Fertilization and embryonic development of human oocytes after cooling.

Injury to living cells resulting from rapid cooling to temperatures at or near 0 degrees C has long been recognized, and the phenomenon, which is termed 'cold shock', has been known to occur in some mammalian gametes. Although human embryos have been successfully stored at low temperatures, cryopreservation of the human oocyte is proving to be more difficult. Whether or not this lack of success is a direct result of cellular injury brought about by 'cold shock' is the purpose of the current investigation. Human oocytes were cooled, in the absence of cryoprotectants, at two different cooling rates (-3 degrees C/min and -1000+ degrees C/min) to a temperature of 0 degrees C and rewarmed prior to insemination. In both cases fertilization after cooling was similar to the rates achieved in a routine in-vitro fertilization and embryo transfer procedure. After cooling at -3 degrees C/min, the rate of fertilization was 19/22 (86%) and after cooling at -1000+ degrees C/min, 9/9 (100%), with non-cooled control rates of 62/87 (71%) and 35/50 (70%) respectively. Fertilized oocytes from both groups were successfully cultured for a further 24 h before termination of the experiment.     

Observational clinical follow-up of oocyte cryopreservation using a slow-freezing method with 1,2-propanediol plus sucrose followed by ICSI

BACKGROUND: The value of oocyte cryopreservation remains controversial. Two major problems exist: poor survival and injury to the oocyte meiotic spindle after freezing and thawing. METHODS: For slow oocyte cryopreservation, we used 1.5 mol/l 1,2-propanediol and 0.3 mol/l sucrose. We waited 3 h after thawing for possible recovery of the meiotic spindles before performing ICSI. RESULTS: Forty-three women undergoing IVF or ICSI cycles cryopreserved some or all of their harvested oocytes; of these, 20 thawed their cryopreserved oocytes for personal use and one for donation. The survival rate of oocytes after thawing was 75%, with 67% of oocytes fertilizing normally after ICSI. All 21 cycles (100%) resulted in fertilization and embryo transfers. Seven pregnancies (33%) resulted. Four women delivered five babies with normal karyotypes. Three conceptions are ongoing. Compared to 38 cycles of frozen-thawed embryos at the pronuclear stage in the same period, the percentages of survival, pregnancy and implantation were similar. Additionally, four unmarried women with white blood cell diseases underwent oocyte freezing before preconditioning treatment for haematopoietic stem cell transplantation. CONCLUSIONS: This protocol achieved reproducible success of survival, fertilization and pregnancy for freezing and thawing of human oocytes. The 3 h post-thaw incubation could permit restoration of the meiotic spindles, thus facilitating normal fertilization.     

Permeability of human oocytes to ethylene glycol and their survival and spindle configurations after slow cooling cryopreservation

BACKGROUND: To develop novel cryopreservation methods, we estimated the permeability coefficients Lp (hydraulic conductivity) and P(EG) (cryoprotectant permeability) of mature human oocytes after exposure to ethylene glycol (EG) and tested the efficiency of a multi-step slow cooling protocol based on this cryoprotectant. METHODS: Oocytes were perfused with 1.5 mol/l EG for 10 min. Oocyte volume at each time point was calculated and normalized to the original volume. Slow cooling was conducted by exposing oocytes to increasing EG concentrations (0.5, 1.0 and 1.5 mol/l n = 155) or 1.5 mol/l of propane-1,2-diol (PrOH) n = 102. Oocytes which survived cryopreservation n = 80 and fresh oocytes n = 73 were prepared for confocal microscopy analysis of the meiotic spindle. RESULTS: During EG exposure, oocytes underwent an abrupt 50% volume reduction. Complete recovery of the initial volume was not observed. From the values of a best fit plot, the coefficients Lp = 0.82 +/- 0.29 microm min(-1) atm(-1) (mean +/- SD) and P(EG) 0.10 +/- 0.01 microm s(-1) were generated. Survival rates after freezing with EG were lower than with PrOH (51.6 versus 71.5%, respectively, P < 0.05). The frequencies of normal spindle configuration were lower in frozen EG and frozen PrOH oocytes compared with fresh oocytes (53.8, 50.9 and 66.7%, respectively, P < 0.05). CONCLUSIONS: The oocyte plasmalemma possesses limited permeability to EG and EG exposure causes considerable osmotic stress. However, post-thaw rates of survival and normal meiotic spindle organization may be preserved by protocols which are designed in order to minimize osmotic stress.     

