Initial differentiation of blastomeres in 4-cell human embryos and its significance for early embryogenesis and implantation

The transfer of double cleavage embryos developed from two four-cell embryos may not represent an optimal treatment strategy in cycles with a greater number of four-cell embryos on Day 2

OBJECTIVE

This study examined the impact of the number of Day 2 four-cell (D2-4C) embryos on double embryo transfer and blastocyst culture therapy in the first in vitro fertilization (IVF) cycle.

METHODS

A retrospective review was performed on 1039 blastocyst culture cycles to compare outcomes between available and unavailable blastocyst cycles, emphasizing the relationship between the number of D2-4C embryos and blastocyst availability. Furthermore, the correlation between four-cell embryo counts and live births was analyzed in 986 transfer cycles.

RESULTS

The analysis revealed that the number of D2-4C embryos independently influenced the availability of blastocysts (odds ratio [OR] 1.693, 95% confidence interval [CI] 1.306-2.195, P < 0.001). Receiver operating characteristic (ROC) analysis indicated that D2-4C embryos displayed the highest predictive value for available blastocysts, with an area under the curve (AUC) of 0.861 (95% CI 0.826-0.896). The cut-off point was determined to be 4.5, particularly for individuals younger than 25 years, where the AUC reached 0.927. This suggests that the number of D2-4C embryos has significant predictive value for available blastocysts. The live birth rate (LBR) of fresh embryo transfers significantly increased with the number of D2-4C embryos (P = 0.004). LBRs for zero, one, and two four-cell embryos in double cleavage embryo transfer were 20.24%, 34.97%, and 38.08%, respectively (P = 0.005). In the twin group, the percentages for zero, one, and two four-cell embryos were 1.21%, 9.75%, and 89.02%, respectively (P < 0.001). Single blastocyst transfer achieved an LBR comparable to that of two four-cell embryos (34.8% vs 39.0%, P = 0.415), while the twin rate significantly decreased with single blastocyst transfer (25.17% vs 1.40%, P < 0.001).

CONCLUSION

The number of D2-4C embryos exhibits significant predictive value for available blastocysts, particularly among young women. Furthermore, most twins resulted from the transfer of double cleavage embryos derived from two four-cell embryos. Consequently, when the D2-4C count exceeds four in a cycle, blastocyst culture therapy is preferred over double cleavage-stage embryo transfer.

DUX: One Transcription Factor Controls 2-Cell-like Fate

The double homeobox (Dux) gene, encoding a double homeobox transcription factor, is one of the key drivers of totipotency in mice. Recent studies showed Dux was temporally expressed at the 2-cell stage and acted as a transcriptional activator during zygotic genome activation (ZGA) in embryos. A similar activation occurs in mouse embryonic stem cells, giving rise to 2-cell-like cells (2CLCs). Though the molecular mechanism underlying this expanded 2CLC potency caused by Dux activation has been partially revealed, the regulation mechanisms controlling Dux expression remain elusive. Here, we discuss the latest advancements in the multiple levels of regulation of Dux expression, as well as Dux function in 2CLCs transition, aiming to provide a theoretical framework for understanding the mechanisms that regulate totipotency.

Differences in blastomere totipotency in 2-cell mouse embryos are a maternal trait mediated by asymmetric mRNA distribution

It is widely held that the first two blastomeres of mammalian embryos are equally totipotent and that this totipotency belongs to the group of regulative properties. However, this interpretation neglects an important aspect: evidence only came from successful monozygotic twins which can speak only for those pairs of half-embryos that are able to regulate in the first place. Are the frequently occurring incomplete pairs simply an artefact, or do they represent a real difference, be it in the imperfect blastomere's ability to regulate growth or in the distribution of any compound X that constrains regulation? Using the model system of mouse embryos bisected at the 2-cell stage after fertilization, we present evidence that the interblastomere differences evade regulation by external factors and are already latent in oocytes. Specifically, an interblastomere imbalance of epiblast production persists under the most diverse culture conditions and applies to the same extent in parthenogenetic counterparts. As a result, cases in which twin blastocysts continued to develop in only one member account for 65 and 57% of zygotic and parthenogenetic pairs, respectively. The interblastomere imbalance is related to the subcellular distribution of gene products, as documented for the epiblast-related gene Cops3, using mRNA FISH in super-resolution mode confocal microscopy. Blastomere patterns of Cops3 mRNA distribution are α-amanitin-resistant. Thus, the imbalance originates not from de novo transcription, but from influences which are effective before fertilisation. These data expose previously unrecognized limits of regulative capacities of 2-cell stage blastomeres and point to aspects of cytoplasmic organization of the mouse oocyte that segregate unequally to blastomeres during cleavage.

Dynamics of alternative polyadenylation in human preimplantation embryos

Alternative polyadenylation (APA) affects the length of the 3' untranslated region (3'-UTR) and the regulation of microRNAs. Previous studies have shown that cancer cells tend to have shorter 3'-UTRs than normal cells. A plausible explanation for this is that it enables cancer cells to escape the regulation of microRNAs. Here, we extend this concept to an opposing context: changes in 3'-UTR length in the development of the human preimplantation embryo. Unlike cancer cells, during early development 3'-UTRs tended to become longer, and gene expression was negatively correlated with 3'-UTR length. Moreover, our functional enrichment results showed that length changes are part of the development mechanism. We also investigated the analogy of 3'-UTR length variation with respect to lncRNAs and found that, similarly, lncRNA length tended to increase during embryo development.

