear discriminant analysis. RESULTS: Zygote images coming from the two IVF centres were analysed with the software, resulting in a series of precise measurements of 24 variables. Using subjective scoring, the cytoplasmic halo was the only feature which was significantly different between the two IVF centres. Computer-assisted measurements revealed significant differences between centres in PN centring, PN proximity, cytoplasmic halo and features related to nucleolar precursor bodies distribution. The zygote classification error achieved with the computer-assisted measurements (0.363) was slightly inferior to that of the subjective ones (0.393). CONCLUSIONS: A precise and objective characterization of the morphology of human PN zygotes can be achieved by the use of an advanced image analysis tool. This computer-assisted analysis allows for a better morphological characterization of human zygotes and can be used for classification.

Up-regulation of glucose metabolism during male pronucleus formation determines the early onset of the s phase in bovine zygotes.

After in vitro fertilization with spermatozoa from bulls with high in vitro fertility, a beneficial paternal effect is manifested during the G1 phase of the first cell cycle. This benefit determines an earlier onset of the first S phase, and then a successful morula-blastocyst transition 7 days later. We hypothesized that the origin of the paternal effect could be a shift of the metabolism of the fertilized oocyte, because in mice, sperm decondensation is responsible for a dramatic increase in glucose metabolism. In this study we investigated the interaction between both pronuclei and compared glycolysis and pentose phosphate pathway (PPP) activities in bovine oocytes fertilized with spermatozoa from bulls of high or low fertility. Here we demonstrate that male pronucleus formation is necessary for the onset of the S phase in the female pronucleus, and that the component promoting an early S phase in both pronuclei is metabolic and linked to an up-regulation of the PPP during the male pronucleus formation. This long-lasting paternal effect is more evidence of the important role of epigenetic control during early embryo development.

Localization of tyrosine phosphorylated proteins in human sperm and relation to capacitation and zona pellucida binding.

Mammalian sperm must undergo a process known as capacitation before fertilization can take place. A key intracellular event that occurs during capacitation is protein tyrosine phosphorylation. The objective of this study was to investigate and visualize protein tyrosine phosphorylation patterns in human sperm during capacitation and interaction with the zona pellucida. The presence of specific patterns was also assessed in relation to the fertilizing capacity of the spermatozoa after in vitro fertilization. Protein tyrosine phosphorylation was investigated by immunofluorescence. Phosphorylation increased significantly with capacitation and was localized mainly to the principal piece of human sperm. Following binding to the zona pellucida, the percentage of sperm with phosphotyrosine residues localized to both the neck and the principal piece was significantly higher in bound sperm than in capacitated sperm in suspension. When the percentage of principal piece-positive sperm present after capacitation was <7%, fertilization rates after in vitro fertilization were reduced. Different compartments of human spermatozoa undergo a specific sequence of phosphorylation during both capacitation and upon binding to the zona pellucida. Tyrosine phosphorylation in the principal and neck piece may be considered a prerequisite for fertilization in humans.

Facilitated glucose transporters play a crucial role throughout mouse preimplantation embryo development.

The role of glucose fluctuates during preimplantation mouse embryo development, indicating that a specific interplay exists between glucose metabolism and uptake. In this study, attempts were made to characterize the role of the Na(+)-coupled active and the facilitated glucose transporters (GLUT) during preimplantation development by using specific glucose analogues and transport inhibitors and by examining the expression of GLUT1. One-cell outbred mouse embryos were cultured in medium M16 (5.5 mmol/l glucose), M16 without glucose (M16-G), M16-G + 2-deoxyglucose, M16-G + 3-O-methylglucose, M16 + phlorizin and M16 + phloretin and development to the blastocyst stage assessed. The absence of glucose, or the presence of 3-O-methylglucose, which is taken up but not metabolized, did not inhibit blastocyst development. 2-Deoxyglucose, which is phosphorylated but not metabolized, inhibited blastocyst development. Culture in M16 supplemented with phlorizin, an inhibitor of Na(+)-coupled active glucose transport did not inhibit blastocyst formation. Phloretin had no effect on the cleavage of two-cell embryos to the four-cell stage, but inhibited the morula/blastocyst transition. Both phloretin and phlorizin inhibited glucose uptake in two-cell embryos. Finally, GLUT1 expression was 10-fold less in blastocysts cultured in M16 compared to in-vivo blastocysts and those cultured in M16-G. The results show that both types of glucose transporters influence preimplantation embryo development and that the embryo has an innate ability to control the uptake of glucose by regulating the expression of GLUT1.