Cryopreservation of human oocytes: a review of current problems and perspectives

It is well recognized that the ability to cryopreserve unfertilizedhuman oocytes would make a significant contribution to infertilitytreatment. However, despite considerable interest, very fewsuccessful pregnancies have arisen from cryopreserved oocytesafter thawing, insemination and transfer of the subsequent embryo.The reasons for this lack of progress may well result from adearth of information on how the various biophysical changesduring a cryopreservation regimen affect human oocyte function.Recently, fundamental studies on the effects of cooling, membranepermeability, cryoprotectant addition and ice formation havebeen performed on human oocytes by a number of groups, and theseform the basis of the current review. It is likely that successfulhuman oocyte cryopreservation will only follow once these factorsare fully understood, but the existing base of knowledge shouldprovide a platform for further improvements in the techniquescurrently employed.     

Fertilization and early embryology: Vitrification of human oocytes following minimal exposure to cryoprotectants; initial studies on fertilization and embryonic development

Investigations were made into the low temperature preservationof pre-ovulatory human oocytes by vitrification using a methodof brief exposure of the oocytes to the vitrification solutionat room temperature. Assessments of morphological survival,fertilization and embryonic development were recorded. All thoseoocytes exposed to the vitrification solution alone were morphologicallynormal and 86% of them were fertilized after incubation withspermatozoa. All the fertilized ova (86%) underwent cell division.Following cooling to –196°C, morphological survival(65%) and fertilization (45%) rates remained high. However,in all vitrified oocytes, embryonic cell division and furtherdevelopment were inhibited. From our study it appears that freshhuman oocytes can be vitrified using only brief exposure tocryoprotective agents and survive to undergo fertilization.However, progress remains to be made in achieving further embryonicdevelopment.     

Cryoloop vitrification of rabbit oocytes

BACKGROUND: Vitrification is assumed to be a promising method to cryopreserve human oocytes but still needs optimization. In this study, rabbit oocytes (fertilized by ICSI) were vitrified with cryoloops, and the effect of three different cryopreservation protocols on spindle configuration and embryo quality was assessed. METHODS: Metaphase II rabbit oocytes were randomly assigned to one of four groups: (i) control; (ii) E40 [40% ethylene glycol (EG)]; (iii) ED20 [20% EG + 20% dimethylsulphoxide (DMSO)]; and (iv) ED20 + M (20% EG + 20% DMSO + vitrification machine). After warming, one part of each group was fertilized by ICSI to examine the fertilization and embryo cleavage ability, and the others were immunostained for tubulin and chromatin before visualization using confocal microscopy. RESULTS: The survival rates after warming were 79.1, 83.1 and 82.3%, respectively. In protocols E40 and ED20, the spindles were severely injured and the embryo quality not good compared with those in the ED20 + M group. CONCLUSIONS: The fastest cooling rate in combination with EG and DMSO as cryoprotectants had the fewest adverse effects on the spindle configuration of rabbit oocytes and embryo development.     

Cryoprotection of human oocytes: inappropriate exposure to DMSO reduces fertilization rates

Human oocytes were exposed to the cryoprotectant dimethyl-sulphoxide (DMSO) at either 4 or 37 degrees C. Subsequent fertilization of these oocytes showed that exposure to DMSO at 37 degrees C was associated with a greatly reduced fertilization rate when compared to untreated control oocytes, whereas no such reduction was seen in oocytes exposed to DMSO at 4 degrees C. The significance of these results for the potential cryopreservation of human oocytes is discussed.     

