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In Vitro Fertilization (IVF)
In Vitro Fertilization (IVF)
Introduction
Chapter 2
For the past few decades, reproductive biotechnolo-
gies such as artificial insemination (AI), embryo trans-
In Vitro Fertilization (IVF) fer (ET), and embryo production via in vitro fertilisation
(IVF), have undergone incredible advances.
Diego MORENO GARCIA1, Alberto NERA1, Lamia
The first IVF of a mammalian oocyte, confirmed cy-
BRIAND1, Emmanuel TOPIE1, Djemil BENCHARIF1
tologically, was performed in a rabbit using spermatozoa
and Daniel TAINTURIER1
that had capacitated in the uterus and recently ovulated
Laboratory of Biotechnology and Pathology of Repro-
1 oocytes [1]. Five years later, the birth of baby rabbits con-
duction, Nantes-Atlantic National College of Veterinary firmed the biological normality of in vitro fertilisation.
Medicine, France For practical reasons, but also to understand the mecha-
nisms of capacitation, fertilisations were then attempted
*
Corresponding Author: Prof. Daniel TAINTURIER, using spermatozoa that had capacitated in vitro. The first
Laboratory of Biotechnology and Pathology of Repro- IVF under these conditions were achieved in rodents
duction, Nantes-Atlantic National College of Veterinary (hamsters, 1963; mice, 1968), then in man in 1978 [2], and
Medicine, Food Science and Engineering - Oniris. CS much later in large domestic mammals: the first IVF calf
40706, 44307 NANTES Cedex, France, Email: daniel. was born in 1982 [3], then the first goats in 1985, lambs
tainturier@oniris-nantes.fr and piglets in 1986, and the first foal in 1990 [4]. Some
time later, IVF was achieved using oocytes that had been
First Published February 26, 2016 matured in vitro in various species, with the first calf born
under these conditions in 1986, the first piglet in 1988,
Copyright: © 2016 Daniel TAINTURIER et al. and the first lamb in 1990 [4].
This article is distributed under the terms of the Creative In reality, IVF is already an integral part of the em-
Commons Attribution 4.0 International License bryo transfer (ET) process used for the industrial produc-
(http://creativecommons.org/licenses/by/4.0/), which tion of bovine embryos; this process involves in vitro oo-
permits unrestricted use, distribution, and reproduction cyte maturation, IVF, in vitro embryo development, and
in any medium, provided you give appropriate credit to finally the in utero transplantation of the embryo in the
the original author(s) and the source. recipient dam. IVF is also a valuable means of learning
more about the mechanisms involved in vivo fertilisation.
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the multiplication of high-performance female descend- of small antral follicles and to observe the Cumulus Oo-
ants using oocytes harvested from animals with a known cyte Complexes (COC) in vivo [11].
genetic potential. The oocytes are harvested via a needle
introduced into the dorsal sac of the vagina under ultra- In Vitro Oocyte Maturation (IVM)
sound guidance. The ultrasound probe can be used to An oocyte blocked at the germinal vesicle stage re-
visualise ovarian follicles of 6 to 8 mm in diameter, which quires a maturation phase to enable fertilisation. This in-
are then punctured. In cows, these probes are usually 5 volves a certain number of modifications: nuclear matura-
or 7.5 MHz sectorial probes. The animal is sedated, often tion culminates in the emission of the first polar globule
with additional epidural anaesthesia, the probe is inserted and the formation of the second maturation phase (be-
intravaginally and the ovary grasped via the rectum and tween 18-21h in cows; 24 in the ewe, and 27 hours in
held against the head of the probe. The follicles are thus goats). Membrane maturation, which enables the oocyte
visible on the screen of the ultrasound allowing a needle to specifically recognise the spermatozoa of its species,
to be guided through the vaginal wall and into the follicle. and cytoplasmic maturation, which prevents polyspermia
An aspiration system into a specific medium (containing via the cortical reaction, and which ensures the synthesis
PBS and heparin) allows collection of the follicular flu- of the proteins needed for fertilisation [12].
