REPRODUCTICE TECHNOLOGY (ART) USED. Hlinka D. Svobodov L. Hrniarov E. - PowerPoint PPT Presentation

THE EMBRYO AS A WINDOW BACK TO THE QUALITY OF THE GAMETS AND ASSISTED REPRODUCTICE TECHNOLOGY (ART) USED. Hlinka D. Svobodová L. Hrnčiarová E. Reichová T. Hulvert J. Krutinová D. Švábiková L. Saveljeva N. Stránska G. a Lazarovská S. Prague Fertility Centre

THE MILESTONES OF HUMAN EMBRYOLOGY GENETIC TESTING ICSI TIME-LAPSE

TIME-LAPSE CONTRIBUTION STANDARDISATION OF EMBRYO GRADING NEW INSIGHTS INTO EMBRYONIC DEVELOPMENT Patient A Patient B

TL SYSTEM IS USED JUST AS AN UNDISTURBED CULTURE WHY?

TL SYSTEM IS USED JUST AS AN UNDISTURBED CULTURE Healthy kids born from ugly embryos Paradoxically, sometimes it could be better to transfer the worse embryo in stimulation cycle and the better one use for next cryo cycle

TL SYSTEM IS USED JUST AS AN UNDISTURBED CULTURE Except from PGT cycles sooner or later all developing embryos are transferred and, therefore, the exact embryo scoring is not so urgently required by embryologists No one embryolog is happy to annotate manually all of embryos

THE POTENTIAL OF TL SYSTEM IS MUCH HIGHER THAN THE EMBRYO SCORING TL system could be used as a diagnostic and quality control tool Which marker is  Sperm dependent?  Oocyte dependent?  Induced by in-vitro conditions/methods?

THE POTENTIAL OF TL SYSTEM IS MUCH HIGHER THAN THE EMBRYO SCORING Untill now no reliable diagnostic marker has been proven ? ? ? ? ? ? ? ? The problem is in extreme embryo plasticity where one cause can be expressed by many effects and one anomaly can be caused by many different reasons

THE POTENTIAL OF TL SYSTEM IS MUCH HIGHER THAN THE EMBRYO SCORING We have focused on causality of the processses ? ? ? ? ? ? ? ?

THE POTENTIAL OF TL SYSTEM IS MUCH HIGHER THAN THE EMBRYO SCORING Objects of our studies are the most important embryo contributors: Oocyte ICSI the major biological the ultimate contributor to the unnatural embryo creation intervention

THE ROLE OF OOCYTE MATURITY AND ICSI TIMING Ooplasmic maturation Nuclear maturation = = Asynchrony Completion of meiosis Developmental competences the 2 nd Pb No 1 st Pb the 1 st Pb GV TII TII TII MI AI- TI TI IK AII AI MI I MII (metaphase) oocyte = developmentally competent oocyte Maturation time 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 Working Hrs 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 Days D-2 D-1 D0 D1 Trigger OPU ICSI

THE ROLE OF OOCYTE MATURITY AND ICSI TIMING Ooplasmic maturation Nuclear maturation = = Completion of meiosis Developmental competences the 2 nd Pb No 1 st Pb the 1 st Pb Fully competent oocyte To cover the whole oocyte dependent period GV TII TII TII MI AI- TI TI IK AII AI MI I The oocyte ´ s growth • transcription • protheinsynthesis No relevant marker to assess ooplasmic maturation Maturation time 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 Working Hrs 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 Days D-2 D-1 D0 D1 Trigger OPU ICSI

THE ROLE OF OOCYTE MATURITY AND ICSI TIMING Ooplasmic maturation Nuclear maturation = = Completion of meiosis Developmental competences the 2 nd Pb No 1 st Pb the 1 st Pb Fully competent oocyte To cover the whole oocyte dependent period GV TII TII TII MI AI- TI TI IK AII AI MI I The oocyte ´ s growth 1PN • transcription • protheinsynthesis Maturation time 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 Working Hrs 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 Days D-2 D-1 D0 D1 Trigger OPU ICSI

THE ROLE OF OOCYTE MATURITY AND ICSI TIMING Ooplasmic maturation Nuclear maturation = = Completion of meiosis Developmental competences the 2 nd Pb No 1 st Pb the 1 st Pb Fully competent oocyte To cover the whole oocyte dependent period GV TII TII TII MI AI- TI TI IK AII AI MI I It will not be the case for all oocytes The oocyte ´ s growth • transcription Still growing oocytes • protheinsynthesis Chromosome condensation and stop of transcription Maturation time 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 Working Hrs 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 Days D-2 D-1 D0 D1 Trigger OPU ICSI

THE ROLE OF OOCYTE MATURITY AND ICSI TIMING Ooplasmic maturation Nuclear maturation = = Completion of meiosis Developmental competences the 2 nd Pb No 1 st Pb the 1 st Pb Fully competent oocyte To cover the whole oocyte dependent period GV TII TII TII MI AI- TI TI IK AII AI MI I Unable to cover the whole oocyte dependent period Unable to cover the whole oocyte dependent period The oocyte ´ s growth • transcription Unable to cover the whole oocyte dependent period Still growing oocytes • protheinsynthesis Maturation time 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 Working Hrs 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 Days D-2 D-1 D0 D1 Trigger OPU ICSI

THE ROLE OF OOCYTE MATURITY AND ICSI TIMING Ooplasmic maturation Nuclear maturation = = Completion of meiosis Developmental competences the 2 nd Pb No 1 st Pb the 1 st Pb Fully competent oocyte To cover the whole oocyte dependent period GV TII TII TII MI AI- TI TI IK AII AI MI I Normal (young) responders Unable to cover the whole oocyte dependent period Poor (aged) responders Maturation time 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 Working Hrs 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 Days D-2 D-1 D0 D1 Trigger OPU ICSI

DIFFERENT TIMING OF MATURATION IN DIFFERENT GROUPS OF PATIENTS PLM: Maturation is delayed (TI – MII transition) in poor responders when compared to normal (young) responders Normal responder ………… tTI - MII: approx. 2 hrs Impaired competences can alter the next embryonic development Delayed responder ………… tTI - MII: approx. 4,5 hrs

THE ROLE OF OOCYTE MATURITY AND ICSI TIMING Ooplasmic maturation Nuclear maturation = = Completion of meiosis Developmental competences the 2 nd Pb No 1 st Pb the 1 st Pb GV TII TII TII MI AI- TI TI IK AII AI MII Oocyte growth 2 nd meiosis 1 st meiosis • Chromosome condensation • Chromosome condensation • Chromosome segregation • Chromosome segregation Maturation time 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 51 Working Hrs 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 Days D-2 D-1 D0 D1 Trigger OPU ICSI