Cryopreservation of human and rabbit oocytes and one-cell embryos: a comparison of DMSO and propanediol

The aim of this study was to improve the cryopreservation ofhuman oocytes and pronuclear embryos. One-step and multiple-stepaddition of dimethyl sulphoxide (DMSO) and 1, 2-propanediol(PROH) and three different freezing protocols with intermediatetemperatures of –35, –70 and –110°C wereinvestigated. This work was performed using rabbit oocytes aswell as human oocytes and one-cell embryos from the routineIVF programme. Also, human polyploid pronucleate oocytes wereused in controlled prospective studies of morphological intactnessand development in vitro. Rabbit oocytes survived best (113/126)when PROH was added in one step and controlled freezing stoppedat –110°C. But the development was better (141/187)if DMSO was added in multiple steps and the oocytes were cooledto –70°C before being plunged into liquid nitrogen.The mode of addition of the cryoprotectant influenced developmentonly if slow freezing was stopped at –35°C (51 versus34%). Using PROH, the development after thawing was also betterif cooling was stopped at –35°C (51 versus 37%) andDMSO was superior to PROH when the oocytes were cooled slowlyto –110°C (66 versus 37%). In the human, significantlymore pronucleated than unfertilized oocytes developed afterfreezing (92 versus 50%). The best results were achieved withpronuclear embryos using 1.5 M PROH and cooling to –110°C,when 91.7% of the surviving oocytes developed further. Thisis a marked improvement of the development rate and comparableto embryo freezing     

The intra-vaginal culture technique for supernumerary oocytes from gamete intra-Fallopian transfer

The intra-vaginal culture technique has been utilized for supernumerary oocytes produced as a result of gamete intra-Fallopian transfer therapy. This has enabled knowledge regarding fertilization to be gained and in addition, by adapting the technique to include a transportational element, it has been possible to perform embryo cryopreservation in a separate unit. Analysis of the results of 72 GIFT treatment cycles reveals that when more than four oocytes were collected at laparoscopy, 15/32 (47%) pregnancies were achieved, in comparison with 7/40 pregnancies (17.5%) when four or fewer oocytes were recovered (P less than 0.01). Whilst the GIFT pregnancy rate was higher when spare oocytes were fertilized and embryos cryopreserved (9/16; 56%), six of the 16 patients (37.5%) with failed fertilization of spare oocytes still achieved a GIFT pregnancy.     

Fertilization and development of mouse oocytes cryopreserved using a theoretically optimized protocol

Rational design of a cryopreservation protocol was demonstratedby using theoretical models of the cryopreservation processto develop an optimal freezing protocol for mouse oocytes. Acoupled mechanistic model of the processes of freeze-inducedcell dehydration and intracellular ice formation was developed,and cryomicroscopical measurements of intracellular ice formationkinetics were used to determine biophysical parameters requiredby the model, and to test model predictions of the freezingbehaviour of mouse oocytes. A simple phenomenological modelfor oocyte damage resulting from exposure to concentrated electrolyteand cryoprotectant solutions during cryopreservation was obtainedby defining a cost function equal to the duration of the freezingprotocol. A two-step freezing protocol was theoretically optimizedby using a sequential simplex algorithm to minimize the costfunction, subject to the constraint that the predicted probabilityof intracellular ice formation remain below 5%, yielding a putativeoptimum at the cooling rate B = 0.59°C/min, and plunge temperatureTp = –67°C. By systematically varying B and Tp aboutthese values in experiments with mouse oocytes cryopreservedin 1.5 M dimethyl sulphoxide, the maximal recovery of intactoocytes with a normal morphology (82%) was obtained for B =0.59°C/min and Tp = –80°C. Further evaluationof the fertilizability and developmental capacity of oocytescryopreserved using the optimized protocol yielded cleavageto the 2-cell stage in 65% of oocytes inseminated, and blastocystformation in 50% of these 2-cell embryos.     

Intracytoplasmic sperm injection and embryo development of human oocytes cryopreserved using 1,2-propanediol