Blastocyst Morphology Holds Clues Concerning The Chromosomal Status of The Embryo

Background

Embryo morphology has been proposed as an alternative marker of chro- mosomal status. The objective of this retrospective cohort study was to investigate the association between the chromosomal status on day 3 of embryo development and blas- tocyst morphology.

Materials and Methods

A total of 596 embryos obtained from 106 cycles of intra- cytoplasmic sperm injection (ICSI) followed by preimplantation genetic aneuploidy screening (PGS) were included in this retrospective study. We evaluated the relation- ship between blastocyst morphological features and embryonic chromosomal altera- tion.

Results

Of the 564 embryos with fluorescent in situ hybridization (FISH) results, 200 reached the blastocyst stage on day 5 of development. There was a significantly high- er proportion of euploid embryos in those that achieved the blastocyst stage (59.0%) compared to embryos that did not develop to blastocysts (41.2%) on day 5 (P<0.001). Regarding blastocyst morphology, we observed that all embryos that had an abnormal inner cell mass (ICM) were aneuploid. Embryos with morphologically normal ICM had a significantly higher euploidy rate (62.1%, P<0.001). As regards to the trophectoderm (TE) morphology, an increased rate of euploidy was observed in embryos that had nor- mal TE (65.8%) compared to embryos with abnormal TE (37.5%, P<0.001). Finally, we observed a two-fold increase in the euploidy rate in high-quality blastocysts with both high-quality ICM and TE (70.4%) compared to that found in low-quality blastocysts (31.0%, P<0.001).

Conclusion

Chromosomal abnormalities do not impair embryo development as ane- uploidy is frequently observed in embryos that reach the blastocyst stage. A high-quality blastocyst does not represent euploidy of chromosomes 13, 14, 15, 16, 18, 21, 22, X and Y. However, aneuploidy is associated with abnormalities in the ICM morphology. Further studies are necessary to confirm whether or not the transfer of blastocysts with low-quality ICM should be avoided.

Developmental capacity and pregnancy rate of tetrahedral- versus non-tetrahedral-shaped 4-cell stage human embryos

PURPOSE

The arrangement of the blastomeres within the 4-cell stage embryo reflects the orientation of the cleavage planes during the second division. To examine their relevance, the developmental capacity and the pregnancy rate were compared between tetrahedral-shaped and non-tetrahedral-shaped 4-cell stage human embryos.

METHODS

The study included 3,546 4-cell stage embryos. The arrangement of the blastomeres at the 4-cell stage was annotated as being tetrahedral or non-tetrahedral on day 2 of preimplantation development. Embryo quality was compared on day 3 and day 5. Pregnancy rates were calculated per single embryo transfer on day 3 or day 5.

RESULTS

In total, 2,803 4-cell stage embryos (79 %) displayed a tetrahedral arrangement and 743 (21 %) displayed a non-tetrahedral arrangement. Tetrahedral-shaped embryos developed more into high-quality embryos on day 3 (p < 0.001) and day 5 (p = 0.036) and had a higher blastulation rate (p = 0.009). Though, the number of high-quality embryos selected for transfer did not differ between both groups on day 3 (p = 0.167) and day 5 (p ~ 1). Three hundred thirty single embryo transfers were analysed. No significant difference in clinical pregnancy was found between both groups after transfer on day 3 (p = 0.209) and day 5 (p = 0.653).

CONCLUSIONS

The arrangement of the blastomeres according to their previous cleavage planes was correlated to the developmental potential of the 4-cell stage embryo up to the blastocyst stage. If embryo transfers are performed on day 3 and day 5 of development using embryos of adequate quality, the blastomere arrangement at the 4-cell stage had no predictable value regarding pregnancy success.

Enhanced generation of human embryonic stem cells from single blastomeres of fair and poor-quality cleavage embryos via inhibition of glycogen synthase kinase β and Rho-associated kinase signaling

STUDY QUESTION

Could selected pluripotency-enhancing small molecules (SMs) lead to efficient derivation of human embryonic stem cells (hESCs) from cleavage embryos-derived single blastomeres (SBs)?

SUMMARY ANSWER

Inhibition of glycogen synthase kinase β (GSK3β) and Rho-associated kinase (ROCK) signaling can enhance the derivation of hESCs from cleavage embryo-derived SBs.

WHAT IS KNOWN ALREADY

Parameters involved in sustaining the pluripotency of biopsied blastomeres for generating hESCs without causing injury to a viable embryo have remained obscure. This research seeks to improve the culture conditions for increasing the efficiency of deriving hESCs from SBs from cleavage-stage embryos by using SMs.

