Predictive Value of Granulosa Cell DNA Damage in the Success of Assisted Reproductive Technique

Zeynep Kamil Maternity and Pediatric Research and Training Hospital60 enrolled

Overview

Deoxyribonucleic acid (DNA) damage of granulosa cells obtained during oocyte retrieval will be evaluated by flow cytometry with detection of Histone H2A.X and Phosphorylated Gamma H2A.X protein levels in patients with low ovarian reserve and unexplained infertile patients as a control group undergoing intracytoplasmic sperm injection (ICSI) treatment. Fertilization, embryo quality, transfer rate, implantation, clinical pregnancy will be recorded as well as demographic data. DNA damage of granulosa cells will be compared between two groups. The effect of DNA damage of granulosa cells on fertilization, quality of oocyte and embryo, implantation, and clinical pregnancy will be also evaluated.

Granulosa cells surrounding the oocytes will be mechanically obtained during the oocyte pick-up procedure in women undergoing intracytoplasmic sperm injection (ICSI) treatment due to unexplained infertility and low ovarian reserve. Deoxyribonucleic acid (DNA) damage in these cells will be evaluated by flow cytometry. Fertilization rates, embryo quality by grading, and transfer rates will also be assessed. Implantation and clinical pregnancy rates will be recorded as well as demographic data such as age, body-mass index, smoking, alcohol use, employment, coexisting chronic disease, infertility duration, etiology of infertility, treatment protocol. Implantation will be evaluated by determination of serum human chorionic gonadotropin (hCG) at day 15 following an embryo transfer. Clinical pregnancy will be diagnosed upon presence of gestational sac on ultrasound examination. DNA damage of granulosa cells will be compared between low ovarian reserve group and control group. The effect of DNA damage of granulosa cells on fertilization, quality of oocyte and embryo, implantation, and clinical pregnancy will be also evaluated.

Study Type

OBSERVATIONAL

Enrollment

Conditions

DNA Damage Granulosa Cells

Eligibility

Sex: FEMALEMin age: 18 YearsMax age: 35 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * For patients who are undergoing in Vitro Fertilization (IVF) treatment with Low ovarian reserve, Antimullerian Hormone level must be lower than 1 ng/mL * For patients who are undergoing in Vitro Fertilization (IVF) treatment with Unexplained infetility, Antimullerian Hormone level must be greater than 1,5 ng/mL Exclusion Criteria: * Chronic systemic disease (rheumatoid arthritis, hypertension, diabetes..) * Endocrinopathy (Thyroid, prolactin... abnormalities) * Chemotherapy or radiotherapy history * Endometriosis * Policystic ovary syndrome * Male infetility

Outcomes

Primary Outcomes

Determining the correlation of ovarian reserve and age factor with DNA Damage markers in granulosa cells.

Demographic data will be noted for each patient at the day of oocyte retrieval, and DNA damage markers will be shown by flowcytometry at the same day.

Time frame: 1 day

Secondary Outcomes

Fertilization defined as the presence of two pronuclei under light microscope one day after intracytoplasmic sperm injection procedure

Presence of two pronuclei under light microscope

Time frame: 1 day after ICSI procedure

Implantation defined as positive serum human chorionic gonadotropin levels 12 days after embryo transfer

Positive human chorionic gonadotropin levels

Time frame: 12 days after embryo transfer

Clinical pregnancy will be defined as the presence of gestational sac in transvaginal ultrasonographic examination 5 weeks after embryo transfer

Presence of a gestational sac in transvaginal ultrasonographic examination

Time frame: 5 weeks