What if genetic test fail? There could be a sperm membrane explanation
Héctor Godoy Morales (MX), José Gutiérrez Frusch (MX), Ricardo Mera Mejía (MX), Karina Cázarez Pérez (MX), Francisco Rocha Cárdenas (MX), José Lozano Sánchez (MX)
[Godoy Morales] ART Reproducción, [Gutiérrez Frusch] ART Reproducción, [Mera Mejía] ART Reproducción, [Cázarez Pérez] ART Reproducción, [Rocha Cárdenas] ART Reproducción, [Lozano Sánchez] ART Reproducción
Context: Why top quality euploid embryos do not achieve implantation is one of the enigmas in assisted reproduction techniques (ART). Achieving blastocyst stage and implantation may depend on synchronized expression of membrane protein in germ cells that translate into manifestation of tight junctions in euploid embryos. Objective: Demonstrate that euploid embryos fertilized with sperm that express Claudin 1 in their membranes achieve a better blastocyst rate. Methods: Controlled ovarian stimulation and ovum pickup was done according to treating physician. Semen sample was obtained by masturbation (90% was used for ART and 10% for Claudin 1 biomarker). Sperm was fixed and permeabilized with BD Cytofix/Cytoperm™, marked with secondary monoclonal antibodies reactive to Claudin 1 and analyzed by flow cytometry. Fluoroscopy was used to determine the expression zone. Statistical analysis, descriptive statistics and normalization by Kologrov was used done using SPSS v23. Significance was determined with p<0.05. Embryos were divided into 2 groups: control group with 107 embryos were fertilized with sperm without Claudin 1 expression; study group included 56 embryos with Claudin 1 expression. All embryos were biopsied on day 3 with pulsated laser. FISH was run for chromosomes 1, 13, 15, 16, 17, 18, 21, 22 and sexual. Patients: Eighteen couples diagnosed with primary infertility. Intervention: NA Main Outcome Measure: Blastocyst rate Results: In control group 66% of embryos arrested before blastocyst versus 17% of embryos in study group (p=.002). Of biopsied embryos in control group 40% reached blastocyst versus 70% in control group (p=.005). 88% of euploid embryos fertilized with Claudin 1 positive sperm reached day 5 (p=.002). Conclusions: The expression of tight junction markers may help increase the blastocyst rate in euploid embryos leading to better prognosis in ART.