A Prospective Study to Determine if Mitochondrial Activity of Cumulus Cells From the Cumulus-oocyte Complex is Associated With Maternal Age and Oocyte Competence to Blastocyst

Background The number of couples undergoing in vitro fertilization (IVF) is rapidly growing worldwide. However, only approximately 5% of aspirated human oocytes have the competence to implant and develop into a child (Ziebe, 2013). Reasons for this low percentage of competence include genetic abnormalities and metabolic problems.

Moreover, this oocyte developmental competence decreases as a woman ages, and therefore maternal age is the single best predictor of reproductive outcome in women (Keefe et al, 2015). In general, the aging process is complex and includes impaired mitochondrial dysfunction, oxidative stress, diminished metabolic activity, and activity of several cell-signaling systems (Bentov, 2011).

Oocyte Competency is the Key to Embryo Potential The oocyte is the major determinant of embryo developmental competence in women. The oocyte transmits not only the mother's nuclear but also her mitochondrial genome to the embryo. The maternal and paternal genomes are neither symmetrical nor equal in their contributions to embryo fate.

Oxygen Consumption and Oocyte/Embryo Competence Clinically useful biomarkers of oocyte competency are needed (Keefe et al, 2015). Oxygen consumption is a quality marker for human oocyte competence conditioned by ovarian stimulation regimens (Tejera et al., 2011). Furthermore, oxygen consumption rates of embryos have been found to be associated with successful implantation and can be used to select the embryo with the best developmental potential (Tejera et al., 2012).

Rationale of Studying Cumulus Cells Ovarian follicles are highly specialized structures that support the growth and development of oocytes during controlled ovarian stimulation for IVF. Cumulus cells are somatic cells that form an intimate association with the oocyte in the follicle. Cumulus cells possess specialized cytoplasmic projections that penetrate through the zona pellucida [shell] and form gap junctions at their tips with the oocyte, generating an elaborate structure called the cumulus-oocyte complex (COC) (Albertini et al., 2001; Gilchrist et al., 2008). Cumulus cells metabolize the bulk of the glucose consumed by the COC to supply metabolic intermediates to the oocyte, and COC glucose metabolism is pivotal in determining oocyte developmental competence (Sutton-McDowall et al., 2010). It is well known that cumulus cells support oocyte development through the provision of essential nutrients, information molecules, metabolic precursors and signaling molecules (Hutt et al., 2007). Because of the metabolic and communication link between the cumulus and the oocyte, glucose availability and metabolism within the cumulus can have a significant impact on oocyte meiotic and developmental competence (Thompson JG, 2007).