STUDY DESIGN, SIZE, DURATION

In order to identify SMs which may enhance hESC generation from SBs, 11 pluripotency-enhancing SMs were screened and CHIR99021 (CH), a GSK3β inhibitor, was selected. To optimize culture condition in hESC generation from SMs, we used ROCK inhibitor Y27632 (Y) and basic fibroblast growth factor in combination with CH or its alternative, Kenpaullone, in different time courses over 12 days. We also assessed a critical time point for CH + Y treatment of cleavage embryos from 4- to 8-cell embryo. In total, 224 embryos and 1607 SBs were used in the study.

PARTICIPANTS/MATERIALS, SETTING, METHODS

Blastomeres of fair and poor-quality from 6- to 8-cell stage human embryos were mechanically dispersed and individually seeded into a 96-well plate that was precoated with mitotically inactivated feeder cells. Derivation of hESC line from each SB was carried out in hESC defined medium supplemented with SMs. Randomly selected hESC lines were evaluated by immunostaining for pluripotency markers, karyotype analysis and differentiation potential into the three embryonic germ layer derivatives.

MAIN RESULTS AND THE ROLE OF CHANCE

We found that 3 μM CH was the only SM that was capable of directing SBs from fair and poor-quality 6-8-cell embryos into hESC lines. The application of hESC-conditioned medium had no additive effect on hESC establishment from SBs. Also, we indicated that CH combined with Y improved hESC generation efficiency by up to 31%. By using of Kenpaullone as an alternative to CH, we confirmed the involvement of GSK3 inhibition in hESC derivation from SBs. Interestingly, by treatment of 4-cell embryos, these SMs could enhance the derivation efficiency of SB-derived hESC lines up to 73% and the maximum number of hESC lines from SBs of one embryo was achieved in this state.

LIMITATIONS, REASONS FOR CAUTION

The low quality of the embryos used in this study most likely had an effect on hESC generation. Furthermore, although we attempted to minimize any differences in inter-embryo quality, we cannot exclude the possibility that small differences in starting quality between embryos may have contributed to the differences observed, other than the addition of SMs.

WIDER IMPLICATIONS OF THE FINDINGS

This approach would allow the establishment of autogeneic or allogeneic matched cells from embryos fertilized in vitro without destroying them.

STUDY FUNDING/COMPETING INTEREST(S)

This study was financially supported by the National Elite Foundation and the Royan Institute for Stem Cell Biology and Technology. The authors have no conflict of interest to declare.

Generating different genetic expression patterns in the early embryo: insights from the mouse model

The divergence of two differentiating extraembryonic cell types (trophectoderm and primitive endoderm) from the pluripotent epiblast population (the source of fetal progenitor cells) by the blastocyst stage of mouse development relies upon the activation and execution of lineage-specific gene expression programmes. While our understanding of the central transcription factor 'effectors' directing these cell-fate choices has accumulated rapidly, what is less clear is how the differential expression of such genes within the diverging lineages is initially generated. This review summarizes and consolidates current understanding. I introduce the traditional concept and importance of a cell's spatial location within the embryo, referencing recent mechanistic and molecular insights relating to cell fate. Additionally, I address the growing body of evidence that suggests that heterogeneities among blastomeres precede, and possibly inform, their spatial segregation in the embryo. I also discuss whether the origins of such early heterogeneity are stochastic and/or indicative of intrinsic properties of the embryo. Lastly, I argue that the robustness and regulative capacity of preimplantation embryonic development may reflect the existence of multiple converging, if not wholly redundant, mechanisms that act together to generate the necessary diversity of inter-cell-lineage gene expression patterns.

Defining the genomic signature of totipotency and pluripotency during early human development

The genetic mechanisms governing human pre-implantation embryo development and the in vitro counterparts, human embryonic stem cells (hESCs), still remain incomplete. Previous global genome studies demonstrated that totipotent blastomeres from day-3 human embryos and pluripotent inner cell masses (ICMs) from blastocysts, display unique and differing transcriptomes. Nevertheless, comparative gene expression analysis has revealed that no significant differences exist between hESCs derived from blastomeres versus those obtained from ICMs, suggesting that pluripotent hESCs involve a new developmental progression. To understand early human stages evolution, we developed an undifferentiation network signature (UNS) and applied it to a differential gene expression profile between single blastomeres from day-3 embryos, ICMs and hESCs. This allowed us to establish a unique signature composed of highly interconnected genes characteristic of totipotency (61 genes), in vivo pluripotency (20 genes), and in vitro pluripotency (107 genes), and which are also proprietary according to functional analysis. This systems biology approach has led to an improved understanding of the molecular and signaling processes governing human pre-implantation embryo development, as well as enabling us to comprehend how hESCs might adapt to in vitro culture conditions.

Global gene expression of the inner cell mass and trophectoderm of the bovine blastocyst

Background

The first distinct differentiation event in mammals occurs at the blastocyst stage when totipotent blastomeres differentiate into either pluripotent inner cell mass (ICM) or multipotent trophectoderm (TE). Here we determined, for the first time, global gene expression patterns in the ICM and TE isolated from bovine blastocysts. The ICM and TE were isolated from blastocysts harvested at day 8 after insemination by magnetic activated cell sorting, and cDNA sequenced using the SOLiD 4.0 system.