Protein tyrosine phosphorylation in sperm during gamete interaction in the mouse: the influence of glucose.

A key intracellular event during capacitation is protein tyrosine phosphorylation, but its involvement during sperm interaction with the oocyte has not been investigated. Glucose is necessary to achieve fertilization and thus may have an influence on sperm protein tyrosine phosphorylation. The objectives of this study were to 1) visualize protein tyrosine phosphorylation patterns in sperm during capacitation and interaction with the oocyte and 2) determine the influence of glucose. Protein tyrosine phosphorylation was investigated by Western analysis and immunofluorescence. Protein tyrosine phosphorylation was increased during capacitation, and immunofluorescence revealed that zona binding and gamete fusion were correlated with an increase in tyrosine phosphorylation of proteins in the midpiece. During capacitation, the absence of glucose led to a delay in the appearance of protein tyrosine phosphorylation. Following binding to the zona pellucida and the oolemma, tyrosine phosphorylation in the flagellum was also delayed in the absence of glucose and resulted in a significant inhibition of the midpiece phosphorylation. The correlation between successful gamete fusion and the tyrosine phosphorylation of midpiece proteins suggests that the effect of glucose on sperm-oocyte interaction is mediated through regulation of protein tyrosine phosphorylation in a specific area of the fertilizing sperm.

Characterization of glycolysis and pentose phosphate pathway activity during sperm entry into the mouse oocyte.

Studying the events that occur during gamete fusion and sperm decondensation in the oocyte remains difficult because sperm-oocyte fusion and subsequent sperm decondensation represent a short part of the fertilization process, and their exact timing is difficult to determine. There is therefore a need for greater understanding of the events that occur during this period. The main purpose of this study was to examine the metabolic aspects of this time frame by characterizing glucose metabolism (glycolytic and pentose phosphate pathway [PPP] activities) during sperm fusion and decondensation into zona-free oocytes in mice. The metabolism of glucose through both glycolysis and the PPP was measured in ovulated MII oocytes, free of cumulus cells, and the levels of glucose metabolized were found to be low. Upon sperm entry, both glycolytic and PPP activity increased substantially. To determine whether this elevation in glucose metabolism was part of the activation process, the metabolism of parthenogenetically activated oocytes was measured, and no increase in metabolism was observed. The characterization of glucose metabolism during sperm fusion and decondensation into the oocyte, and comparison to parthenogenetically activated oocytes, showed that the fertilizing sperm is responsible for an increase in both glycolytic and PPP activity during fusion and/or decondensation. The significance of this observation during the fertilization process and for the developing embryo is as yet unclear and warrants further investigation.

A possible role for the pentose phosphate pathway of spermatozoa in gamete fusion in the mouse.

Glucose metabolism is essential for successful gamete fusion in the mouse. Although the metabolic activity of the oocyte does not appear to play a significant role in the fusion step, the metabolic role of the spermatozoon is not known. The aim of this study was therefore to characterize the role of glucose metabolism in mouse spermatozoa. Initially, the high-affinity glucose transporter GLUT3 was identified in mouse sperm. In characterizing the glucose metabolism of mouse sperm, we have shown 1) that mouse epididymal spermatozoa have a functional pentose phosphate pathway (PPP), implying that they produce NADPH, which is required for reducing reactions, and ribose 5-phosphate, which is required for nucleic acid synthesis; and 2) that sperm are able to fuse with the oocyte when NADPH is substituted for glucose, suggesting that sperm need to produce NADPH via the PPP in order to be able to achieve fertilization. The existence of an NADPH-regulated event that influences the ability of the sperm to fuse with the oocyte is envisaged.

Sperm nuclear DNA damage and altered chromatin structure: effect on fertilization and embryo development.

