Pavlo Mazur
Laboratory Director, IVMED
Category:
IVF laboratory
There was an interesting case in my practice where a patient’s embryos were unable to develop beyond the zygote stage, experiencing fragmentation and failed implantation. Pronuclear transplantation was performed, resulting in a normal blastocyst that was transferred, leading to a successful pregnancy and the birth of a healthy baby boy. Subsequently, the patient conceived naturally. This case demonstrates that nuclear transplantations can be effective in treating infertility in certain situations.In summary, nuclear transplantation techniques can be divided into two main groups: those performed before fertilization on very immature cells or mature cells, and those performed after fertilization. Before fertilization, techniques such as spindle transfer and polar body transfer have been successful in producing normal embryos. After fertilization, pronuclear transplantation is an option, although it is less commonly performed. Embryos can be derived from a single cell, and this method works just as well for polar body transfer. By using the first polar body as another spindle of a mature cell, we can multiply the number of embryos from a single cell. It may seem like magic, but it’s simply a matter of dividing by two at each step. This technique is particularly useful for mitochondrial diseases, as polar bodies typically contain a minimal amount or no mitochondria at all. This reduces the risk of heteroplasmy compared to spindle transfer. The most challenging aspect is the second polar body. It is extruded right after the fertilization process, marking the final stage of maturation in human oocytes. At this point, there is only one C from the female or mother inside the cytoplasm, and the second one comes from the sperm, resulting in a diploid normal embryo. The second meiotic division leads to the extrusion of the second polar body, which contains a haploid set of chromosomes. This polar body can be collected and inserted into an activated, nucleated donor oocyte. By doing so, the diploidy of the cells can be restored, and an asynchronous zygote can be obtained. The pronucleus from the sperm will advance, while the pronucleus from the polar body will lag. However, if synchronization is achieved, a normal zygote can be formed, leading to the development of a normal blastocyst that can be transferred after testing. Working with human oocytes can be challenging because the second polar body is extremely fragile and thin, making its removal from an activated cell difficult but still possible.
In conclusion, I want to emphasize that nuclear transplantations are not the future of IVF. These techniques should only be used in cases of infertility where no other options are available. They have strict indications and are considered highly experimental. Only a small group of patients can benefit from these techniques with good results. However, as we continue to advance our knowledge and experience, more and more children will be born after applying different types of nuclear transplantations. In cases where the genetic cause of infertility, such as the TBB-8 mutation, is known, these techniques can provide significant help and hope.’
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