id and the oocyte surrounded by its cumulus oophorus,
composed of follicular cells. This minimally invasive tech- Under natural conditions, the follicle undergoes sig-
nique enables a high rate of repeated harvest, up to twice nificant modification during maturation. Expansion of
a week for several weeks, with no negative effects on the the cumulus is reliant on the presence of FSH in the folli-
donors [8-9]. As such up to 5 oocytes can be collected at cular fluid, whose action is modulated by LH. FSH stimu-
a time and around 35% of the subsequent blastocysts are lates the synthesis of hyaluronic acid by the cells of the
suitable for in vitro transfer [10]. The OPU technique is cumulus, which results in the formation of an abundant
also useful for other species such as the bison and horses. viscoelastic matrix, which in turn expands the intercellu-
In small ruminants, oocytes are usually recovered via lap- lar spaces and thus the cumulus as a whole [13]. In addi-
arotomy or laparoscopy. Currently, the use of high resolu- tion, once the inhibitory action of OMI (Oocyte Meiotic
tion ultrasound with high frequency transducers (25-70 Factor) has been lifted by the LH peak, the permeable
MHz) enables dynamic examination of the development junctions that unite the oocyte to the cells of cumulus rup-
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(PVA) [13].
ture. In vitro, this inhibition is not an issue as there are no
OMI-producing cells [14]. In addition, the gonadotrophic hormones, notably
FSH, have been used in oocyte maturation media in cattle
During in vitro oocyte maturation, the nuclear phase by promoting the expansion of the cells of the cumulus in
normally occurs spontaneously, whereas cytoplasmic as- vitro [20-21]. FSH potentiates the action of growth fac-
pects are dependent on the maturation medium [14]. tors such as EGF or PDGF, and stimulates the expression
The most widely used medium for maturing oocytes is of the LH receptor by the cells of the cumulus; LH has a
TCM-199; this medium is buffered with bicarbonate and direct action on the metabolism of the oocyte, increasing
contains mineral salts, sources of carbon and energy (glu- glycolyis and oxidative phosphorylation. GH accelerates
cose), and amino acids such as cystine and cysteine, im- nuclear maturation, stimulates the expansion of the cu-
portant in the metabolism of glutathione and glutamine, mulus, and improves the rate of development to the blas-
which with glucose and pyruvate provide the principal tocyst stage in the absence of serum and gonadotrophic
energy sources of the oocyte [15-16]. This medium has hormones [22]. In addition to the effect on nuclear matu-
similar characteristics to the follicular fluid; its osmotic ration, GH also has an effect on cytoplasmic maturation
pressure varies between 280 and 310 mOsm/kg and the expressed on the rate of development; This effect results
pH between 7.0 and 7.6. Normally, the osmotic pressure from an acceleration of the migration of cortical granules
of follicular fluid lies between 280 and 320 mOsm/kg and [13].
the pH between 7.3 and 7.4 [17].
Other factors can also intervene during IVM. Epider-
High molecular weight molecules are often added mal growth factor (EGF) whose beneficial effect on nu-
to this medium, such as foetal calf serum [18], or serum clear and cytoplasmic maturation has been demonstrated
from a cow that is in oestrus [19], whose surfactant effect in cattle. This effect was reported on denuded oocytes,
prevents the adhesion of the oocyte cumulus complexes. suggesting that EGF may act, at least in part, directly on
However, the use of these animal-derived additives pos- the oocyte [23]. Factors from the insulin family, largely
es a sanitary risk and hinders the reproducibility of ex- involved in the control of folliculogenesis [24]; notably
periments. Good results have been achieved by replac- IGF-1, whose beneficial effect during IVM has been dem-
ing these animal proteins with synthetic polymers with onstrated in horses [25], cats [26], and cattle, where the
the same surfactant properties, such as polyvinyl alcohol maximal rates of expansion of the cumulus and nuclear
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performed by centrifugation using a density gradient, or undergone modifications of the membrane induced by bi-
via spontaneous ascending migration in a diluent (swim carbonate [37]. Bicarbonate alters the plasma membrane
up). Next is spermatic capacitation, this is achieved in vit- inducing the rapid collapse of the transversal asymmetry
ro through the presence of specific substances in the me- of the phospholipids, facilitating the elimination of cho-
dium in which the spermatozoa are suspended [31]. lesterol from the membrane during capacitation [38]. Af-
ter 1 to 10 hours, depending on the species, a significant
The most widely used medium for the capacitation percentage of spermatozoa have capacitated. The times
of spermatozoa and IVF is FERT-TALP (Fertilization Ty- required are similar in vivo and in vitro [31].