In the first part of this report we investigate whether chromatin anomalies in human spermatozoa can influence fertilization after intracytoplasmic sperm injection (ICSI). We have examined the sperm chromatin packaging quality using the chromomycin A3 (CMA3) fluorochrome and the presence of DNA damage in spermatozoa using in-situ nick translation. When comparing the spermatozoa of patients undergoing in-vitro fertilization (IVF) and ICSI distinct differences are evident in that ICSI males have a higher CMA3 fluorescence, indicating spermatozoa with loosely packed chromatin, and more spermatozoa containing endogenous DNA nicks. When examining the unfertilized oocytes of ICSI patients we found that men who had a high percentage of anomalies in their chromatin, i.e. > 30% CMA3 fluorescence and > 10% nicks, had more than double the number of unfertilized oocytes containing spermatozoa that had remained condensed. The observation that failed fertilized oocytes, injected with spermatozoa from patients with a higher percentage of sperm nuclear anomalies, contain more condensed spermatozoa indicates that a selection process against these spermatozoa may be in place at the time of fertilization. In the second part of the study we show that spare ICSI embryos have significantly lower rates of development to the blastocyst stage compared with those developed after routine IVF. These results show that a greater understanding of the molecular basis of male infertility is therefore needed to broaden our knowledge on the effect that abnormal spermatozoa have on fertilization and embryo development.

Glucose participates in sperm-oocyte fusion in the mouse.

Glucose metabolism is necessary for successful fertilization in the mouse, but the precise step of this process that requires glucose has not been determined. In this study we have investigated the involvement of glucose in the gamete binding and fusion process. The relationship between the metabolism of this carbohydrate in the oocyte and this particular step of fertilization has also been studied. A binding and fusion assay was performed by inseminating zona-free oocytes with capacitated sperm. Sperm binding and the fusion reaction were assessed by counting the sperm bound to the oolemma and the sperm heads decondensed in the ooplasm, respectively. To determine the importance of glucose metabolism, nonmetabolized glucose analogues (L-glucose, 2-deoxyglucose, 3-O-methylglucose) were used instead of glucose. The binding/fusion assay was also performed in the presence of glucose uptake inhibitors (cytochalasin B, phloretin, phlorizin). We have obtained evidence that glucose was specifically required for sperm penetration into zona-free oocytes (gamete fusion) but not for sperm binding to the oolemma. The metabolism of this carbohydrate appears to be essential, since nonmetabolized glucose analogues were unable to support this process. Although glucose metabolism was detectable in the oocyte, it did not appear to be related to the gamete fusion function. We hypothesize that the male gamete, which utilizes glucose as an energy substrate for various functions, may have a specific need to metabolize this hexose during fusion and incorporation within the oocyte.

Sperm chromatin anomalies can influence decondensation after intracytoplasmic sperm injection.

In this study we investigated whether morphology and chromatin anomalies in human spermatozoa can influence fertilization after intracytoplasmic sperm injection (ICSI). We examined unfertilized oocytes, using the fluorochrome Hoechst 33342, to determine whether a relationship exists between failure of fertilization and sperm chromatin quality. Sperm chromatin packaging quality was assessed using the chromomycin A3 (CMA3) fluorochrome, and the presence of DNA damage in spermatozoa, using in-situ nick translation, Normal males present sperm parameters with a normal morphology of > 20%, CMA3 fluorescence of < 30% and exhibit endogenous nicks in < 10% of their spermatozoa. When patients were separated according to these values no difference was observed in their fertilization rates after ICSI. When the unfertilized ICSI oocytes were examined, we found that patients with CMA3 fluorescence of <30% and nicks in < 10% of their spermatozoa had only 17.5 and 21.6% respectively of their unfertilized oocytes containing spermatozoa that remained condensed. In contrast, patients with higher CMA3 and nick values had a significantly higher number, 41.2 and 48.9%, of their unfertilized oocytes containing condensed spermatozoa. sperm morphology did not show any such pattern. The percentage of spermatozoa which had initiated decondensation in unfertilized oocytes was not influenced by morphology, CMA3 fluorescence or nicks. In light of these results we postulate that poor chromatin packaging and/or damaged DNA may contribute to failure of sperm decondensation after ICSI and result in failure of fertilization.

Glucose is not essential for the occurrence of sperm binding and zona pellucida-induced acrosome reaction in the mouse.

Glucose is necessary, in some species, for successful fertilization, but its role in the different gamete functions has only been documented partially. In this study we have examined the progression of mouse spermatozoa through the oocyte investments in order to determine which steps require glucose. Evidence is presented of glucose involvement during this sequence of events, since in-vitro fertilization was inhibited in glucose-free medium even when spermatozoa were capacitated in the presence of glucose. Access to the zona pellucida was not inhibited in the absence of glucose, suggesting that capacitation, progressive motility and zona binding of spermatozoa do not depend on the presence of an extracellular glycolysable substrate. However, zona penetration was prevented in the absence of glucose. Most importantly, the zona pellucida-induced acrosome reaction was found to occur in glucose-free medium. It is proposed that hyperactivated motility, which has been described to require glucose in the literature, may be the precise process responsible for the failure of spermatozoa to enter the perivitelline space.

