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Extracellular vesicles: a promising tool for assessment of embryonic competence
Summary: Extracellular vesicles offer indeed a novel means to assess embryonic fitness. Further validation studies, technology development and more complex study designs are certainly required to implement the profiling of embryonic extracellular vesicles as a diagnostic test for embryo selection.
224. Can embryonic extracellular vesicles [EEV] enhance embryo selection [Commentary]
from: Administrator (office@fertaid.com), Australia on 2/06/2018 9:56:08 AM Profession:
Comment: Preliminary publications suggest there may be value in exploring the role of EEV in implantation and embryo selection.
Submission In an excellent review of the role of EEV in embryo selection and implantation, the authors have summarised the current research in this area. Essentially there are three types of EEV - exosomes (secretory interactive small vesicles), microvesicles (larger less functional vesicles) and apoptotic bodies (containing products of programmed cell death). Both exosomes and apoptotic vesicles may have a role in intercellular communication but in opposing functions - one to interact with other cells and the other to indicate poor embryo health.
Early studies suggest healthy embryo secrete fewer and smaller vesicles than less healthy embryos but measuring these remains the great challenge. There is also is the problem with non-embryonic vesicle contamination (which raises all sorts of questions about the purity of culture systems). The dilution effect of the relatively large size of culture drops is another issue in identification.
However the interesting observation that smaller exosomes may contain microRNA implies a signalling between the fallopian or endometrium and the blastocyst. This interaction may be bidirectional. Do current culture systems starve the embryo of maternal signalling and does the maternal system remain unaware of the presence to in vitro embryos until just prior to implantation. What size vesicles are able to escape the zona pellucida before and after hatching? Will future culture systems contain vesicles to support embryo development in vitro or will clients receive uterine injections of synthetic vesicles to prepare it for the embryo at transfer. All heady and exciting ideas.
It is known that few embryos are able to initiate successful implantation and embryo selection (which now occupies considerable effort and cost) is the primary focus of all IVF technology. Will selection, in the future, be supported or replaced by EEV analysis is a tantalising concept. There have never been reports of pregnancy rates close to 100% per transfer and nor greater than 100% cumulative rate. This implies the IVF industry still has a long way to go. In a broader perspective, one may allow ones mind to explore the realisation that maybe one can take the embryo out of the body but at what cost. The potential lack of bidirectional support and communication may just be the industry's Achilles heal. The industry will benefit in keeping aware of work in laboratory and domestic species where maybe some answers will be found. It reminds one of the old PAF studies in maternal-embryo communication research.
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