Zygote serine decreased uptake from the fertilization medium is associated with implantation and pregnancy.

PURPOSE: To identify an association between amino acids (AAs) metabolism and reproductive outcome. METHODS: Prospective collection, observational study, in patients undergoing fresh, double embryo transfer (ET), in a tertiary hospital referral IVF unit. Spent day 1 and day 3 media were collected. Concentrations of taurine, aspartic acid, proline, and serine in the medium were determined using a liquid-chromatography mass-spectrometer (LCMS/MS). Data was analyzed according to excretion versus uptake, and a cut-off value was calculated based on a receiver operating curve (ROC). Pregnancy rates were also calculated after stratification into subgroups in accordance with AA metabolism. RESULTS: Seven out of 19 patients conceived (36.8 %). The ORs for pregnancy when the zygotes secreted aspartic acid, serine and proline above the cut-off value were 2.9, 5.67 and 5.21 (p < 0.05). When both transferred embryos were above the cut-off value of serine the PR's were 62.5 %, 12.5 % when both were below, and 33.3 % when one was above and the other below (p = 0.04). Similar results were obtained for proline; PR's were 66.7, 18.7 and 28.6 % respectively, but with a borderline statistical significance (p = 0.08). The same trend was observed in the case of aspartic acid but not near statistical significance. No differences in PRs were found in association with taurine turnover during fertilization or any of the studied AAs during the cleavage stage. There was no correlation between zygote or embryo AAs metabolism and embryo morphology. CONCLUSIONS: Serine and possibly proline decreased uptake from the fertilization medium is associated with pregnancy and might be useful for embryo selection.

Frozen-Thawed Embryo Transfer Success Rate is Affected by Age and Ovarian Response at Oocyte Aspiration Regardless of Blastomere Survival Rate.

OBJECTIVE: To identify the factors influencing the success of frozen-thawed embryo transfers, whether originating directly from current cycles or from their matching fresh cycles. METHODS: Analysis of 273 frozen-thawed embryo transfer cycles and their matching fresh embryo transfer cycles, with respect to maternal, embryological and clinical factors, comparing successful to unsuccessful cycles. RESULTS: The cumulative clinical pregnancy and live birth rates following fresh ET and corresponding FETs were 50.5% and 38.8%, respectively. No outcome measure differed between fresh and frozen ET's. Only maternal age, number of oocytes retrieved and fertilized, and number of cleaved embryos in the fresh cycle were correlated with a higher pregnancy or live birth rate in the FET cycle. None of the other parameters had any effect on the outcome. Pre-freezing embryo quality and blastomere survival rate had no effect on pregnancy/live birth rates. CONCLUSION: Clinical pregnancy and live birth rates of fresh and frozen ETs were not significantly different. The only parameters that affected FET success were those resulting from the patient's age and ovarian reserve at the time of oocyte aspiration. Post-thawing blastomere survival rate and type of endometrial preparation for FET did not affect the success rate.

Familial Dysautonomia (FD) Human Embryonic Stem Cell Derived PNS Neurons Reveal that Synaptic Vesicular and Neuronal Transport Genes Are Directly or Indirectly Affected by IKBKAP Downregulation.

A splicing mutation in the IKBKAP gene causes Familial Dysautonomia (FD), affecting the IKAP protein expression levels and proper development and function of the peripheral nervous system (PNS). Here we found new molecular insights for the IKAP role and the impact of the FD mutation in the human PNS lineage by using a novel and unique human embryonic stem cell (hESC) line homozygous to the FD mutation originated by pre implantation genetic diagnosis (PGD) analysis. We found that IKBKAP downregulation during PNS differentiation affects normal migration in FD-hESC derived neural crest cells (NCC) while at later stages the PNS neurons show reduced intracellular colocalization between vesicular proteins and IKAP. Comparative wide transcriptome analysis of FD and WT hESC-derived neurons together with the analysis of human brains from FD and WT 12 weeks old embryos and experimental validation of the results confirmed that synaptic vesicular and neuronal transport genes are directly or indirectly affected by IKBKAP downregulation in FD neurons. Moreover we show that kinetin (a drug that corrects IKBKAP alternative splicing) promotes the recovery of IKAP expression and these IKAP functional associated genes identified in the study. Altogether, these results support the view that IKAP might be a vesicular like protein that might be involved in neuronal transport in hESC derived PNS neurons. This function seems to be mostly affected in FD-hESC derived PNS neurons probably reflecting some PNS neuronal dysfunction observed in FD.

Hyaluronic acid can successfully replace albumin as the sole macromolecule in a human embryo transfer medium.