Chromatin packaging and morphology in ejaculated human spermatozoa: evidence of hidden anomalies in normal spermatozoa.

This study aimed to investigate the association between anomalies in sperm chromatin packaging, morphology and fertilization in patients undergoing routine in-vitro fertilization (IVF) or subzonal insemination (SUZI). Sperm chromatin packaging was assessed using chromomycin A3 (CMA3), a fluorochrome specific for guanine-cytosine rich sequences of DNA. One hundred to 150 sperm cells were assessed in 55 patients to compare sperm chromatin packaging and morphology to fertilization after IVF or SUZI. When the morphology and CMA3 fluorescence of individual spermatozoa was assessed, > 75% of the macrocephalic sperm fluoresced in all patients. In contrast, a mean of 37% of the spermatozoa with normal morphology fluoresced in IVF patients compared with 58% of the normal spermatozoa in male factor patients treated by SUZI. SUZI patients displaying a high fluorescence (> 70%) in their spermatozoa also had a significantly lower fertilization rate. Lower packaging quality in morphologically normal spermatozoa may represent a major limiting factor in the fertilizing ability of male factor patients. This study confirms that a high percentage of CMA3 positivity is present in certain forms of male factor infertility and that such a test may be used to distinguish separate populations in morphologically normal spermatozoa.

Evidence of sperm entry into assumed unfertilized human oocytes after sub-zonal sperm microinjection.

Sub-zonal sperm microinjection (SUZI) as a treatment for male factor infertility can facilitate fertilization, however, in many cases oocytes remain unfertilized even though the sperm is placed in close contact with the oolemma. In order to improve our understanding of gamete interaction in cases of failed fertilization, we have analysed the failed fertilized oocytes from both SUZI and conventional in-vitro fertilization. The fluorochrome Hoechst 33342 (which binds specifically to DNA) was used to check for the possible presence of paternal chromatin in the unfertilized oocytes. A significantly higher (P < 0.01) number of microinjected oocytes showed signs of fertilization 2-3 days after sperm microinjection compared to normally inseminated oocytes, 30/175 (17.1%) and 2/79 (2.5%) respectively. In addition, four out of eight couples returning for a second treatment by SUZI displayed anomalies in fertilization in both cycles. The semen characteristics of patients with or without anomalies in fertilization was not different. The irregularities observed in the fertilization process infer that certain male factor patients have intrinsic sperm anomalies lying at the sperm membrane and/or chromatin level that could lead to anomalies in the appearance of the pronuclei.

Effects of glucose and fructose on fertilization, cleavage, and viability of mouse embryos in vitro.

In this study we examined the role of glucose, and the use of fructose as a replacement, in embryo culture medium. Three embryo culture media were used: a routine embryo culture medium (M16), M16 without glucose (M16-G) and M16-G supplemented with fructose (M16F-G). Their effect on fertilization, rate of cleavage, and embryo viability were examined in both an outbred (OF1) and an inbred (C57Bl) mouse strain. Of the three media, only M16 was found to support fertilization. In vitro-fertilized embryos from OF1 oocytes and C57Bl oocytes and OF1 sperm were placed in the different media at the early 2-cell stage. In 65% of OF1 embryos cultured in M16, development was blocked at the 2-cell stage, whereas in M16-G and M16F-G embryos, only 22% and 32%, respectively, were blocked. M16F-G medium also produced morulae and blastocysts with higher cell numbers than M16-G. In vitro-fertilized C57Bl 2-cell embryos cultured in M16 displayed retarded cleavage to the 4-cell stage compared to embryos cultured in M16-G and M16F-G. In contrast, the morulae and blastocyst cell numbers were significantly lower in M16-G compared to M16 and M16F-G. The viability of morulae and blastocysts obtained from OF1 and C57Bl embryos cultured in M16-G and M16F-G was lower compared to control C57Bl morulae and blastocysts cultured in M16. The results show that although morphologically normal embryos could be obtained in M16-G and M16F-G, inherent anomalies existed that limited viability.

Pharmacological manipulation of meiotic maturation in vitro: a comparative study between the amphibian-(Xenopus) and the mammalian (mouse)-oocyte.

