Increased incidence of aberrant morphological phenotypes in human embryogenesis—An association with endometriosis

109

Purpose To review 15 years of activities in ovarian tissue cryobanking from medical database files, including patient indications, histological evaluation and clinical characteristics. Methods Retrospective longitudinal analysis of data from an ovarian tissue bank in an academic hospital. Five hundred and eighty-two patients had their ovarian tissue cryobanked between April 1997 and January 2012. Analysis of cryobanking database: precryopreservation patient characteristics, indications and safety issues, laboratory files and postcryopreservation clinical data. Results Of the 582 patients who had their ovarian tissue cryopreserved, 106 patients donated for research purposes and 476 patients for fertility preservation and long-term cryopreservation. Clinical data analysis of the 476 patients revealed a mean age at the time of cryopreservation of 23± 8.5 years (range: 9 months -39 years), with 96.2 % of subjects aged ≤35 years (n=458). Among 391 cases of malignant disease, hematological malignancies (39.9 %, n=156) and breast cancer (21.7 %, n=85) were the two main indications.At histology, malignant cells were found in ovarian tissue from leukemia patients (n = 3) and non-Hodgkin's lymphoma patients (n=2). Eleven patients underwent autotransplantation, resulting in 5 live births and 1 ongoing pregnancy. Conclusion This is the largest and most comprehensive study to describe and analyze indications and clinical patient characteristics before and after ovarian tissue cryopreservation. The procedure is safe, easy and promising. The database concept is a useful tool in patient selection for autotransplantation.

Section: Incidence Of Indications and Comparison With Other Reportssupporting

confidence: 86%

A review of 15 years of ovarian tissue bank activities

Dolmans

Jadoul

Gilliaux

et al. 2013

109

“…Despite the fact that oocyte-retrieved count and fertilization rate were similar in both endometriosis and control groups of the present study, there was a substantial difference in the number of high-and low-quality embryos between groups (Table 2). This is consistent with other studies that showed a significant increase in the percentage of arrested embryos and aberrant zygote formation in patients with endometriosis compared with control group [49,55]. Indeed, our clinical analysis revealed that women with endometriosis required higher dosage of gonadotropins during ovarian stimulation (Table 2).…”

Section: Discussionsupporting

confidence: 92%

Epigenetic alterations of CYP19A1 gene in Cumulus cells and its relevance to infertility in endometriosis

Hosseini

Mehraein

Shahhoseini

et al. 2016

Purpose The purpose of the present study was to investigate the epigenetic mechanisms responsible for the aberrant aromatase expression (CYP19A1) in Cumulus Cells (CCs) of infertile endometriosis patients. Method Cumulus cells were obtained from 24 infertile patients with and without endometriosis who underwent ovarian stimulation for intracytoplasmic sperm injection. Expression of CYP19A1 gene was quantified using Reverse Transcription Q-PCR. DNA methylation, histone modifications, and binding of Estrogen Receptor, ERβ to regulatory DNA sequences of CYP19A1 gene were evaluated by Chromatin ImmunoPrecipitation (ChIP) assay.Results CYP19A1 gene expression in CCs of endometriosis patients was significantly lower than the control group (P = 0.04). Higher incorporation of MeCP2 (as a marker of DNA methylation) on PII and PI.4 promoters, and hypoacetylation at H3K9 in PII and hypermethylation at H3K9 in PI.4 were observed in CYP19A1 gene in endometriosis patients (P < 0.05). Moreover, a decreased level of ERβ binding to PII and an increased level of its binding to PI.3 and PI.4 promoters of CYP19A1 were observed in endometriosis patients when compared to control. Conclusion Significant reduction of CYP19A1 gene expression in CCs of endometriosis patients may be the result of epigenetic alterations in its regulatory regions, either by DNA methylation or histone modifications. These epigenetic changes along with differential binding of ERβ (as a transcription factor) in CYP19A1 promoters may impair follicular steroidogenesis, leading to poor Oocyte and embryo condition in endometriosis patients.

“…Indeed, a previous study found microtubule and chromosomal changes in poor quality oocytes, which could potentially explain the reduced fertilization rates, as well as reduced implantation rates [2]. Furthermore, a direct correlation between the disease and prevalence of nuclear and cytoplasmic aberrations was observed in pre-implantation embryos obtained from women undergoing IVF cycles for endometriosis-associated infertility [29]. Another possible mechanism involves the effect of follicular fluid (FF) on gamete interaction.…”

Section: Discussionmentioning

confidence: 99%

Conventional IVF versus ICSI in sibling oocytes from couples with endometriosis and normozoospermic semen

Komsky-Elbaz

Raziel

Friedler

et al. 2012

Purpose This study compares the fertilization rate and embryonic development of oocytes randomly inseminated by conventional IVF or ICSI in patients with endometriosis and normozoospermic semen during IVF cycles. Methods Sibling oocytes were randomized to be inseminated either by ICSI or IVF. Rates of fertilization, cleavage, blastulation and embryonic morphology were assessed. Results A total of 786 sibling cumulus-oocyte complexes (COC) were randomized between insemination by conventional IVF (387 COC) or ICSI (399 COC). A significantly higher fertilization rate was found in the ICSI group (ICSI versus IVF, 73.3±23 % versus 54.7±31.9 % respectively; P=0.003), yielding a higher mean number of day 2 embryos (5.2±3.4 versus 3.6±2.9 respectively; P=0.002). Triploid fertilization rate (3PN/COC) was significantly higher in the IVF group compared to the ICSI group (3.9±8.7 % versus 0.9±3.1 % respectively; P=0.02). The morphology score and rate of development of day 2 and 3 embryos were not different between the two groups. Comparison of embryo transfer cycles in which either IVF or ICSI only embryos were transferred did not reveal any statistically significant differences in pregnancy or implantation rates.Conclusion ICSI appears to be a better treatment option than conventional IVF in endometriosis-associated infertility, since it offers the advantages of higher fertilization rate and mean number of embryos and lower rate of total fertilization failure and triploid fertilization.