目的:补充了神经营养因子4(NT4)的无基质培养系统是否可以改善人体体外卵泡发育和减数分裂成熟,最终产生可受精的卵母细胞?
结论:NT4补充体外培养物可以显着增强生长,类固醇激素的产生,来自新鲜卵巢髓质的人类次级卵泡的成熟潜力(来自青春期后和青春期前患者),从而产生可受精的卵母细胞。
背景:在体外重建卵泡发育在生育力保存领域至关重要,生殖生物学研究,和生殖毒性评估。然而,体外培养系统的效率仍然欠佳,由于从人类卵泡的体外生长(IVG)获得可受精的卵母细胞仍未实现,关于青春期前女孩卵泡的数据特别少。我们先前已经发现来自IVG的次级卵泡的小鼠卵母细胞缺乏神经内分泌调节。NT4及其相应的受体已在人卵泡中得到鉴定。重要的是,在IVG过程中添加NT4可显着提高小鼠的卵泡生长和卵母细胞成熟率。
■从10名年龄在6至21岁的患者中收集了在卵巢组织冷冻保存(OTC)的组织制备过程中获得的新鲜髓质组织,所有这些人都接受了单侧卵巢切除术作为保留生育能力的一种手段。分离的次级卵泡在无基质系统中在有或没有NT4的情况下在体外单独培养。
方法:次级卵泡,通过酶消化和机械破碎从每个患者中提取,被随机分配到对照组或补充NT4的组(100ng/ml),然后在超低附着板上进行个体培养。通过显微镜评估卵泡生长和活力。抗苗勒管激素(AMH)的水平,雌二醇,和定量培养基中的孕酮。在DEAD盒多肽4(DDX4)染色后,使用共聚焦荧光显微镜鉴定卵母细胞特异性标记。在使用捐赠的精子样品进行IVM和ICSI后,评估了单个卵母细胞的成熟和受精能力。
结果:总体而言,两组的孤立卵泡存活长达6周,随着直径的增加(P<0.05),达到近1毫米的末端直径,证实类固醇生成和卵母细胞标志物(DDX4)的表达,并产生形态正常的MII卵母细胞。与对照组相比,NT4组初始卵泡直径相似(206±61.3vs184±93.4μm),但从培养第9天开始卵泡直径显著增加(P<0.05).从第3周开始,NT4组的雌二醇和孕酮产量显著增加,而两组间AMH产量无显著差异。NT4组快速生长卵泡的比例明显高于对照组(13/23vs6/24,P<0.05)。NT4组中每个活卵泡的MII卵母细胞成熟效率也增加了(对照组与NT4组相比,4/24vs10/23,P<0.05)。值得注意的是,从对照组获得的MII卵母细胞在ICSI后表现出异常受精。相比之下,从NT4组获得的MII卵母细胞进展到胚泡阶段,并显示出转移的潜力。
方法:不适用。
结论:本研究中检查的队列是所有被诊断为重型β-地中海贫血的患者。这种培养系统对其他疾病的患者是否有效仍然未知。由于NT4的选择剂量是根据小鼠的剂量发现确定的,用于人IVG系统的最佳剂量需要进一步确认.从这项研究中获得的卵母细胞和胚胎尚未量化倍性状态或表观遗传特征。
结论:在OTC组织制备过程中获得的新鲜髓质组织可以作为雌性生育力保存的可受精卵母细胞的宝贵来源,即使是青春期前的女孩,没有肿瘤重新引入的威胁。经过对系统的进一步表征和优化,这种文化系统具有提供强大的未来研究工具的潜力,用于全面探索人类卵泡发育机制并进行生殖毒性评估。
背景:这项工作得到了国家重点研发计划(资助号2022YFC2703000)和国家自然科学基金(资助号82271651和81871214)的支持。本研究中用于人卵泡体外培养的培养基已在中国申请了国家发明专利(No.202211330660.7)。专利的发明者,按顺序,are:Y.G.,C.F.,X.L.
OBJECTIVE: Does a matrix-free culture system supplemented with neurotrophic factor 4 (NT4) improve human in vitro follicular development and meiotic maturation, ultimately resulting in fertilizable oocytes?