Results

A total of 870 genes were differentially expressed between ICM and TE. Several genes characteristic of ICM (for example, NANOG, SOX2, and STAT3) and TE (ELF5, GATA3, and KRT18) in mouse and human showed similar patterns in bovine. Other genes, however, showed differences in expression between ICM and TE that deviates from the expected based on mouse and human.

Conclusion

Analysis of gene expression indicated that differentiation of blastomeres of the morula-stage embryo into the ICM and TE of the blastocyst is accompanied by differences between the two cell lineages in expression of genes controlling metabolic processes, endocytosis, hatching from the zona pellucida, paracrine and endocrine signaling with the mother, and genes supporting the changes in cellular architecture, stemness, and hematopoiesis necessary for development of the trophoblast.

Human pre-implantation embryo development

Understanding human pre-implantation development has important implications for assisted reproductive technology (ART) and for human embryonic stem cell (hESC)-based therapies. Owing to limited resources, the cellular and molecular mechanisms governing this early stage of human development are poorly understood. Nonetheless, recent advances in non-invasive imaging techniques and molecular and genomic technologies have helped to increase our understanding of this fascinating stage of human development. Here, we summarize what is currently known about human pre-implantation embryo development and highlight how further studies of human pre-implantation embryos can be used to improve ART and to fully harness the potential of hESCs for therapeutic goals.

Derivation of novel genetically diverse human embryonic stem cell lines

Human embryonic stem cells (hESCs) have the potential to revolutionize many biomedical fields ranging from basic research to disease modeling, regenerative medicine, drug discovery, and toxicity testing. A multitude of hESC lines have been derived worldwide since the first 5 lines by Thomson et al. 13 years ago, but many of these are poorly characterized, unavailable, or do not represent desired traits, thus making them unsuitable for application purposes. In order to provide the scientific community with better options, we have derived 12 new hESC lines at New York University from discarded genetically normal and abnormal embryos using the latest techniques. We examined the genetic status of the NYUES lines in detail as well as their molecular and cellular features and DNA fingerprinting profile. Furthermore, we differentiated our hESCs into the tissues most affected by a specific condition or into clinically desired cell types. To our knowledge, a number of characteristics of our hESCs have not been previously reported, for example, mutation for alpha thalassemia X-linked mental retardation syndrome, linkage to conditions with a genetic component such as asthma or poor sperm morphology, and novel combinations of ethnic backgrounds. Importantly, all of our undifferentiated euploid female lines tested to date did not show X chromosome inactivation, believed to result in superior potency. We continue to derive new hESC lines and add them to the NIH registry and other registries. This should facilitate the use of our hESCs and lead to advancements for patient-benefitting applications.

Human chorionic gonadotropin from day 2 spent embryo culture media and its relationship to embryo development

OBJECTIVE

To detect hCG in spent embryo culture media at day 2 after intracytoplasmic sperm injection and to assess the relationship of hCG to embryo development.

DESIGN

Experimental study.

SETTING

Fertility center and clinical diagnostic laboratory.

SAMPLE(S)

A total of 102 spent culture media from day 2 human embryos and corresponding unexposed media for blank control.

INTERVENTION(S)

The culture media samples were tested for hCG by ELISA.

MAIN OUTCOME MEASURE(S)

Quantity of hCG produced by embryos and correlation with the embryos' developmental status.

RESULT(S)

hCG was found in 93 of 102 culture media tested by enzyme-linked immunosorbent assay. The correlation analysis revealed that the concentration of hCG was independent of embryo developmental status.

CONCLUSION(S)

The ability to detect hCG from day 2 spent culture media may be used as a marker for embryo competence.

Are poor responders patients at higher risk for producing aneuploid embryos in vitro?

PURPOSE

To test the hypothesis that aged women with poor ovarian response express an increase on embryo chromosomal alterations when compared to aged women who presented normal response.

METHODS

Couples undergoing intracytoplasmic sperm injection cycles with preimplantation genetic screening, were subdivided into two groups: Poor Responder group (n = 34), patients who produced ≤4 oocytes; and Normoresponder group (n = 50), patients who produced ≥5 oocytes. Groups were compared regarding cycles' outcomes and aneuploidy frequency.

RESULTS

There were no significant differences between and groups regarding the fertilization rate (p = 0.6861), clinical pregnancy (p = 0.9208), implantation (p = 0.6863), miscarriage (p = 0.6788) and the percentage of aneuploid embryos (p = 0.270). Embryo transfer rate was significantly lower on poor responder group (p = 0.0128) and logistic regression confirmed the influence of poor response on the chance of embryo transfer (p = 0.016).

CONCLUSIONS

Aged females responding poorly to gonadotrophins are not at a higher risk for producing aneuploid embryos in vitro.

