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Fertility expert finds genetic markers that are linked with harvested eggs’ developmental capacity
Fertility experts like Dr. Pasquale Patrizio of the School of Medicine have
long been interested in understanding why so few human eggs harvested during
in vitro fertilization result in pregnancies.
“The two big questions are why so few eggs produce live births and can
we one day identify the best one among the many that look alike?’’ Patrizio
says. “To do so we needed to understand the genetic make up of eggs first.”
In a paper published in the current issue of the American Journal of Obstetrics
and Gynecology, Patrizio and a colleague have identified some possible molecular
suspects.
An extensive genetic analysis by Patrizio, professor of obstetrics and gynecology
and director of the Yale Fertility Center, and former Yale colleague Dagan
Wells, now at the University of Oxford in the United Kingdom, showed significant
differences in gene activity among eggs at different stages of maturity. Patrizio
and Wells conducted analysis of gene expression in immature eggs, mature eggs
developed in culture in the laboratory and eggs matured in the ovary within
their own egg-shell.
They found that eggs that matured in culture, as opposed to eggs that were
already mature at the time of harvesting, tended to lack gene activity normally
involved in the development of the cytoplasm of the egg, or the area outside
the nucleus. Furthermore, they compiled a list of mRNA-mediated gene expression
changes that take place as the eggs matured.
The study is significant for many reasons, say the researchers: First, it provides
the most comprehensive and detailed information about the genetic make-up of
human eggs at different stages of maturity. Second, it provides gene expression
profiles that will make it possible to identify eggs with exceptional developmental
capacity. Third, it reveals that eggs harvested while still immature and then
matured in lab dishes, a practice known as in vitro maturation, display significant
differences in gene activity when compared to already mature eggs.
The findings of significant differences in the genetic profiles of eggs matured
in lab dishes as opposed to eggs matured within the ovary may be a clue that
the current culture conditions are suboptimal, and this can also explain the
lower pregnancy rates seen with the process of in vitro maturation, Patrizio
says.
Fertility clinics have started to offer in vitro maturation to some patients
because it requires fewer drugs and therefore has fewer side effects such as
ovarian hyperstimulation.
“However, the advantage of using fewer days of stimulation and fewer drugs,
may be negated by the observation that these eggs are unable to properly complete
their maturation process and that important proteins manufactured during in vivo
maturation are missing,’’ Patrizio says.
The results of this study will help researchers develop ways to better culture
immature eggs and pave the way to identify which ones might be most likely
to lead to live births, he says.
— By Bill Hathaway
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