DISCLOSURE. Presentation outline. 1. Oocyte quality: impact, acquisition and approaches. 2. Oocyte polarity: a feature of oocyte maturation

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Oocyte polarity: a sign of oocyte quality? Carlos E. Plancha 1,2 1 Unidade de Biologia da Reprodução, Inst. Histologia e Biologia do Desenvolvimento,. Faculdade de Medicina de Lisboa, Portugal 2 CEMEARE Centro Médico de Assistência à Reprodução, Lisboa, Portugal DISCLOSURE CE Plancha does not have any commercial and/or financial relationship with manufacturers of pharmaceuticals, laboratory supplies and/or medical devices. Presentation outline 1. Oocyte quality: impact, acquisition and approaches 2. Oocyte polarity: a feature of oocyte maturation 3. Oocyte polarity: a reflection of oocyte quality? 4. Future challenges

Presentation outline 1. Oocyte quality: impact, acquisition and approaches 2. Oocyte polarity: a feature of oocyte maturation 3. Oocyte polarity: a reflection of oocyte quality? 4. Future challenges Oocyte Quality: a major determinant of Embryo Quality and Reproductive Success % Transfers that resulted in Live Births for ART Cycles using Fresh Embryos, from Own and Donor Eggs, by Woman s Age Oocyte Quality is an oocyte attribute of major relevance in the efficiency of the reproductive process, which strongly decreases with age! 2008 Assisted Reproductive Technology Report Centers for Disease Control and Prevention, USA Department of Health American Society for Reproductive Medicine Society for Assisted Reproductive Technology Dec 2010 During Oogenesis the oocyte acquires critical funtionalities for initial Development Growth Maturation Oocyte growth phase: - Oocyte diameter increases - High transcriptional and translational activity - Accumulation of RNA / proteins - Building of new structures. (zona pellucida, cortical granules) Oocyte maturation phase: Prophase I Metaphase II - Nuclear / cytoplasmic events with resumption of meiosis and arrest at M II shortly before ovulation - Organelle redistribution - Cell polarity and asymmetric division

Successful oogenesis and folliculogenesis require complex paracrine connectivity Cellular interactions TZP Cumulus cells Perifollicular Matrix Laminin (Trans-Zonal Process) Trans-Zonal Processes Oocyte surface Adapted from Baker, Oogenesis and ovulation Gap junctions N Dekel et al. (1978) Gam Res 1:47. Anderson and Albertini (1976) MA Edson et al. (2009) The Mammalian Ovary from Genesis to Revelation. Endocrine Reviews, 30:624-712. SG Hillier (2009) Paracrine support of ovarian stimulation. Mol Hum Reprod 15: 843 850. Oocyte Quality can be viewed as the aquisition of a series of competences during oogenesis 1. Meiotic a. competence to reach the metaphase II arrest b. competence to allow correct meiotic chromosome segregation 2. Activation competence to fuse with sperm, finish meiosis, block polyspermy, and form pronuclei 3. Developmental competence to trigger and support embryonic development Oocyte Quality is a very complex attribute! - decreases strongly with age!... and... - depends on the female clinical situation! - varies within the same egg cohort! - Can be affected by culture conditions! However, we infer Oocyte Quality a posteriori Can we learn to predict Oocyte Quality?

1. Learn from the oocyte / follicle that produced a viable embryo Ongoing implantation Individual culture - follow-up : find markers Live healthy birth METABOLIC MARKERS : Production / Consumption (H. Leese) SECRETOME (M. Katz-Jaffe) CHROMOSOMAL ANALYSIS PGS / PGD CUMULUS CELL FUNCTION Gene Expression Metabolic Function OOCYTE (Invasive) Fluorescence Microscopy OOCYTE (Non-Invasive) Polscope BIOMARKERS Serum / Follicle Fluid ULTRASOUND Follic. Vol. Increase DOPPLER Peri-follicular Vascular Function 2. Study and manipulate oogenesis in experimental models - early stages - Oogonia cluster breakdown and Primordial follicle formation Preantral to antral follicle transition Primordial to primary follicle transition Rodrigues et al. (2008) Oogenesis: prospects and challenges for the future. J Cell Physiol 216:355-365. 2. Study and manipulate oogenesis in experimental models - late stages - - ovarian follicle development - primordial preantral Ovulation, Oocyte pick-up antral Time - weeks, months - oocyte maturation - hours -