Functional genomics of 5- to 8-cell stage human embryos by blastomere single-cell cDNA analysis

Blastomere fate and embryonic genome activation (EGA) during human embryonic development are unsolved areas of high scientific and clinical interest. Forty-nine blastomeres from 5- to 8-cell human embryos have been investigated following an efficient single-cell cDNA amplification protocol to provide a template for high-density microarray analysis. The previously described markers, characteristic of Inner Cell Mass (ICM) (n = 120), stemness (n = 190) and Trophectoderm (TE) (n = 45), were analyzed, and a housekeeping pattern of 46 genes was established. All the human blastomeres from the 5- to 8-cell stage embryo displayed a common gene expression pattern corresponding to ICM markers (e.g., DDX3, FOXD3, LEFTY1, MYC, NANOG, POU5F1), stemness (e.g., POU5F1, DNMT3B, GABRB3, SOX2, ZFP42, TERT), and TE markers (e.g., GATA6, EOMES, CDX2, LHCGR). The EGA profile was also investigated between the 5-6- and 8-cell stage embryos, and compared to the blastocyst stage. Known genes (n = 92) such as depleted maternal transcripts (e.g., CCNA1, CCNB1, DPPA2) and embryo-specific activation (e.g., POU5F1, CDH1, DPPA4), as well as novel genes, were confirmed. In summary, the global single-cell cDNA amplification microarray analysis of the 5- to 8-cell stage human embryos reveals that blastomere fate is not committed to ICM or TE. Finally, new EGA features in human embryogenesis are presented.

From mouse egg to mouse embryo: polarities, axes, and tissues

This review describes the three classical models (mosaic, positional, and polarization) proposed to explain blastocyst formation and summarizes the evidence concerning them. It concludes that the polarization model incorporates elements of the other two models and best explains most known information. I discuss key requirements of a molecular basis for the generation and stabilization of polarity and identify ezrin/E-cadherin, PAR proteins, and Cdx2 as plausible key molecular players. I also discuss the idea of a network process operating to build cell allocations progressively into committed differences. Finally, this review critically considers the possibility of developmental information being encoded within the oocyte and zygote. No final decision can be reached on a mechanism of action underlying any encoded information, but a cell interaction process model is preferred over one that relies solely on differential inheritance.

Assisted fertilization and embryonic axis formation in higher primates

In naturally fertilized embryos of various organisms, the spermatozoon provides a localized cue to initiate early embryonic patterning. In mice, the sperm entry point (SEP) may reorient the first cleavage division, which separates the zygote into two halves that follow distinct fates. However, it is unknown whether the mechanical injection of spermatozoa into an oocyte by intracytoplasmic sperm injection (ICSI), a technique commonly used in human assisted reproduction, possesses such a role. Rhesus macaque embryos fertilized by ICSI were examined in order to determine the consequences of placing the spermatozoon at specific positions in the ooplasm and whether this can provide new information about patterning in mammalian eggs. The SEP specified by the injected spermatozoa was most often localized near the first cleavage plane and was mainly distributed along the boundary zone that separates the embryonic and abembryonic parts of the monkey blastocyst. Moreover, the ICSI data, when compared with naturally fertilized mouse embryos, showed a similar outcome in terms of cleavage axes and first embryonic axis specification. As there are no studies to date regarding sperm entry in human oocytes and its influence on embryonic development, this investigation using the rhesus macaque as a clinical model is noteworthy.

Blastocyst trophectoderm biopsy and preimplantation genetic diagnosis for familial monogenic disorders and chromosomal translocations

OBJECTIVE

Modern in vitro fertilization practices involve transfer of embryos as blastocysts, when anabolic metabolism is well established and pregnancy rates can be maintained while transferring embryos singly to avoid multiple pregnancies. Embryo biopsy for preimplantation genetic diagnosis (PGD), however, is generally performed on day 3, when the embryo comprises just 6 to 8 cells, one or two of which are removed for testing. Implantation rates and clinical pregnancy rates have remained relatively low and a harmful effect from losing one or more cells from such early embryos has not been excluded.

METHODS

We performed a sequential study involving 399 egg retrievals and 1879 embryo biopsies for patients undergoing PGD to avoid a serious monogenic disease or an unbalanced chromosomal translocation. We compared implantation and viable pregnancy rates after biopsies taken on day 3 (cleavage-stage biopsy) with biopsies delayed until day 5 or 6, when the embryo is a blastocyst and 5 or more cells can be sampled from the trophectoderm while the inner cell mass, from which the fetus develops, remains intact. All embryos were transferred as blastocysts.

RESULTS

Despite fewer blastocysts than cleavage embryos biopsied and tested (3.6 compared to 6.6), implantation rates per embryo transferred were 43.4% if biopsied at the blastocyst stage and 25.6% if biopsied at the cleavage stage (P < 0.01), with ongoing or live-birth pregnancy rates per egg retrieval of 34.2% (average transfer number 1.1) for blastocyst biopsies and 25.5% (transfer number 1.6) for cleavage stage biopsies (P < 0.05, 1-tailed). The multiple pregnancy rate for monogenic disease exclusion fell from 16.7% to 2% (P = 0.04, 1-tailed).

CONCLUSIONS

For exclusion of genetic disease, day 5-6 blastocyst-stage biopsies are more likely to be followed by implantation and singleton births than is the case after PGD performed on day 3.

Polar body diagnosis - a step in the right direction?