CONCLUSIONS: NT4 supplementation of in vitro culture significantly enhances the growth, steroid hormone production, and maturity potential of human secondary follicles derived from fresh ovarian medulla (from post- and pre-pubertal patients), thereby yielding fertilizable oocytes.
BACKGROUND: Reconstituting folliculogenesis in vitro is of paramount importance in the realms of fertility preservation, reproductive biology research, and reproductive toxicity assessments. However, the efficiency of in vitro culture systems remains suboptimal, as the attainment of fertilizable oocytes from in vitro growth (IVG) of human follicles remains unachieved, with the data being particularly scant regarding follicles from prepubertal girls. We have previously found that mouse oocytes from secondary follicles derived from IVG are deficient in neuroendocrine regulation. NT4 and its corresponding receptor have been identified in human follicles. Significantly, the addition of NT4 during the IVG process markedly enhances both follicle growth and oocyte maturation rates in mice.
UNASSIGNED: Fresh medulla tissue obtained during tissue preparation for ovarian tissue cryopreservation (OTC) were collected from 10 patients aged from 6 to 21 years old, all of whom had undergone unilateral oophorectomy as a means of fertility preservation. Isolated secondary follicles were individually cultured in vitro with or without NT4 in a matrix-free system.
METHODS: Secondary follicles, extracted via enzymatic digestion and mechanical disruption from each patient, were randomly allocated to either a control group or an NT4-supplemented group (100 ng/ml), followed by individual culture on an ultra-low attachment plate. Follicle growth and viability were assessed by microscopy. Levels of anti-Müllerian hormone (AMH), estradiol, and progesterone in the medium were quantified. An oocyte-specific marker was identified using confocal fluorescence microscopy following DEAD box polypeptide 4 (DDX4) staining. The competence of individual oocytes for maturation and fertilization were assessed after IVM and ICSI with donated sperm samples.
RESULTS: Overall, isolated follicles from both groups survived up to 6 weeks with increasing diameters over the duration (P < 0.05), reaching terminal diameters of almost 1 mm with confirmed steroidogenesis and expression of oocyte marker (DDX4), and producing morphologically normal MII oocytes. When compared with the control group, the NT4 group had a similar initial follicular diameter (206 ± 61.3 vs 184 ± 93.4 μm) but exhibited a significant increase in follicular diameter from the ninth day of culture onwards (P < 0.05). From Week 3, estradiol and progesterone production were significantly increased in the NT4 group, while no significant difference was observed in AMH production between groups. The proportion of \'fast-growth\' follicles in the NT4 group was significantly higher than that in the control group (13/23 vs 6/24, P < 0.05). An increased efficiency of MII oocyte maturation per live follicle in the NT4 group was also observed (control group vs NT4 group, 4/24 vs 10/23, P < 0.05). It is noteworthy that an MII oocyte obtained from the control group exhibited abnormal fertilization after ICSI. In contrast, an MII oocyte acquired from the NT4 group progressed to the blastocyst stage and showed potential for transfer.
METHODS: N/A.
CONCLUSIONS: The cohort examined in this study was all patients diagnosed with beta-thalassemia major. Whether this culture system is effective for patients with other diseases remains unknown. Since the chosen dose of NT4 was established based on dose finding in mice, the optimal dose for use in a human IVG system needs further confirmation. The oocytes and embryos procured from this study have not been quantified for ploidy status or epigenetic signatures.
CONCLUSIONS: Fresh medulla tissue obtained during tissue preparation for OTC may serve as a precious source of fertilizable oocytes for female fertility preservation, even for pre-pubertal girls, without the threat of tumour reintroduction. After further characterization and optimization of the system, this culture system holds the potential to provide a powerful future research tool, for the comprehensive exploration of human follicular development mechanisms and for conducting reproductive toxicity evaluations.
BACKGROUND: This work was supported by the National Key R&D Program of
China (grant number 2022YFC2703000) and National Natural Science Foundation of
China (grant numbers 82271651 and 81871214). The medium used in human follicle in vitro culture in this study has been applied for a national invention patent in
China (No. 202211330660.7). The inventors of the patent, in order, are: Y.G., C.F., and X.L.