Clinical use of progesterone in human sperm preparation media for increasing IVF success.

Autor: McPherson NO; Discipline of Reproduction and Development, School of Biomedicine, University of Adelaide, Adelaide, Australia; Freemasons Centre for Male Health and Wellbeing, University of Adelaide, Adelaide, Australia; Robinson Research Institute, University of Adelaide, Adelaide, Australia; Monash IVF Group, Clayton, Australia. Electronic address: nicole.mcpherson@adelaide.edu.au., Nottle M; Discipline of Reproduction and Development, School of Biomedicine, University of Adelaide, Adelaide, Australia; Robinson Research Institute, University of Adelaide, Adelaide, Australia., McIlfatrick S; Discipline of Reproduction and Development, School of Biomedicine, University of Adelaide, Adelaide, Australia; Robinson Research Institute, University of Adelaide, Adelaide, Australia., Saini A; Discipline of Reproduction and Development, School of Biomedicine, University of Adelaide, Adelaide, Australia; Robinson Research Institute, University of Adelaide, Adelaide, Australia., Hamilton H; Monash IVF Group, Clayton, Australia., Bowman E; Monash IVF Group, Clayton, Australia., Tully CA; Discipline of Reproduction and Development, School of Biomedicine, University of Adelaide, Adelaide, Australia; Robinson Research Institute, University of Adelaide, Adelaide, Australia; Repromed, Dulwich, Australia., Pacella-Ince L; Discipline of Reproduction and Development, School of Biomedicine, University of Adelaide, Adelaide, Australia; Robinson Research Institute, University of Adelaide, Adelaide, Australia; Repromed, Dulwich, Australia., Zander-Fox D; Discipline of Reproduction and Development, School of Biomedicine, University of Adelaide, Adelaide, Australia; Monash IVF Group, Clayton, Australia; Monash University, Clayton, Australia., Bakos HW; Monash IVF Group, Clayton, Australia; University of Newcastle, Newcastle, Australia; Memphasys Ltd, Homebush, Australia.
Jazyk: angličtina
Zdroj: Reproductive biomedicine online [Reprod Biomed Online] 2024 Apr; Vol. 48 (4), pp. 103625. Date of Electronic Publication: 2023 Oct 20.
DOI: 10.1016/j.rbmo.2023.103625
Abstrakt: Research Question: Can the addition of progesterone and neurotensin, molecular agents found in the female reproductive tract, after sperm washing increase the fertilization potential of human spermatozoa?
Design: (i) Cohort study of 24 men. Spermatozoa selected by swim-up were incubated in either progesterone or neurotensin (0.1-100 µM) for 1-4 h, and hyperactive motility and binding to hyaluronan (0.1-100 µM) were assessed. The effect of progesterone 10 µM on sperm function was assessed in a blinded manner, including: hyperactive motility, binding to hyaluronan, tyrosine phosphorylation, acrosome reaction and oxidative DNA damage. (i) Embryo safety testing [one-cell mouse embryo assay (MEA), endotoxin and sterility counts (n = 3)] in preclinical embryo models of IVF (murine and porcine, n = 7 each model) and a small preliminary human study (n = 4) of couples undergoing standard IVF with oocytes inseminated with spermatozoa ± 10 µM progesterone.
Results: Progesterone 10 µM increased sperm binding to hyaluronan, hyperactive motility and tyrosine phosphorylation (all P < 0.05). Neurotensin had no effect (P > 0.05). Progesterone 10 µM in human embryo culture media passed embryo safety testing (MEA, endotoxin concentration and sterility plate count). In preclinical models of IVF, the exposure of spermatozoa to progesterone 10 µM and oocytes to progesterone 1 µM was not detrimental, and increased the fertilization rate in mice and the blastocyst cell number in mice and pigs (all P ≤ 0.03). In humans, every transferred blastocyst that had been produced from spermatozoa exposed to progesterone resulted in a live birth.
Conclusion: The addition of progesterone to sperm preparation media shows promise as an adjunct to current methods for increasing fertilization potential. Randomized controlled trials are required to determine the clinical utility of progesterone for improving IVF outcomes.
(Copyright © 2023 The Author(s). Published by Elsevier Ltd.. All rights reserved.)
Databáze: MEDLINE
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