OBJECTIVE: To examine the effect on pregnancy and implantation rates when highly purified, fermentation-based hyaluronic acid was the only macromolecule supplement to the transfer medium in a human IVF program. DESIGN: Prospective randomized study. SETTING: In vitro fertilization center in an academic medical institution. PATIENT(S): Eighty patients were included in this prospective randomized double blind study. Inclusion criteria were age

Human granulosa luteal cell oxidative phosphorylation function is not affected by age or ovarian response.

OBJECTIVE: To safely prepare a functional autologous mitochondrial concentrate (MC) from follicular fluid (FF) cells, and to determine the effect of age and ovarian response on the oxidative phosphorylation (OXPHOS). DESIGN: The nontoxicity of the MC was confirmed in human and mouse oocytes. The OXPHOS function was assessed by measuring the activity of succinate dehydrogenase (SDH) and cytochrome c oxidase (COX), and adenosine triphosphate (ATP) production in comparison with citrate synthase. The integrity of the mitochondrial DNA (mtDNA) was demonstrated by polymerase chain reaction (PCR). SETTING: Tertiary hospital. PATIENT(S): A total of 40 patients undergoing IVF of heterogeneous ages and ovarian response. ANIMAL(S): Superovulated 8- to 12-week-old female B(6)C(3)F(1) mice. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): A system for the preparation of functional nontoxic MC was established. The correlation between the mitochondrial mass and function to age and ovarian response was calculated. The integrity of mtDNA was demonstrated. RESULT(S): After injection into mouse oocytes, the MC did not interfere with parthenogenetic development. The MC OXPHOS function was intact. Total activity of SDH and COX was in correlation with the retrieved oocytes number, and in reverse correlation with age. However, after correction to the mitochondrial mass, COX and SDH activities were constant, unaffected by age or ovarian response. The mtDNA was intact in all samples, regardless of age and ovarian response. CONCLUSION(S): The function of the respiratory chain in mitochondria of FF cells is constant, unaffected by age or ovarian response.

Derivation of xeno-free and GMP-grade human embryonic stem cells--platforms for future clinical applications.

Clinically compliant human embryonic stem cells (hESCs) should be developed in adherence to ethical standards, without risk of contamination by adventitious agents. Here we developed for the first time animal-component free and good manufacturing practice (GMP)-compliant hESCs. After vendor and raw material qualification, we derived xeno-free, GMP-grade feeders from umbilical cord tissue, and utilized them within a novel, xeno-free hESC culture system. We derived and characterized three hESC lines in adherence to regulations for embryo procurement, and good tissue, manufacturing and laboratory practices. To minimize freezing and thawing, we continuously expanded the lines from initial outgrowths and samples were cryopreserved as early stocks and banks. Batch release criteria included DNA-fingerprinting and HLA-typing for identity, characterization of pluripotency-associated marker expression, proliferation, karyotyping and differentiation in-vitro and in-vivo. These hESCs may be valuable for regenerative therapy. The ethical, scientific and regulatory methodology presented here may serve for development of additional clinical-grade hESCs.

Derivation, propagation and controlled differentiation of human embryonic stem cells in suspension.

Undifferentiated human embryonic stem cells (hESCs) are currently propagated on a relatively small scale as monolayer colonies. Culture of hESCs as floating aggregates is widely used for induction of differentiation into embryoid bodies. Here we show that hESC lines can be derived from floating inner cell masses in suspension culture conditions that do not involve feeder cells or microcarriers. This culture system supports prolonged propagation of the pluripotent stem cells as floating clusters without their differentiation into embryoid bodies. HESCs cultivated as aggregates in suspension maintain the expression of pluripotency markers and can differentiate into progeny of the three germ layers both in vitro and in vivo. We further show the controlled differentiation of hESC clusters in suspension into neural spheres. These results pave the way for large-scale expansion and controlled differentiation of hESCs in suspension, which would be valuable in basic and applied research.

Monozygotic multiple gestation after intracytoplasmic sperm injection and preimplantation genetic diagnosis.

OBJECTIVE: To report a possible association between intracytoplasmic sperm injection (ICSI)-preimplantation genetic diagnosis (PGD) and monozygotic multiple gestation. DESIGN: Small case series. SETTING: In vitro fertilization unit in an academic medical center. PATIENT(S): Three patients were treated with ICSI-PGD for sexing as well as selection against a known translocation. INTERVENTION(S): Transfer of day 4 embryos to the uterus. MAIN OUTCOME MEASURE(S): Clinical pregnancy. RESULT(S): Two pairs of monozygotic twins and a triplet pregnancy. CONCLUSION(S): Repeated manipulation of the zona pellucida as well as extended embryo culture during ICSI-PGD treatments may result in monozygotic twin and triplet pregnancies.

At what age can human oocytes be obtained?

OBJECTIVE: To determine whether oocyte retrieval and in vitro maturation (IVM) is effective in girls undergoing fertility preservation before cancer treatment. DESIGN: Cohort study. SETTING: Tertiary university medical center. PATIENT(S): Patients