The pharmacological manipulation of oocyte maturation in vitro offers an interesting tool for the study of the cell division cycle. The molecular mechanisms which are involved in this process are initiated at the oocyte plasma membrane and lead to a cascade of events, such as breakdown of the nuclear membrane (GVBD), chromosome condensation and cell division. Our pharmacological results point to an essential role for membrane in the communication between external information and intracellular signals mediating the physiological process. In Xenopus as well as in mouse oocytes, protein phosphorylation processes appear to be involved, either through the activation/inhibition of protein C kinase (calcium activated and phospholipid-dependent) and/or protein-A-kinase (cAMP dependent). Indeed in both systems, forskolin inhibits the first step of the process (GBVD) assessing the existence of an oocyte adenylate cyclase. Moreover, inhibitors of protein kinase C induce maturation in Xenopus oocyte whereas activators of this kinase prevent the process in denuded mouse oocytes. Interestingly, inhibitors of transmethylation reactions maintain the prophase block in both systems suggesting a role for membrane fluidity (phospholipid methylation) in the regulation of oocyte maturation.

[Transmethylation inhibitors prevent the spontaneous reinitiation of meiosis in denuded ovocytes of mice]. / Les inhibiteurs de transméthylation empêchent la réinitiation spontanée de la méiose chez l'ovocyte dénudé de souris.

Methyltransferase inhibitors such as 5'-methyl-5'-thioadenosine (MTA), 5'-deoxy-5'-isobutylthioadenosine (SIBA) and 5'-deoxy-5'-isobutylthio-3-deaza-adenosine (3-deaza-SIBA) maintain the meiotic prophase block in denuded mouse oocytes. The inhibitory effect is dose-dependent and reversible. This inhibition is potentiated by forskolin and by the phorbol 12,13 dibutyrate (PD Bu), a tumor-promoting phorbol ester.

Inhibition of denuded mouse oocyte meiotic maturation by tumor-promoting phorbol esters and its reversal by retinoids.

Two tumor-promoting phorbol esters, phorbol 12,13-dibutyrate (PDBu) and phorbol 12-myristate 13-acetate (PMA), when added to the culture medium of denuded mouse oocytes prevent their spontaneous meiotic maturation, whereas phorbol 13-acetate, which is inactive as a tumor promoter, does not inhibit this process. Retinoids appear to antagonize this inhibitory action of tumor promoters. However, the inhibitory effect of forskolin on meiotic maturation is not prevented, but is potentiated by retinal. These data indirectly suggest a role for calcium and/or phospholipids in the regulation of meiotic maturation. They also suggest that forskolin and phorbol esters mediate their effects through different pathways.

Pregnancy-associated plasma protein-A (PAPP-A): concentration in uterine fluid and immunohistochemical localization in the endometrium.

Pregnancy-associated plasma protein-A (PAPP-A) was localized immunohistochemically in the endometrium and measured in uterine fluid of non-pregnant women. The variations of PAPP-A concentrations in uterine fluid during the menstrual cycle paralleled those found in the endometrium. In patients receiving hormone therapy there was a significant correlation between the uterine fluid PAPP-A concentration and the progestogen to oestrogen potency ratio of the hormonal treatment. The presence of PAPP-A in the uterine fluid cannot simply be explained by blood contamination or cell damage. These results are interpreted as indirect evidence for an exocrine as well as an endocrine secretion of PAPP-A by the endometrium which might be influenced by hormones.

Inhibition of denuded mouse oocyte meiotic maturation by forskolin, an activator of adenylate cyclase.

Forskolin, a diterpene that activates rapidly adenylate cyclase activity in several somatic cell systems, prevents spontaneous meiotic maturation of denuded mouse oocytes (ED50 of inhibition approximately 2.5 microM), unlike cholera toxin. The oocyte is sensitive to the action of forskolin during the period preceding germinal vesicle breakdown (GVBD). Washing of the cells abolishes the effect. The diterpene potentiates the inhibitory effect of iso-butyl-methyl-xanthine (IBMX), a phosphodiesterase inhibitor, and it increases cAMP concentration in the oocytes. These findings not only confirm the antagonistic effect of cAMP on the first step of meiosis reinitiation (GVBD) in mammalian oocytes, but also provide the first demonstration of a functional adenylate cyclase system in mammalian oocytes upon which regulatory signals may act.