INTRODUCTION

Polar body diagnosis (PBD) is a new diagnostic method for the indirect genetic analysis of oocytes, which is carried out as part of in vitro fertilization. The biopsy of polar bodies is technically demanding and cannot be adopted uncritically in routine practice, in the absence of robust data to support this laboratory procedure.

METHODS

Selective literature review and analysis of own PBD data.

RESULTS

The main application of PBD is the detection of chromosomal aneuploidies and maternally inherited translocations in oocytes. The major disadvantage of PBD is that the paternal contribution to the genetic constitution of the developing embryo cannot be evaluated. Moreover, the potential value of polar body biopsy for the diagnosis of monogenetic diseases is limited.

DISCUSSION

The role of PBD in improving of success rates in assisted reproduction requires evaluation in further clinical trials. For maternal translocations, PBD can be used to reduce the risk of miscarriage. Rapid development in the field of molecular diagnostic and biopsy techniques will also influence PBD and will most likely allow wider application of this method in the near future.

Single-cell duplex RT-LATE-PCR reveals Oct4 and Xist RNA gradients in 8-cell embryos

BACKGROUND

The formation of two distinctive cell lineages in preimplantation mouse embryos is characterized by differential gene expression. The cells of the inner cell mass are pluripotent and express high levels of Oct4 mRNA, which is down-regulated in the surrounding trophectoderm. In contrast, the trophectoderm of female embryos contains Xist mRNA, which is absent from cells of the inner mass. Prior to blastocyst formation, all blastomeres of female embryos still express both of these RNAs. We, thus, postulated that simultaneous quantification of Oct4 and Xist transcripts in individual blastomeres at the 8-cell stage could be informative as to their subsequent fate. Testing this hypothesis, however, presented numerous technical challenges. We overcame these difficulties by combining PurAmp, a single-tube method for RNA preparation and quantification, with LATE-PCR, an advanced form of asymmetric PCR.

RESULTS

We constructed a duplex RT-LATE-PCR assay for real-time measurement of Oct4 and Xist templates and confirmed its specificity and quantitative accuracy with different methods. We then undertook analysis of sets of blastomeres isolated from embryos at the 8-cell stage. At this stage, all cells in the embryo are still pluripotent and morphologically equivalent. Our results demonstrate, however, that both Oct4 and Xist RNA levels vary in individual blastomeres comprising the same embryo, with some cells having particularly elevated levels of either transcript. Analysis of multiple embryos also shows that Xist and Oct4 expression levels are not correlated at the 8-cell stage, although transcription of both genes is up-regulated at this time in development. In addition, comparison of data from males and females allowed us to determine that the efficiency of the Oct4/Xist assay is unaffected by sex-related differences in gene expression.

CONCLUSION

This paper describes the first example of multiplex RT-LATE-PCR and its utility, when combined with PurAmp sample preparation, for quantitative analysis of transcript levels in single cells. With this technique, copy numbers of different RNAs can be accurately measured independently from their relative abundance in a cell, a goal that cannot be achieved using symmetric PCR. The technique illustrated in this work is relevant to a wide array of applications, such as stem cell and cancer cell analysis and preimplantation genetic diagnostics.

Oocyte dysmorphism is not associated with aneuploidy in the developing embryo

OBJECTIVE

Controlled ovarian hyperstimulation yields numerous oocytes with different morphologic features. The purpose of this study was to assess the effect of oocyte dysmorphism on the development and ploidy status of the derived embryo.

DESIGN

Retrospective study.

SETTING

Private assisted reproduction unit.

PATIENT(S)

A retrospective analysis was performed on 616 oocytes and 266 embryos of 65 infertile couples who had undergone preimplantation genetic diagnosis and aneuploidy screening for repeated implantation failures.

INTERVENTION(S)

Oocytes with normal and abnormal morphology and the derived embryos were compared in terms of fertilization, cleavage, and blastocyst formation rates as well as the ploidy status.

RESULT(S)

Oocyte dysmorphism did not have an adverse effect on fertilization and cleavage rates and quality of day 3 embryos. Single cytoplasmic and multiple abnormalities of the oocyte significantly decreased the blastocyst formation rate of the cleaving embryo. Oocyte dysmorphism did not have a significant association with embryonic aneuploidy.

CONCLUSIONS(S)

Oocyte dysmorphism was not associated with a higher risk of aneuploidy in the developing embryo. Cytoplasmic dysmorphism or multiple morphologic abnormalities of the oocyte adversely affects the blastocyst formation potential of the derived embryo.

Derivation of embryonic stem cells for therapy: new technologies

Embryonic stem cells are currently derived from the inner cell mass of human blastocysts, generated from spare embryos donated for research. To overcome ethical concerns raised by destruction of the embryo, two groups of workers have attempted to derive these cells from isolated blastomeres of 8- to 10-cell stage embryos using the embryo biopsy method akin to that used in preimplantation diagnosis. This paper briefly discusses these two techniques in relation to the routine derivation of stem cells from blastocysts. Some embryological aspects of using the inner cell mass of blastocysts in preference to early embryonic cells are presented. The paper also considers some pitfalls in therapeutic cloning, especially in non-human primates, since legislation to allow this procedure for stem cell research is currently being passed in Australia.

