Het Silver-Russell-syndroom in Nederland

Vitrification at Day3 stage appears not to affect the methylation status of H19/IGF2 differentially methylated region of in vitro produced human blastocysts

One of the most widely used assisted reproductive technology (ART) is vitrification. The aim of this study is to evaluate DNA methylation of H19/IGF2 differentially methylation region (DMR) in in vitro produced human blastocysts derived from non-vitrified and vitrified day3 embryos. Day3 embryos derived from ICSI cycles from fertile couples referring for family balancing program were either biopsied or vitrified/warmed and subsequently biopsied. Following biopsy, embryos were cultured to day 5. Day5 blastocysts with desired sex were transferred or vitrified for future use. Blastocysts with un-desired sex were donated for research. The assessment of the embryos was performed in two non-vitrified and vitrified groups. Methylation level of H19/IGF2 DMR was analysed by bisulfite conversion and sequencing at 18 CpG sites (CpGs) located in this region. Results showed that the overall methylated CpGs percentages of this region in the vitrified and non-vitrified groups were 35.3% ± 3.6 and 38.27 ± 4.1%, respectively. The difference between the two groups was not significant. Vitrification of day3 embryo appears to have no adverse effect on DNA methylation status of H19/IGF2 DMR of embryos cultured in vitro to blastocyst stage. These data may have implications for performing frozen embryo cycles transfer instead of fresh embryo transfer cycles, owing to the naturally synchronized uterus and subsequently improved endometrial receptivity in frozen embryo transfer instead of imbalanced hormonal milieu in fresh embryo transfer cycles.

High Frequency of Imprinted Methylation Errors in Human Preimplantation Embryos

Assisted reproductive technologies (ARTs) represent the best chance for infertile couples to conceive, although increased risks for morbidities exist, including imprinting disorders. This increased risk could arise from ARTs disrupting genomic imprints during gametogenesis or preimplantation. The few studies examining ART effects on genomic imprinting primarily assessed poor quality human embryos. Here, we examined day 3 and blastocyst stage, good to high quality, donated human embryos for imprinted SNRPN, KCNQ1OT1 and H19 methylation. Seventy-six percent day 3 embryos and 50% blastocysts exhibited perturbed imprinted methylation, demonstrating that extended culture did not pose greater risk for imprinting errors than short culture. Comparison of embryos with normal and abnormal methylation didn’t reveal any confounding factors. Notably, two embryos from male factor infertility patients using donor sperm harboured aberrant methylation, suggesting errors in these embryos cannot be explained by infertility alone. Overall, these results indicate that ART human preimplantation embryos possess a high frequency of imprinted methylation errors.

Are imprinting disorders more prevalent after human in vitro fertilization or intracytoplasmic sperm injection?

OBJECTIVE

To review the literature and present original data to answer the question of whether in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) is associated with an increase in imprinted diseases in offspring. If the answer is positive, to investigate whether there is a causal relationship between IVF or ICSI and the imprinted diseases.

DESIGN

Review study.

RESULT(S)

Eight epidemiologic studies were suitable to calculate the weighted relative risk for the birth of a child with Beckwith-Wiedemann syndrome following IVF or ICSI compared with the risk in the normal population. This relative risk was 5.2 (95% CI 1.6-7.4). In one study the relative risk was corrected for parents' fertility problems and no significant association was found. Data on the Silver-Russell syndrome are too sparse to draw conclusions, but a positive association with IVF or ICSI treatment is probable. No significant associations were found between the incidences of the Angelman and Prader-Willi syndromes and IVF or ICSI treatments. Children with Prader-Willi syndrome or Angelman syndrome are more likely to be born to parents with fertility problems. All retinoblastomas in children born after IVF or ICSI could be explained by de novo mutations in the RB1 gene and were not associated with imprinted genes. Imprinted diseases result from methylation errors already present in sperms or oocytes. There is no proof of a causal relationship between imprinted diseases and IVF or ICSI treatments.

CONCLUSION(S)

Imprinting disorders are more prevalent after human IVF or ICSI. Future studies should correct for fertility problems in the affected and comparison groups. It is highly improbable that assisted reproduction technologies cause imprinted diseases in humans.