This study reports the subsequent embryo development of cryopreservedmature human oocytes following insemination or intracytoplasmicsperm injection (ICSI). Metaphase II oocytes were cryopreservedusing a slow freezingrapid thawing procedure employing the cryoprotectant1,2- propanediol. The study was conducted at two centres. Thenormal insemination of cryopreserved oocytes was undertakenin one centre, and ICSI of cryopreserved oocytes in the other.Both methods resulted in a 50% normal fertilization rate. Alow rate of abnormal fertilization was observed in the inseminatedgroup of oocytes (5%) compared with 21% for the ICSI oocytes;this was not significantly different. Embryo development wasassessed daily for 7 days. All normal fertilized cryopreservedoocytes in both groups cleaved on day 2, with a similar appearanceto in-vitro fertilization and ICSI embryos. In the normal inseminatedoocytes, there was a significant decrease in the number of embryoscleaving on day 3 (33%) compared with the development of ICSIoocytes, with a subsequent gradual reduction over days 4 and5 (22 and 11% respectively) resulting in one early blastocyston day 7 (11%). In contrast, all ICSI-generated embryos continuedto cleave on day 3, with a gradual reduction over subsequentdays (day 4, 86%; day 5, 57%; day 6, 43%; day 7, 29%). By day7, two of the blastocysts had started to hatch, resulting ina 66% hatching rate of blastocysts formed from ICSI of cryopreservedoocytes. This is the first study to show normal developmentto the hatching blastocyst stage following ICSI of cryopreservedhuman oocytes.     

Fertilization and early embryology: Parthenogenetic activation of human oocytes following cryopreservation using 1, 2-propanediol

Fresh and aged human oocytes were cryopreserved using 1, 2-propanediol(PROH). After thawing, the oocytes were cultured for 20 h andexamined for parthenogenetic activation using light microscopyand an ultraviolet DNA stain. Control fresh or aged oocytesand oocytes exposed to PROH without cryopreservation were alsoexamined for activation. No control oocytes were observed toactivate spontaneously (n = 43) and parthenogenetic activationwas not induced by exposure to PROH alone (n = 26). In bothfresh and aged cryopreserved oocytes, 27 and 29% of the oocytesrespectively were activated, and these proportions were significantlyelevated compared with the controls (P < 0.01). Althougha similar rate of activation was observed for the cryopreservedfresh and aged oocytes, the form of parthenogenetic activationvaried between these two types of oocyte. A single pronucleuswas observed in 18% of the fresh and 5% of the aged cryopreservedoocytes. In contrast, the presence of two or more pronucleiwas observed in 0% of the fresh and 19% of the aged cryopreservedoocytes.     

Combined impact of the number of pre-ovulatory oocytes and cryopreservation on IVF outcome

Three hundred and twenty-seven consecutive in-vitro fertilization (IVF) cycles in which luteal-phase leuprolide had been given were ranked according to the number of pre-ovulatory oocytes obtained (1-5, 6-10, greater than 10). Excess pre-embryos were cryopreserved at the pronuclear stage and later transferred into monitored natural cycles on the day after ovulation. The results indicate that the retrieval of large numbers of pre-ovulatory oocytes (greater than 10) has a small negative impact on oocyte quality as judged by fertilization rates (4% lower). However, implantation was not impaired compared to lower levels of retrieval in either the original IVF or subsequent cryo-thaw cycles. Overall, despite the small reduction in fertilization rate, the retrieval of many pre-ovulatory oocytes has produced a 'take-home baby rate' per stimulation cycle of 28.3% when 6-10 pre-ovulatory oocytes were retrieved and 41.5% when greater than 10 were retrieved: even higher rates are anticipated when the remaining cryopreserved pre-embryos are ultimately thawed.     

Permeability characteristics and osmotic sensitivity of rhesus monkey (Macaca mulatta) oocytes

BACKGROUND: Permeability characteristics and sensitivity to osmotic shock are principal parameters that are important to derive procedures for the successful cryopreservation of mammalian oocytes. METHODS AND RESULTS: The osmotically inactive volume of rhesus monkey oocytes was determined by measuring their volumes in the presence of hypertonic solutions of sucrose from 0.2 to 1.5 mol/l, compared with their volume in isotonic TALP-HEPES solution. Boyle-van't Hoff plots at infinite osmolality indicated that the non-osmotic volumes of immature and mature oocytes were 20 and 17% respectively. Osmotic responses of oocytes exposed to 1.0 mol/l solutions of glycerol, dimethylsulphoxide (DMSO) and ethylene glycol (EG) were determined. Rhesus monkey oocytes appeared to be less permeable to glycerol than to DMSO or to EG. Sensitivity of oocytes to osmotic shock was determined by exposing them to various solutions of EG (0.1 to 5.0 mol/l) and then abruptly diluting them into isotonic medium. Morphological survival, as measured by membrane integrity, of oocytes diluted out of EG depended significantly on the concentration of EG (P < 0.01). CONCLUSION: Determination of permeability characteristics and sensitivity to osmotic shock of rhesus oocytes will aid in the derivation of procedures for their cryopreservation.     