Presentation outline 1. Oocyte quality: impact, acquisition and approaches 2. Oocyte polarity: a feature of oocyte maturation 3. Oocyte polarity: a reflection of oocyte quality? 4. Future challenges Immature oocytes exhibit polarity Eccentric GV specifies animal pole TE Schroeder (1985) Develp Growth Diff 27:311. Human primary oocyte in primordial follicle Rabbit primary oocyte in primordial follicle Hamster and Mouse full grown primary oocytes from antral follicles All animal eggs have a polar structure (Raven, 1961) Asymmetric organization in oocytes intensifies with maturation mouse DF Albertini, SL Barrett (2004) The developmental origins of mammalian oocyte polarity. Sem Cell Dev Biol 15:599. hamster Mafalda Rato, CE Plancha (2005) Personal results

Mechanisms of asymmetric cell division a) different volumes b) different components B Maro, M-H Verlhac (2002) Polar body formation: new rules for asymmetric divisions. Nature Cell Biol 4:E281. During oocyte maturation, asymmetry in the two divisions of meiosis ensures one big gamete and two small polar bodies activation J Azoury et al. (2008) Spindle Positioning in Mouse Oocytes Relies on a Dynamic Meshwork of Actin Filaments. Current Biology 18:1514-1519. Wang et al. (2011) Mechanism of the chromosome-induced polar body extrusion in mouse eggs. Cell Division 6:17. Two views on how the first meiotic spindle becomes cortically located The first meiotic spindle starts from a cortical location Prophase I Metaphase I The first meiotic spindle starts from a central position and moves towards a cortical location S Brunet, B Maro (2007) Germinal vesicle position and meiotic maturation in mouse oocyte. Reproduction 133:1069-1072. SL Barrett, DF Albertini (2010) Cumulus cell contact during oocyte maturation in mice regulates meiotic spindle positioning and enhances developmental competence. J Assist Reprod Genet 27:29 39. In any case at MI the first meiotic spindle is cortically located, with involvement of the actin microfilament system Diagram of possible mechanisms of actin-dependent spindle translocation. (I) Contraction of anti-parallel actin filaments connecting the cortex to the spindle by bipolar myosin II mini thick filaments. (II) Cargo-like transport of the spindle along actin filaments with barbed ends oriented toward the cortex, with myosin II localized at the spindle pole. (III) Actin polymerization-driven motility from the rear. Actin red, Microtubules green, Chromosomes blue, Myosin II black. AS Fabritius, ML Ellefson, FJ McNally (2011) Nuclear and spindle positioning during oocyte meiosis. Curr Opin Cell Biol 23:78-84.

The second meiotic spindle seems cortically located from the beginning MII activation Wang et al. (2011) Mechanism of the chromosome-induced polar body extrusion in mouse eggs. Cell Division 6:17. Oocyte polarity ensures asymmetrical division of cytoplasmic content between the gamete and the polar bodies in oocyte maturation and activation Presentation outline 1. Oocyte quality: impact, acquisition and approaches 2. Oocyte polarity: a feature of oocyte maturation 3. Oocyte polarity: a reflection of oocyte quality? 4. Future challenges Oocyte IVM was observed about 50 years before clinical IVF has started. (rabbit) Oocytes spontaneously resume meiosis after removal from the follicular environment Pincus and Enzmann (1935) Comparative behaviour of mammalian eggs in vivo and in vitro. J Exp Med 62:655.

IVM oocytes exhibit less fertilization and developmental competence then In Vivo matured ones (IVO) Schroeder and Eppig 1988; Eppig and O Brien 1998; Cha and Chian 1998; Mermillod et al. 1999; Moor et al. 2001; Trounson et al. 2001 Strategies to find morphological evidence to explain functional differences between IVM and IVO oocytes γ-tubulin / pericentrin restricted to pointed MII spindle poles in IVO oocytes IVO M II Spindles B6D2 C57BL/6 Bl. Swiss CF-1 Nu/Nu IVM M II Spindles Area/Volume and Pole Width of MII meiotic spindle increase in IVM oocytes Ibanez et al. (2005) Genetic strain variations in the metaphase-ii phenotype of mouse oocytes matured in vivo or in vitro. Reproduction 130:845-55. Area (Volume) of MII meiotic spindle is higher in non-gonadotropin supplemented IVM 1500 1350 1200 1050 900 750 600 450 Spindle Area IVM > IVO, IVO-N a Quantification of Spindle Size and Shape c b a c versus h/2 h/2 h/2 h/2 Area of spindle = h/2 (a+c) 2 + h/2 (b+c) 2 b 300 150 0 IVM M-1 N=30 IVM M-2 N=31 IVO M-1 N=30 IVO M-2 N=35 IVO-N-MII N=30 A Sanfins et al. (2003) Distinctions in meiotic spindle structure and assembly during in vitro and in vivo maturation of mouse oocytes. Biol Reprod 69: 2059.