rode’s Albumin Lactate Pyruvate medium) [32]. This me-
dium is often supplemented with heparin in cows or in the Successful in vitro fertilisation is dependent on a high
serum of ewes that are in oestrus in small ruminants, to concentration of spermatozoa in contact with the oocyte,
capacitate the spermatozoa in vitro. yet in vivo only a few spermatozoa make it to the oviduct.
Although the spermatozoal density is high, in vitro ca-
Heparin leads the efflux of cholesterol and phospho- pacitation is still less effective than in vivo. If capacitation
lipids from the plasma membrane of the spermatozoa, is incomplete when the gametes come into contact, ferti-
which is an important step in the capacitation process lisation may not occur until 6 to 8 hours later. This leads
[33-35]. In association with heparin, other acceptors of to ageing of the oocytes, which prejudices the success of
cholesterol, such as BSA, are often used in the capacita- fertilisation and subsequent embryo development [31].
tion / fertilisation medium. BSA can act by absorbing the
cholesterol from the membrane, leading to changes in the The conditions used for IVF are the same as those
plasma membrane [36]. Although capacitation induced used for IVM. Although 37°C is the optimal tempera-
by heparin does not require the presence of BSA, the ture to fertilise the oocytes of mice and women, it does
capacitated spermatozoa need the latter to undergo the not enable fertilisation in domestic animals with a core
acrosome reaction, the exact role of BSA during the acro- body temperature of 38-39°C. In cattle, IVF is performed
some reaction is not fully understood [35]. in an atmosphere enriched with 5% CO2 for a duration of
around 20 hours [4].
In order for heparin to capacitate the spermatozoa,
there needs to be a minimum amount of bicarbonate in
the capacitation / fertilisation medium [35]. BSA only in-
tervenes on the sub-population of spermatozoa that have
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For in vitro embryo production, it has been clearly Molecules Used to Replace Molecules
established that these embryos are morphologically and of Animal Origin in In Vitro Embryo
physiologically different from those fertilised in vivo. For
example, there may be differences in the structure of the
Culture Media
zona pellucida [65]. The zona pellucida of embryos pro- Polyvinyl alcohol (PVA) has been proposed as a pre-
duced by IVF can be considered as immature and certain ferred additive, especially given that this synthetic poly-
pathogenic microbes seem to adhere more easily to the mer has a similar surfactant activity to albumin. Despite
zona pellucida of embryos that are produced in vitro [66- this similarity, the majority of studies have reported gen-
68]. Using electron microscopy, Vanroose et al., 2000 [65], erally lower development rates with PVA in comparison
concluded that the intact zona pellucida of an embryo with BSA and with BSA and FCS [52].
produced in vitro is made in such a way that the bovine vi- Polyvinylpyrrolidone (PVP) is another synthetic
ral diarrhoea virus (BVDV) or bovine herpes virus (BHV- polymer that has been used as a substitute for BSA in em-
1) should not be able to cross it and infect the embryonic bryo culture media. In cattle, blastocyst rates are compa-
cells. However, small viruses such as BVDV can bind to rable to those obtained with BSA [70, 71]. This molecule
the outer layers of the zona pellucida and contaminate the has been used more recently as a replacement for FCS in
embryo as it hatches. bovine oocyte maturation media, indicating that PVP has
For all of these reasons, in addition to the hygiene a similar effect to FCS as a function of the maturation of
conditions associated with handling embryos during in oocytes and the development of the embryo [72, 73].