Human oocyte cryopreservation: new perspectives regarding oocyte survival

The success of human oocyte cryopreservation depends on morphological and biophysical factors that could influence oocyte survival after thawing. Various attempts to cryopreserve human oocytes have been performed with contrasting results. Therefore the effect of some factors, such as the presence or absence of the cumulus oophorus, the sucrose concentration in the freezing solution and the exposure time to cryoprotectants, on human oocyte survival after thawing were investigated. The oocytes were cryopreserved in 1,2-propanediol added with sucrose, using a slow-freezing-rapid-thawing programme. After thawing, the oocytes were inseminated by intracytoplasmic sperm injection (ICSI) and the outcomes of insemination and subsequent embryo development were also recorded. The post-thaw cryosurvival rate was not different for the oocytes cryopreserved with their cumuli partially removed mechanically (56%) when compared with those cryopreserved with their cumuli totally removed enzymatically (53%). On the contrary, a significantly higher survival rate was obtained when the oocytes were cryopreserved in the presence of a doubled sucrose concentration (0.2 mol/l) in the freezing solution and the survival rate was even higher when the sucrose concentration was tripled (0.3 mol/l) (60 versus 82% P < 0.001). Furthermore, a longer exposure time (from 10.5 to 15 min) to cryoprotectants, before lowering the temperature, significantly increased the oocyte survival rate (P < 0.005). Intracytoplasmic sperm injection produced a good fertilization rate (57%) of thawed oocytes and a high embryo cleavage rate (91%) and a satisfactory embryo morphology was observed (14 and 34% for grade I and grade II embryos respectively).     

Birth following vitrification of a small number of human oocytes: case report

We report the birth of a healthy baby girl at 37 weeks gestation to a 47 year old recipient, after vitrification of mature oocytes from four in-vitro fertilization (IVF) patients. A total of 17 oocytes was vitrified in 1-2 microl of ethylene glycol (40%) and 0.6 mol/l sucrose (20.54%) in open pulled straws. Eleven oocytes survived after vitrification and five pronuclear zygotes were obtained after intracytoplasmic sperm injection (ICSI). Three embryos were transferred to three patients, two of whom were the original oocyte donors and pregnancy was not established. The third embryo was donated to a 47 year old infertile woman after preimplantation diagnosis had confirmed euploidy for chromosomes X, 13, 14, 15, 16, 18, 21 and 22. The successfully completed pregnancy is encouraging for further research to explore the potential benefits of vitrification for the cryopreservation of human oocytes, given the relatively low success of conventional freezing of human oocytes by slow cooling methods.     

Abnormalities of sperm chromosome condensation in the cytoplasm of immature human oocytes

This study analysed data from 27 couples in an IVF-ET programme. The maternal age range was 28-43 years. Statistical analyses on 182 oocytes showed no maternal age effect on the number of oocytes, their stage of maturation or their fertilization rate. There was also no effect of age of either partner or of seminal parameters on the fertilization rate. In contrast, occurrence of diploid oocytes was confined to three of the older women. The proportion of failures of fertilization was significantly higher in immature oocytes. These failures, which included 18 uncleaved, multipronuclear or fragmented zygotes, were related to disturbances of oocyte maturation. Four (out of five) oocytes re-inseminated with fresh semen produced polyspermy. One zygote showed marked asynchrony in the development of the two pronuclei. In eight zygotes the paternal complements had an allocyclic pattern of chromosome condensation between and within chromosomes or chromosome regions. In two other zygotes the paternal complement showed one chromosome prematurely condensed. This single-chromatid chromosome would be lost in the following cleavage division, suggesting that aneuploidy due to 'anaphase lag' is not a rare event during embryo cleavage.     

