Identification and Standardization of a Method That Would Allow the Study of the Metabolic Profile of Blastocoele Lays the Foundation to Assess Blastocyst Metabolomic Profile and Its Relation With Embryo Morphology and Embryo Implantation

While the number of assisted reproduction cycles increases worldwide, the introduction of actual technological improvements in the ability to quickly and non-invasively identify the best embryos for transfer still represents a critical goal for reproductive medicine. Indeed, embryo assessment is currently performed through the analysis of morphology and cleavage rate. Recent studies have sought to identify a correlation between qualitative-quantitative profiles of small molecules of metabolic interest and the outcome of embryo transfer. Some of these molecules seem to be best suited for this purpose, including glucose, lactate, pyruvate or amino acid levels. Approaches relying on both optical and non-optical spectroscopy have been proposed to non-invasively monitor the embryo culture media. However, the non-invasive approach only offers an indirect strategy to monitor embryos and a turn-around solution to bypass the limits of detection of these analytical techniques. In this paper the investigators pave the way for direct assessment of embryos through the mass spectrometry-based analysis of blastocoele fluid, which is withdrawn from the blastocoele cavity prior to cryostorage of blastocysts. The investigators show how it is possible to detect most of the already documented metabolites of interest right at the very heart of the blastocyst, without disrupting the workflow of a classic laboratory pipeline.

Study Overview

• Status: Recruiting
• Conditions: Blastocoele Fluid

• Study Type: Observational
• Enrollment (Anticipated): 100

Contacts and Locations

• Study Contact: Name: Simone Palini, biology; Phone Number: +39 339 4572101; Email: simonepalini@yahoo.it
• Study Contact Backup: Name: Silvia De Stefani, Biotecnology; Phone Number: +39 320 1111937; Email: silvia.destefani83@libero.it

Study Locations

• Italy
  • Rimini
    • Cattolica, Rimini, Italy, 47841
      • Recruiting
      • Cervesi Hospital
      • Contact: Simone Palini, biology; Phone Number: +39 339 4572101; Email: simonepalini@yahoo.it
      • Contact: Silvia De Stefani, Biotecnology; Phone Number: +39 320 1111937; Email: silvia.destefani83@libero.it

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 45 years (Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: Female

• Sampling Method: Probability Sample

Study Population

All the patients that are unable to be subjected to embryo transfer due to her ovarian hyperstimulation. In those cases the embryos will be vitrified and during this procedure we collapse the blastocyst sucking the fluid.

Description

Inclusion Criteria:

• Ovarian hyperstimulation disease
• Blastocyst formation

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort
Hyper1; Only patients who achieved hyperstimulation pathology after external administration of gonadotrophin during IVF treatment

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
standardize the method of aspiration	The method for blastocyst micropuncturing and aspiration of blastocoel fluid is according also to the last literature about blastocyst vitrification. In brief, expanded day 5 blastocysts were removed from culture and transferred to a 30 nl droplet of pre-warmed Hepes buffer. An injection pipette was introduced avoiding contaminations through the trophectoderm, and blastocoel fluid was aspirated until the blastocyst had fully collapsed around the pipette. The retrieved fluids were expelled into new purified water drops and frozen at -80°C alongside 0.5 nl control droplets of purified water.	2 months
metabolite detection	metabolite detection through rapid resolution reversed phase (RR-RP) high performance liquid chromatography (HPLC)-mass spectrometry (MS). From sample volumes as low as 0.5 nl we could detect and quantify against external standards a group of metabolites, whose roles in blastocyst development and embryo metabolism have long been postulated. The list included i) ATP adenosine triphosphate ; ii) glucose-6-phosphate; iii) lactate; iv) NAD+ nicotinamide-adenine dinucleotide+ and v) NADH and vi) NADPH nicotinamide-adenine dinucleotide phosphate; vii) 6-phosphogluconic acid; viii) glutamic acid and ix) α-ketoglutarate.	6 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
analysis of the correlation between blastocyst morphology and metabolic profile in the blastocoele fluid	blastocyst classify according to morphological criteria in the book "Atlas of Human Blastocyst" by L. Veeck and associate, to each morphological class a characteristic metabolic profile, in order to scientifically validate the observational and objective criteria up to now used in our lab	1 year

Collaborators and Investigators

• Sponsor: Cervesi Hospital, Cattolica, Italy
• Collaborators: Istituto Clinico Humanitas; Università degli Studi La Tuscia; Tecnobios Riproduzione
• Investigators: Study Director: Simone Palini, biology, Cervesi Hospital, Cattolica, Italy

Study record dates

Study Major Dates

• Study Start: September 1, 2011
• Primary Completion (Anticipated): January 1, 2022
• Study Completion (Anticipated): December 1, 2023

Study Registration Dates

• First Submitted: August 29, 2011
• First Submitted That Met QC Criteria: August 31, 2011
• First Posted (Estimate): September 1, 2011

Study Record Updates

• Last Update Posted (Actual): February 9, 2021
• Last Update Submitted That Met QC Criteria: February 8, 2021
• Last Verified: July 1, 2020

More Information

Terms related to this study

• Keywords: metabolomics; mass spectrometry; blastocoele fluid
• Other Study ID Numbers: SS4e