Pole width of MII meiotic spindle is higher in non-gonadotropin supplemented IVM (Basal), intermediate in gonadotropin supplemented IVM (Hyped) and lower in IVO oocytes MTOCs 80 70 60 50 40 30 20 10 0 IVM Basal IVM Hyped IVO 5 10 15 20 Spindle Pole Width (m) IVM IVO M-I γ-tubulin M-II SL Barrett, DF Albertini (2007) Allocation of gamma-tubulin between oocyte cortex and meiotic spindle influences asymmetric cytokinesis in the mouse oocyte. Biol Reprod 76:949-57. Pole width of MII meiotic spindle is higher in non-gonadotropin supplemented IVM (Basal), intermediate in gonadotropin supplemented IVM (Hyped) and lower in IVO oocytes MTOCs 80 IVM Basal IVM Hyped IVO 70 Spindle Pole Width seems to 60 inversely relate to cytoplasmic 50 centrosome number 40 30 20 10 0 5 10 15 20 Spindle Pole Width (m) IVM IVO M-I γ-tubulin M-II SL Barrett, DF Albertini (2007) Allocation of gamma-tubulin between oocyte cortex and meiotic spindle influences asymmetric cytokinesis in the mouse oocyte. Biol Reprod 76:949-57. Number of cytoplasmic MTOCs decreases in non-gonadotropin supplemented IVM No. of cytoplasmic MTOCs 60 Centrosome Numbers IVM < IVO 48 b 36 b b a 24 a 12 IVM IVO 0 IVM-MI N=15 IVM-MII N=26 IVO-MI N=22 IVO-MII N=30 IVO-N N=20 A Sanfins et al. (2003) Distinctions in meiotic spindle structure and assembly during in vitro and in vivo maturation of mouse oocytes. Biol Reprod 69: 2059.

Spindle anchoring at the cortex is partially lost during non-gonadotropin supplemented IVM IVM IVO CE Plancha et al (2005) Cell polarity during folliculogenesis and oogenesis. RBM online 10:478-484. Retention of MTOCs and oocyte volume is partially lost during non-gonadotropin supplemented IVM IVM IVO Polar Bodies formed in vitro contain MTOCs SL Barrett, DF Albertini (2007) Allocation of gamma-tubulin between oocyte cortex and meiotic spindle influences asymmetric cytokinesis in the mouse oocyte. Biol Reprod 76:949-57. Morphological signs of oocyte polarity and asymmetric division partially lost in mouse non-gonadotropin supplemented IVM Working Model IVM IVO A Sanfins et al. (2003) Distinctions in meiotic spindle structure and assembly during in vitro and in vivo maturation of mouse oocytes. Biol Reprod 69: 2059. CE Plancha et al (2005) Cell polarity during folliculogenesis and oogenesis. RBM online 10:478-484. SL Barrett, DF Albertini (2007) Allocation of gamma-tubulin between oocyte cortex and meiotic spindle influences asymmetric cytokinesis in the mouse oocyte. Biol Reprod 76:949-57.

Morphological signs of oocyte polarity and asymmetric division partially lost in mouse non-gonadotropin supplemented IVM Working Model IVM IVO Are these morphological differences correlated with the described decrease in quality in IVM oocytes? Fertilization rate: presence of 2-PN 6h post-ivf Mouse 81% 48% 41% CE Plancha et al. (2005) Developmental competence of differently matured mouse oocytes. Poster at XXI ESHRE Annual Meeting, Copenhagen, Denmark Evidence of fertilization competence loss! ICM Blastomere numbers at the blastocyst stage Mouse Intermediate TE IVO-N IVO IVM IVM-Rosco ICM TE? Evidence of developmental competence loss! CE Plancha et al. (2005) Developmental competence of differently matured mouse oocytes. Poster at XXI ESHRE Annual Meeting, Copenhagen, Denmark

Oocyte polarity 1. Is an important feature of oocyte maturation 2. May reflect oocyte quality, since partial loss of morphological signs of polarity correlate with a decrease in fertilization and developmental l competences Presentation outline 1. Oocyte quality: impact, acquisition and approaches 2. Oocyte polarity: a feature of oocyte maturation 3. Oocyte polarity: a reflection of oocyte quality? 4. Future challenges To assess if manipulating polarity in mouse oocyte maturation will reflect upon the fertilization and developmental competence levels