Developmental potential of murine germinal vesicle stage cumulus-oocyte complexes following exposure to dimethylsulphoxide or cryopreservation: loss of membrane integrity of cumulus cells after thawing

BACKGROUND: Cumulus cells of the cumulus-oocyte complex (COC) are important in oocyte maturation. Thus, in preserving immature oocytes it is prudent to also preserve their associated cumulus cells. The survival and function of oocytes and their associated cumulus cells was assessed following cryopreservation or exposure to cryoprotectant without freezing. METHODS: Immature COCs were collected from mice primed with pregnant mare's serum. COCs were either slow-cooled or exposed to 1.5 mol/l dimethylsulphoxide without freezing. Treated and fresh COCs were stained for membrane integrity or, after in-vitro maturation and IVF, were assessed for developmental capability. Development of cumulus-denuded fresh oocytes, as well as denuded and frozen-thawed oocytes co-cultured with fresh cumulus cells, was assessed. RESULTS: Slow-cooled oocytes had significantly reduced coverage by intact cumulus cells compared with fresh COCs. Cumulus cell association and developmental capability were not substantially affected by exposure to cryoprotectant without freezing. Denuded fresh oocytes and cryopreserved COCs had decreased developmental potential that was not overcome by co-culture with fresh cumulus cells. CONCLUSIONS: Loss of association between oocyte and cumulus cells was induced by cryopreservation, but not by treatment with cryoprotectant alone. The data indicate that direct physical contact between cumulus cells and the oocyte, throughout maturation, improves subsequent embryo development.     

Rescue of oocytes from antral follicles of cryopreserved mouse ovaries: competence to undergo maturation, embryogenesis, and development to term

Only primordial and primary follicles of frozen-thawed mouse ovaries survive after grafting to the ovarian bursa; large secondary follicles and antral follicles together with the oocytes contained in them degenerate. This study was undertaken to determine whether fully grown oocytes isolated from the antral follicles of frozen-thawed mouse ovaries are viable and can be rescued to undergo maturation, fertilization, and embryo development in vitro. Ovaries were cryopreserved after removal from 22-day-old (C57BL/6J x SJL/J)F(1) mice, with or without prior priming with equine chorionic gonadotrophin, and fresh non-frozen ovaries were used as controls. Only cumulus cell-denuded oocytes were recovered from frozen unprimed ovaries while both cumulus cell-enclosed and denuded oocytes were retrieved from frozen primed ovaries. Oocytes from both groups of frozen-thawed ovaries were able to undergo maturation, fertilization, and development to the blastocyst stage in vitro, though at lower percentages than oocytes from control unfrozen ovaries. Moreover, 19% of 2-cell stage embryos derived from frozen-thawed primed ovaries, compared with 42% of embryos derived from control primed ovaries, developed to term after transfer to pseudopregnant foster mothers (not significantly different). Therefore, fully grown oocytes in antral follicles survive the cryopreservation protocol, as demonstrated by maturation, fertilization and embryo development in vitro, and development to term after embryo transfer.     

Evaluation of the fertilization potential of freshly isolated, in-vitro cultured and cryopreserved human spermatids by injection into hamster oocytes.

The clinical potential for fertilization was examined by using the human sperm-hamster oocyte assay system after microinjection of round (RS), elongating (ES) or elongated (EtedS) spermatids retrieved from obstructive and non-obstructive azoospermic patients. Freshly isolated, in-vitro cultured and cryopreserved spermatids were utilized. For each category of microinjected spermatids, we demonstrated that the more mature the injected spermatid, the higher the incidence of fertilization (for freshly isolated spermatids, P < 0.006 and P < 0.008, for in-vitro cultured spermatids, P < 0.007 and P < 0.007 and for cryopreserved spermatids, P < 0.006 and P < 0.007 for obstructive and non-obstructive azoospermic patients respectively). Short term in-vitro culture of the spermatogenic cells did not improve the incidence of fertilization. However, cryopreservation significantly decreased (P < 0.001) the incidence of fertilization when each corresponding spermatogenic cell stage was compared. The incidence of fertilization was not statistically different when corresponding stages of spermatogenic cells were compared from obstructive and non-obstructive patients.