vitro production, it is essential to have an appropriate cul- Hyaluronic Acid is the most abundant glycosami-
ture medium for the development of the embryo after in noglycan in the follicular fluid, oviduct, and uterus of
vitro fertilisation. Several recent studies have therefore at- the cow [74], mouse [75], and woman [76]. Its receptor
tempted to establish defined culture media to replace all (CD44) is expressed on the surface of oocytes, cells of the
molecules of animal origin (FCS, BSA) using synthetic cumulus, and of the bovine [77] and human [78] embryo,
molecules to standardise the embryo production chain at different stages of development. It is involved in
and reduce health risks. Several different molecules have several processes, the proliferation and differentiation of
been tested for use in culture media. various cell types, dynamic processes carried by the in-
teraction with the extracellular matrix, the regulation of
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protein secretion, gene expression [19], and the fixation was isolated in batches of BSA that showed embryotrophic
of several molecules such as lipases or growth factors that activity in the rabbit [86]. In cattle, Lane et al., 2003 [87],
affect cell function and morphology [79]. There appears used recombinant albumin in association with hyaluronic
to be a close relationship between hyaluronic acid and GF. acid in the culture medium, obtaining blastocyst rates that
Klominek et al., 1989 [80], demonstrated that the pres- were comparable to those obtained with BSA.
ence of PDGF-BB, EGF, bFGF, and TGF-f31, during the Tween-80 is a synthetic surfactant with the ability to
culture of human fibroblasts, produce a marked stimula- reduce the surface tension of the culture medium. This
tion of hyaluronic acid synthesis, an effect that is not ob- polymer can replace the surfactant properties of FCS and
served when using these GF and CYK separately. The ef- BSA in culture media, but does not have their embryo-
fect of hyaluronic acid in culture media was first studied trophic properties. Palasz et al., 2000 [88], improved the
several years ago; Hamashima 1982 [81], demonstrated rate of bovine blastocysts produced in vitro thanks to the
that this molecule promotes the differentiation of the ex- addition of tween-80.
tra-embryonic tissues of mice embryos. More recently, its The effect of ITS was studied by George et al., 2008
beneficial effect on embryo development has been proven [57]. This association of molecules contains an anti-apop-
in pigs where it produced improved blastocyst rates [82]. totic agent (insulin), a protein that detoxifies the medium
In cattle, through higher blastocyst rates [83], hyaluronic by binding metals (transferrin), and an antioxidant (sele-
acid improves the survival rate of embryos after vitrifica- nium). In addition to SOF, ITS gives a blastocyst rate at 8
tion, resulting in increased gestation rates after embryo days after fertilisation that is comparable to that obtained
transfer [84]. A reduction in the expression of the genes with SOF supplemented with FCS. The addition of BSA to
coding for apoptosis (Bax - SOX) has also been observed this SOF-ITS medium gives similar hatching rates to SOF-
in embryos frozen with hyaluronic acid [85]. FCS. This SOF-BSA-ITS combination therefore increases
Preparations of recombinant albumin have recently the cryotolerance of embryos comprised between 160 and
become available. They are free from all potential biologi- 180 µm and reduces the quantity of lipids in the embryo in
cal contamination such as viruses and prions. In addition, comparison with the medium containing FCS.
their composition is purer than that of traditional albu- Plant peptones have been used as a substitute for pro-
mins, which are purified from blood, and which often con- teins of animal origin. These peptones have anti-oxidant
tain unknown molecules. This is the case of citrate, which properties. George et al., 2009 [89], obtained post-thaw
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