Symmetric first meiotic division can be forced by compressing cortical ooplasm near the MI meiotic spindle Two mini MII oocytes originate instead of one MII oocyte and one PB J Otsuki et al. (2012) Symmetrical division of mouse oocytes during meiotic maturation can lead to the development of twin embryos that amalgamate to form a chimeric hermaphrodite. Hum Repr 27(2):380-387. Each of the two mini MII oocytes can be fertilized and cleave, until one quimeric morula compacts and one blastocyst is formed J Otsuki et al. (2012) Symmetrical division of mouse oocytes during meiotic maturation can lead to the development of twin embryos that amalgamate to form a chimeric hermaphrodite. Hum Repr 27(2):380-387. This means that even a very small oocyte, in the limit of being a very large first polar body, is able to be fertilized and initiate embryo development. J Otsuki et al. (2012) Symmetrical division of mouse oocytes during meiotic maturation can lead to the development of twin embryos that amalgamate to form a chimeric hermaphrodite. Hum Repr 27(2):380-387.

This means that even a very small oocyte, in the limit of being a very large first polar body, is able to be fertilized and initiate embryo development. J Otsuki et al. (2012) Symmetrical division of mouse oocytes during meiotic maturation can lead to the development of twin embryos that amalgamate to form a chimeric hermaphrodite. Hum Repr 27(2):380-387. - Asymmetry of the first meiotic division does not seem essential for embryo development. - Asymmetry of the second meiotic division, however, was maintained. Remaining questions : - was there a decrease in fertilization and developmental rates? - had zygotes been separated to develop independently, what would these rates be? - what would happen in case we prevent asymmetry of second meiotic division? To assess if manipulating polarity in mouse oocyte maturation will reflect upon the fertilization and developmental competence levels To probe other models besides the mouse In humans detectable signs of oocyte polarity loss do not seem to correlate with decrease in fertilization and developmental competence L De Santis et al. (2005) Polar body morphology and spindle imaging as predictors of oocyte quality. RBM online 11:36-42. Existing non-invasive approaches may not be enough to accurately discriminate different categories of oocytes G Coticchio et al. (2010) Comparative analysis of the metaphase II spindle of human oocytes through polarized light and high performance confocal microscopy. Fertil Steril 93:2056 2064. Pre- and post-ovulatory ageing associate with a loss of oocyte polarity S Brunet MH Verlhac (2011) Positioning to get out of meiosis: the asymmetry of division. Hum Repr Update 17:68 75.

Open questions : - what are the consequences of preventing asymmetry in the second meiotic division? - should we focus our attention on the second polar body, besides the spindle? - will more powerful non-invasive morphological approaches allow us to better associate oocyte polarity and quality? - can we identify specific human situations or treatments where assessing oocyte polarity will reveal more important than in others? New working model Oocyte polarity kept activation Oocyte polarity lost activation Take-home messages 1. Oocyte quality is a relevant property acquired during oogenesis that has remained elusive to predictive studies 2. Oocyte polarity is an important feature of oocyte maturation 3. Oocyte polarity may reflect oocyte quality, since partial loss of morphological signs of polarity correlate with a decrease in fertilization and developmental competences 4. Future studies are needed to assess the value of oocyte polarity as a sign of oocyte quality Acknowledgements Past / present staff at, Faculty of Medicine of Lisbon P Navarro-Costa MRato P Rodrigues C Martins OG Martins SC Correia S Pimentel IMatos ASanfins NC Dias JE Gomes AJ Cidadão Past / present staff at ART Unit CEMEARE, Lisbon MJ Carvalho (Head) P Sá e Melo G Pinto D Rodrigues L Vicente I Reis T Rocha M Rato S Pimentel SC Correia PR Carvalho PN Costa Other past / present colaborators C Calhaz-Jorge, J Nunes, P Soares, I Cordeiro, F Leal, M Carvalho (Unid. Pluridisciplinar Reprodução Humana, HSM, Portugal) A Neves, S Jorge, S Correia (Unid. Medicina da Reprodução, MAC, Lisboa, Portugal) DF Albertini (Kansas City Medical Center, USA) JSmitz(Dutch-Speaking Brussels Free University)

Oocyte polarity: a sign of oocyte quality? Probably yes, but it is still not clear how Thank You!