Changing genetic world of IVF, stem cells and PGD. B. Polarities and gene expression in differentiating embryo cells and stem cells

Novel genetic techniques in the later twentieth century led to new analytical methods for assessing the growth of embryos and stem cells and improve preimplantation diagnosis. Increasing attention to the nature of polarities in mouse and human embryos revealed the existence of an animal-vegetal axis in human oocytes and embryos. Combinations of meridional and transverse cleavage divisions, the latter due to spindle rotation, determined the unequal division of ooplasm to embryonic blastomeres. Blastomeres with differing functions were accordingly formed in 4-cell embryos, including founders of inner cell mass and trophectoderm. New forms of gene analysis led to the polymerase chain reaction, while fluorescence in-situ hybridization revealed astonishingly high degrees of heteroploidy in human embryos. Developmental genetics gained immense analytical power as cDNA libraries, microarrays, transcriptomes RNAi and other methods clarified the roles of hundreds of genes in pre- and early post-implantation embryos and stem cells.

Totipotency, cell differentiation and reprogramming in humans

Understanding the molecular mechanisms defining totipotency and cell differentiation in humans is a promising strategy in order to expand knowledge about reprogramming. Totipotency and the very first steps of cell differentiation can be studied well in early human embryos. Based on analysis of marker genes such as Oct-4 and -HCG, blastomeres seem to differ in their potency and can be regarded as lineage-specific stem cells as early as the 4-cell stage. The allocation of these stem cells to specific fates might hereby follow a pattern reminiscent of animal and vegetal poles. On the opposite end of the developmental spectrum, differentiated human cells can be used as a means of studying nuclear reprogramming. Intact human 293T kidney cells and primary leukocytes were reprogrammed towards a more undifferentiated state by Xenopus laevis egg extract. Molecular screens identified the chromatin-remodelling ATPase BRG1 as a factor required for this process. Based on these results, more efficient reprogramming protocols allowing for the generation of fully differentiated or undifferentiated human cells for clinical application may be developed.

In-vitro developmental potential of individual mouse blastomeres cultured with and without zona pellucida: future implications for human assisted reproduction

This study was designed to compare the developmental potential of individual blastomeres derived from 2-, 4-, 6- and 8-cell mouse embryos cultured with and without zona pellucida (ZP). In the first series, one, three, five and seven blastomeres were biopsied from 2-, 4-, 6- and 8-cell embryos respectively, and inserted individually into empty ZP recipients, leaving the remaining blastomere within its original ZP. In the second series, the same protocol was used except that the biopsied blastomeres were cultured without ZP and compared with the remaining blastomere within its original ZP. For the first series, individual blastomeres derived from 2-, 4-, 6- and 8-cell embryos cultured with ZP showed blastocyst development of 82.4, 68.6, 44.4 and 23.1% respectively, with corresponding hatching rates of 70.6, 60.0, 25.9 and 7.7%. For the second series, individual blastomeres cultured without ZP progressed with blastocyst development of 73.3, 64.5, 35.7 and 22.7% respectively. Blastocyst multiplication was achieved most efficiently when using individual blastomeres from 4- and 6-cell embryos. This is the first report on comparative in-vitro propagation of single blastomeres derived from various cleavage stages in a mammalian species. Blastomere cloning with its multiple applications may be envisaged for human assisted reproductive technologies.

Genetics, epigenetics and gene silencing in differentiating mammalian embryos

A highly complex pattern of differentiation involving maternal and embryonic factors characterizes the early development of mammalian embryos. These complex genetic and proteonomic patterns of early growth also involve various forms of gene silencing and tissue reprogramming. Understanding the nature of fundamental developmental events is hence essential to appreciate the significance of natural and induced forms of remodelling, damaged forms of gene expression and gene silencing during the initial stages of growth. Natural forms of remodelling include subtle genetic events involved in, for example, the changing nature of imprinting from before fertilization or the inactivation of one X chromosome in female blastocysts. Induced forms include the consequences of nuclear transfer and embryo cloning or the immediate effects of placing embryos in culture media. Animal and human studies are described in this paper, relating reprogramming to detailed embryological and clinical knowledge gained through the use of IVF, preimplantation genetic diagnosis and the establishment in vitro of stem cells. Attention concentrates on the consequences of variations in all growth stages from the formation of oocytes, through fertilization, the differentiation of blastocysts and early haemopoietic stages in mammalian species. Unique features of gene expression or gene modification are described for each developmental stage.

