Embryonales Entwicklungspotenzial

Gynäkologische Endokrinologie - Tập 9 - Trang 233-237 - 2011
A. Germeyer1, T. Strowitzki1
1Abteilung für gynäkologische Endokrinologie und Fertilitätsstörungen, Universitätsfrauenklinik Heidelberg, Heidelberg, Deutschland

Tóm tắt

Mehr als 30 Jahre nach Geburt des ersten Kindes nach extrakorporaler Befruchtung findet diese Technik breite und erfolgreiche Anwendung. Dennoch sind die Schwangerschaftsraten weiterhin unbefriedigend. Sie liegen bei jungen Paaren bei etwa 35% und sinken bei über 35-jährigen Frauen kontinuierlich ab. Auch die Entwicklung der Blastozystenkultur hat bisher nur zu einer geringen Steigerung der Schwangerschaftsraten bis auf maximal 50% beigetragen. Um die Maßgaben des Embyronenschutzgesetzes auch in der liberalen Lesart einhalten zu können, sollten nur so viele fertilisierte Eizellen in Kultur gegeben werden, dass 2 bis maximal 3 entwicklungsfähige Embryonen entstehen. Um dies zu erreichen und dem Ziel des Single-embryo-Transfers bei akzeptablen Schwangerschaftsraten näher zu kommen, wäre daher wünschenswert, den Embryo mit dem besten Entwicklungspotenzial für die weitere Kultur auswählen zu können. Vor diesem Hintergrund sollen im Folgenden die heutigen Möglichkeiten der Embryonenbeurteilung diskutiert werden.

Tài liệu tham khảo

Assou S, Haouzi D, De Vos J, Hamamah S (2010) Human cumulus cells as biomarkers for embryo and pregnancy outcomes. Mol Hum Reprod 16:531–538 Baart EB, Martini E, Eijkemans MJ et al (2007) Milder ovarian stimulation for in-vitro fertilization reduces aneuploidy in the human preimplantation embryo: a randomized controlled trial. Hum Reprod 22:980–988 Berkovitz A, Eltes F, Ellenbogen A et al (2006) Does the presence of nuclear vacuoles in human sperm selected for ICSI affect pregnancy outcome? Hum Reprod 21:1787–1790 Berkovitz A, Eltes F, Lederman H et al (2006) How to improve IVF-ICSI outcome by sperm selection. Reprod Biomed Online 12:634–638 Botros L, Sakkas D, Seli E (2008) Metabolomics and its application for non-invasive embryo assessment in IVF. Mol Hum Reprod 14:679–690 Collins JA, Barnhart KT, Schlegel PN (2008) Do sperm DNA integrity tests predict pregnancy with in vitro fertilization? Fertil Steril 89:823–831 Gardner DK, Vella P, Lane M et al (1998) Culture and transfer of human blastocysts increases implantation rates and reduces the need for multiple embryo transfers. Fertil Steril 69:84–88 Hamel M, Dufort I, Robert C et al (2008) Identification of differentially expressed markers in human follicular cells associated with competent oocytes. Hum Reprod 23:1118–1127 Hazout A, Dumont-Hassan M, Junca AM et al (2006) High-magnification ICSI overcomes paternal effect resistant to conventional ICSI. Reprod Biomed Online 12:19–25 Jarkovska K, Martinkova J, Liskova L et al (2010) Proteome mining of human follicular fluid reveals a crucial role of complement cascade and key biological pathways in women undergoing in vitro fertilization. J Proteome Res 9:1289–1301 Katz-Jaffe MG, Gardner DK, Schoolcraft WB (2006) Proteomic analysis of individual human embryos to identify novel biomarkers of development and viability. Fertil Steril 85:101–107 Kolialexi A, Tsangaris GT, Mavrou A (2009) Proteomics in prenatal diagnosis. Expert Rev Proteomics 6:111–113 Magli MC, Gianaroli L, Ferraretti AP et al (2007) Embryo morphology and development are dependent on the chromosomal complement. Fertil Steril 87:534–541 Munne S (2006) Chromosome abnormalities and their relationship to morphology and development of human embryos. Reprod Biomed Online 12:234–253 Munne S, Chen S, Colls P et al (2007) Maternal age, morphology, development and chromosome abnormalities in over 6000 cleavage-stage embryos. Reprod Biomed Online 14:628–634 Nagy ZP, Sakkas D, Behr B (2008) Symposium: innovative techniques in human embryo viability assessment. Non-invasive assessment of embryo viability by metabolomic profiling of culture media (‚metabolomics‘). Reprod Biomed Online 17:502–507 Nagy ZP, Jones-Colon S, Roos P et al (2009) Metabolomic assessment of oocyte viability. Reprod Biomed Online 18:219–225 O’Neill C (2005) The role of paf in embryo physiology. Hum Reprod Update 11:215–228 Paidas MJ, Krikun G, Huang SJ et al (2010) A genomic and proteomic investigation of the impact of preimplantation factor on human decidual cells. Am J Obstet Gynecol 202:459 e451–e458 Peddinti D, Memili E, Burgess SC (2010) Proteomics-based systems biology modeling of bovine germinal vesicle stage oocyte and cumulus cell interaction. PLoS One 5:e11240 Peer S, Eltes F, Berkovitz A et al (2007) Is fine morphology of the human sperm nuclei affected by in vitro incubation at 37 degrees C? Fertil Steril 88:1589–1594 Scott RT Jr, Treff NR (2010) Assessing the reproductive competence of individual embryos: a proposal for the validation of new „-omics“ technologies. Fertil Steril 94:791–794 Seli E, Robert C, Sirard MA (2010) OMICS in assisted reproduction: possibilities and pitfalls. Mol Hum Reprod 16:513–530 Seli E, Vergouw CG, Morita H et al (2010) Noninvasive metabolomic profiling as an adjunct to morphology for noninvasive embryo assessment in women undergoing single embryo transfer. Fertil Steril 94:535–542 Seli E, Bruce C, Botros L et al (2011) Receiver operating characteristic (ROC) analysis of day 5 morphology grading and metabolomic Viability Score on predicting implantation outcome. J Assist Reprod Genet 28:137–144 Valbuena D, Martin J, de Pablo JL et al (2001) Increasing levels of estradiol are deleterious to embryonic implantation because they directly affect the embryo. Fertil Steril 76:962–968 Verberg MF, Eijkemans MJ, Macklon NS et al (2009) The clinical significance of the retrieval of a low number of oocytes following mild ovarian stimulation for IVF: a meta-analysis. Hum Reprod Update 15:5–12 Vercammen MJ, Verloes A, Van de Velde H, Haentjens P (2008) Accuracy of soluble human leukocyte antigen-G for predicting pregnancy among women undergoing infertility treatment: meta-analysis. Hum Reprod Update 14:209–218