Cumulus cell gene expression predicts better cleavage-stage embryo or blastocyst development and pregnancy for ICSI patients

Objective: To investigate whether the degree of post-warming embryo or blastocyst development is associated with clinical pregnancy in vitrified embryo or blastocyst transfer cycles.Methods: Ninety-six vitrified cleavage-stage embryos and 58 vitrified blastocyst transfer cycles were selected. All transfer cycles were performed from February 2011 to March 2019, and all vitrified embryos or blastocysts were warmed from 4 PM to 6 PM and then transferred the next morning from 9 AM to 10 AM. The scores of the cleavage-stage embryos and blastocysts were assessed at warming and at transfer using the modified Steer method and the Gardner method, respectively. The mean embryo or blastocyst score, score of the single top-quality embryo or blastocyst, and the difference in the score between warming and transfer were compared between nonpregnant and pregnant women.Results: In the cleavage-stage embryo transfer cycles, both the top-quality embryo score at transfer and the difference in the score between warming and transfer were significantly associated with clinical pregnancy. A top-quality embryo score at transfer of ≥60.0 (area under the curve [AUC], 0.673; 95% confidence interval [CI], 0.531–0.815) and a difference in the score between warming and transfer of ≥23.0 (AUC, 0.675; 95% CI, 0.514–0.835) were significant predictors of clinical pregnancy. In blastocyst transfer cycles, the top-quality blastocyst score at transfer was the only significant factor associated with clinical pregnancy. A top-quality blastocyst score at transfer of ≥38.3 was a significant predictor of clinical pregnancy (AUC, 0.666; 95% CI, 0.525–0.807).Conclusion: The top-quality embryo score at transfer and the degree of post-warming embryo development were associated with clinical pregnancy in vitrified cleavage-stage embryo transfer cycles. In vitrified blastocyst transfer cycles, the top-quality blastocyst score at transfer was the only significant factor affecting clinical pregnancy.

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262. Human cumulus cell gene expression as a marker of clinical embryo grade

Reproduction Fertility and Development ◽

10.1071/srb08abs262 ◽

2008 ◽

Vol 20 (9) ◽

pp. 62

Author(s):

K. M. Gebhardt ◽

D. Feil ◽

M. Lane ◽

D. L. Russell

Keyword(s):

Gene Expression ◽

Cumulus Cell ◽

Cumulus Cells ◽

Embryo Morphology ◽

Low Grade ◽

Necrosis Factor Alpha ◽

Developmental Potential ◽

Quality Grade ◽

Cell Gene Expression ◽

Cell Gene

In Australia, Assisted Reproductive Technology (ART) accounts for ~3% of births. However, the success rate remains around 65% for women under 35 years of age, hence multiple embryo transfer is frequently preferred to improve the probabiity of achieving a term pregnancy. A biochemical marker for oocyte and embryo developmental potential would augment successful pregnancy outcomes following IVF/ICSI by optimising oocyte and embryo selection, therefore increasing the number of single embryo transfers (SET) performed in ART cycles. Changes in expression levels in human cumulus cells may reflect the quality of their enclosed oocyte. We investigated cumulus cell gene expression and subsequent embryo development to find a marker of embryo quality. Paired samples of cumulus cells were collected from oocytes that progressed to embryos of either high or low grade from eleven IVF/ICSI patients. Following cumulus oocyte complex retrieval cumulus cells were trimmed from the oocyte, and all oocytes and resulting embryos were cultured and tracked individually. Cumulus cell gene expression was assessed using a real-time RT–PCR assay, measuring expression of cyclooxygenase 2 (COX2; PTGS2), Pentraxin 3 (PTX3), Versican (VCAN), Tumour Necrosis Factor Alpha Induced protein 6 (TNAIFP6; TSG6), Lactate Dehydrogenase A (LDHA), Phosphofructokinase Platelet (PFKP), Gremlin (GREM1), Glyceraldehyde-3-Phosphate Dehydrogenase (GAPDH) and 18S rRNA. Standard curves using plasmid subclones for each target were run to assess copy numbers of genes. Embryo morphology was assessed by an embryologist and correlated with relative gene expression. Cumulus cell gene expression was altered in cumulus cells from oocytes which subsequently developed into higher quality (Grade 1 and 2) embryos compared with cumulus cells from oocytes which developed into lower quality (Grade 3 and 4) embryos. This may lead to establishment of markers prognostic for developmental outcome, facillitating more reliable selection of higher quality embryos, increasing single embryo transfers and improving health outcomes from ART.

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