Wide range of chromosome abnormalities in the embryos of young egg donors

Embryo chromosome studies show high rates of abnormalities, above 50%, but most embryos studied were from patients aged 35 and older. The objectives of this study were firstly, to evaluate the rate of chromosome abnormalities in embryos from young egg donors, and secondly, to compare the range of chromosome abnormality rates between donors and non-egg donor cycles, both undergoing preimplantation genetic diagnosis (PGD) for infertility using fluorescence in-situ hybridization analysis with probes for chromosomes X, Y, 13, 15, 16, 18, 21, and 22. On average, only 43% of the embryos were chromosomally normal, while the comparison group had euploidy rates between 34 (age group 18-34) (P < 0.001) and 21% (age group 40-45) (P < 0.001). There was considerable variation between donor cycles, with almost one-third having less than 30% normal embryos. Also, within donors and recipients repeating several IVF cycles with PGD, only 29-56% of the second PGD cycles had similar rates of normal embryos to the first cycle, while in the comparison group it was 64%. The results can explain why some egg donors are successful whereas others are not, and may also show that a policy of PGD for first time egg donors is appropriate and indicated.

Pregnancies and live births after trophectoderm biopsy and preimplantation genetic testing of human blastocysts

OBJECTIVE

To compare multiple-cell trophectoderm biopsy for preimplantation genetic diagnosis (PGD) from day-5 blastocysts with previously published experience with day-3 cleavage-stage embryos.

DESIGN

Retrospective review of laboratory and clinical experience.

SETTING

Sydney IVF, a private clinic in Australia.

PATIENT(S)

Preimplantation genetic diagnosis (PGD) patients age < 44 years with at least one IVF blastocyst suitable for biopsy, recruited from January 2002 through August 2004.

INTERVENTION(S)

Biopsy of trophectoderm from blastocysts on day 5 or 6, with same-day PGD for mutation testing, translocation testing, aneuploidy screening or sex selection. Spare, normal biopsied blastocysts were cryostored for possible later transfer.

MAIN OUTCOME MEASURE(S)

Fetal heart-positive pregnancy rate and accumulating live birth rate after adding results from biopsied fresh and frozen blastocysts for particular couples.

RESULT(S)

In 231 started PGD treatment cycles, unambiguous results were obtained from 974 of 1,050 biopsied blastocysts (93%); all blastocysts survived the biopsy procedure by reconstitution of their blastocele. One hundred nineteen women (median age, 36 years) have had 127 blastocysts transferred fresh (fetal heart-positive implantation rate, 41%). Of 146 blastocysts cryostored, 27 have been thawed (all with > 50% cell survival) and 24 transferred (implantation rate, 26%). To date, 53 pregnancies have been delivered or are ongoing, with an additional 4 clinical miscarriages (7%) and 6 subclinical miscarriages (total miscarriage rate, including biochemical pregnancies, 16%). There were no twin pregnancies.

CONCLUSION(S)

With technically appropriate blastocyst culture and freezing, blastocyst biopsy and cryostorage and later transfer of biopsied blastocysts is shown to be a practical and probably preferable path to preimplantation genetic testing of embryos compared with cleavage-stage embryo biopsy, being accompanied by a high implantation rate (and hence more conducive to elective single embryo transfer) and by a low rate of twinning and miscarriage.

Genetics of polarity in mammalian embryos

This brief review is devoted to the genetic control of polarity and embryonic axes in preimplantation mammalian embryos. Discussion is related to their formation, the considerable variations in gene activity in these early phases of development, and the influence of timers over polarities and related aspects of development. Modern genetic analyses assess vast numbers of genes in outline, and the actions of individual genes in detail. These factors operate within a mixture of inherited maternal controls, gene silencing, bouts of transcription and the actions of mini RNA in controlling gene expression. Within this context, maternal factors regulate the planes of early cleavage divisions and unevenly distribute animal and vegetal characteristics to successive blastomeres by the 4-cell stage. This varied inheritance confers varying combinations of animal and vegetal cytoplasm to single blastomeres in many human 4-cell embryos. The blastomere inheriting animal cytoplasm only may be the trophectodermal stem cell, that with vegetal cytoplasm may be the germline precursor, and the two with full polarity may produce inner cell mass. Some implications of these findings are considered.

Efficient blastomere biopsy for mouse embryo splitting for future applications in human assisted reproduction

The objective of the current study was to establish a safe, efficient biopsy procedure for embryo splitting using the mouse model for future applications in human assisted reproduction. From mouse embryos at the 2-, 4-, 6- and 8-cell stage, half the number of blastomeres were microsurgically biopsied and transferred into empty mouse zonae pellucidae. Twin embryonic development was monitored during in-vitro culture. Blastocyst developmental rate using 2-, 4-, 6-, and 8-cell splitting was 74.4, 75.0, 66.7 and 38.4 respectively, with corresponding hatching rates of 94.9, 97.5, 92.7 and 83.8%. Blastocysts from 2-, 4-, and 6-cell splitting resulted in elevated hatching rates compared with non-operated blastocysts (87.5%), due to the Tyrode-assisted hatching effect. Blastocyst morphology was superior from 2- and 4-cell splitting when compared with 6- and 8-cell splitting. Furthermore, outgrowth of twin blastocysts from 2- and 4-cell splitting showed well-developed colonies with trophoblast cells and clusters of ICM cells, whereas those obtained from 6- and 8-cell splitting frequently formed small-sized colonies. Due to the high twinning success rate obtained under the experimental conditions employed in this study, it appears that with further modifications and proper safeguards, such embryo splitting efforts could have potential applications in humans.