Oncofertility Publications

Abstract

The ovarian follicle is the functional unit of the ovary that secretes sex hormones and supports oocyte maturation. in vitro follicle techniques provide a tool to model follicle development in order to investigate basic biology, and are further being developed as a technique to preserve fertility in the clinic1-4. Our in vitro culture system employs hydrogels in order to mimic the native ovarian environment by maintaining the 3D follicular architecture, cell-cell interactions and paracrine signaling that direct follicle development 5. Previously, follicles were successfully cultured in alginate, an inert algae-derived polysaccharide that undergoes gelation with calcium ions6-8. Alginate hydrogels formed at a concentration of 0.25% w/v were the most permissive for follicle culture, and retained the highest developmental competence 9. Alginate hydrogels are not degradable, thus an increase in the follicle diameter results in a compressive force on the follicle that can impact follicle growth10. We subsequently developed a culture system based on a fibrin-alginate interpenetrating network (FA-IPN), in which a mixture of fibrin and alginate are gelled simultaneously. This combination provides a dynamic mechanical environment because both components contribute to matrix rigidity initially; however, proteases secreted by the growing follicle degrade fibrin in the matrix leaving only alginate to provide support. With the IPN, the alginate content can be reduced below 0.25%, which is not possible with alginate alone 5. Thus, as the follicle expands, it will experience a reduced compressive force due to the reduced solids content. Herein, we describe an encapsulation method and an in vitro culture system for ovarian follicles within a FA-IPN. The dynamic mechanical environment mimics the natural ovarian environment in which small follicles reside in a rigid cortex and move to a more permissive medulla as they increase in size11. The degradable component may be particularly critical for clinical translation in order to support the greater than 106-fold increase in volume that human follicles normally undergo in vivo.

Shikanov A., Xu M., Woodruff T.K., Shea L.D. (). A Method for Ovarian Follicle Encapsulation and Culture in a Proteolytically Degradable 3 Dimensional System. JoVE. http://www.jove.com/details.php?id=2695&access=ugoti9et

Abstract

OBJECTIVE: To develop an in vitro strategy to support the growth of early-stage follicles and produce mature oocytes competent for fertilization.

DESIGN: Whole ovaries from 8-day-old mice were cultured for 4 days, and then secondary follicles were isolated and cultured for 12 days in a three-dimensional alginate or fibrin-alginate (FA) hydrogel matrix.

SETTING: University-affiliated laboratory.

ANIMALS: Mice.

INTERVENTION(S): None.

MAIN OUTCOME MEASURES: Histologic evaluation of follicle development, steroid hormone production, and rates of oocyte maturation, oocyte fertilization, and embryo formation.

RESULT(S): Culture of 8-day-old mouse ovaries for 4 days resulted in transition of the follicle population from primordial and primary follicles to secondary follicles, similar to that seen in a 12-day-old ovary. Isolated secondary follicles cultured for 12 days showed larger increases in oocyte diameter and more frequent antrum formation and theca cell differentiation in the FA-hydrogel matrix compared with the alginate matrix. Steroid hormone secretion patterns were consistent with the changes in follicle morphology and cell differentiation observed in the cultured follicles. Compared with oocytes from alginate follicle cultures, a greater number of oocytes retrieved from the FA-based follicle cultures progressed to metaphase I, reached metaphase II, and could be fertilized and cleaved to two-cell embryos. The organ culture plus FA-hydrogel follicle culture strategy produced a very high rate of oocyte progression to metaphase II (88 +/- 8.7% [mean +/- SEM]) and formation of two-cell embryos (54 +/- 4%).

CONCLUSION(S): A strategy combining whole ovary culture of early-stage follicles and subsequent FA hydrogel in vitro follicle culture produced a high percentage of oocytes competent for fertilization; this might provide new options for fertility preservation in women and prepubertal girls facing fertility-threatening diseases or treatments.

Shi Ying Jin, Lei Lei, Ariella Shikanov, Lonnie D. Shea, and Teresa K. Woodruff; Fert. Ster. ePub ahead of print. 2010

Abstract

Ovarian cryopreservation before chemotherapy and autotransplantation post-treatment can restore fertility to women with premature ovarian failure. Although the majority of primordial follicles survive the cryopreservation cycle, the follicular pool is reduced after transplantation due to ischemic death. Therefore, we engineered a biomaterial-based system to promote angiogenesis in a mouse model of ovarian transplantation. To mimic the clinical situation of sterility, a bilateral ovariectomy was performed 2 weeks before transplantation, during which time serum levels of follicular stimulating hormone rose to menopausal levels. Before transplantation, vitrified/thawed ovarian tissue from 12-day-old C57Bl/6J pups was encapsulated in fibrin modified with heparin-binding peptide (HBP), heparin, and loaded with 0.5 μg vascular endothelial growth factor (VEGF). The group transplanted with fibrin-HBP-VEGF had twice as many surviving primordial follicles and an increased number of blood vessels relative to the no biomaterial control. Transplanted tissue was viable and supported natural conception that led to live and healthy offspring. The timeline of live births with VEGF delivery suggested that primary follicles survived transplantation, and provided the gametes for the first litter. Thus, VEGF delivery from fibrin supported integration of the transplant with the host, promoted angiogenesis, and enhanced engraftment and function of the tissue.

Shikanov A, Zhang Z, Xu M, Smith RM, Rajan A, Woodruff TK, Shea LD. Tissue Eng Part A. 2011 Dec;17(23-24):3095-104. Epub 2011 Sep 21. PMID: 21740332

Abstract

Synthetic hydrogels with tunable properties are appealing for regenerative medicine. A critical limitation in hydrogel design at low solids concentration is the formation of defects, which increase gelation times and swelling, and reduce elasticity. Here, we report that trifunctional cross-linking peptides applied to 4-arm poly-(ethylene glycol) (PEG) hydrogels decreased swelling and gelation time relative to bi-functional crosslinkers. In contrast to bi-functional peptides, the third cross-linking site on the peptide created a branch point if an intramolecular cross-link formed, which prevented non-functional “dangling-ends” in the hydrogel network and enhanced the number of elastically active cross-links. The improved network formation enabled mouse ovarian follicle encapsulation and maturation in vitro. Hydrogels with bi-functional crosslinkers resulted in cellular dehydration, likely due to osmosis during the prolonged gelation. For trifunctional crosslinkers, the hydrogels supported a 17-fold volumetric expansion of the tissue during culture, with expansion dependent on the ability of the follicle to rearrange its microenvironment, which is controlled through the sensitivity of the cross-linking peptide to the proteolytic activity of plasmin. The improved network design enabled ovarian follicle culture in a completely synthetic system, and can advance fertility preservation technology for women facing premature infertility from anticancer therapies.

Shikanov A, Smoith R M., Xu M, Woodruff T K., Shea L D. Biomaterials. 2011. April; 32(10): 2524-31.

Female cancer patients who seek fertility preservation but cannot undergo ovarian stimulation and embryo preservation may consider: 1) retrieval of immature oocytes followed by in vitro maturation (IVM); 2) ovarian tissue cryopreservation followed by transplantation or in vitro follicle culture (IVFC). Conventional IVM is carried out during the follicular phase of menstrual cycle. There is limited evidence demonstrating that immature oocyte retrieved during the luteal phase can mature in vitro and be fertilized to produce viable embryos. While in vitro follicle culture is successful in rodents, its application in nonhuman primates has made limited progress. The objective of this study was to investigate the competence of immature luteal-phase oocytes from baboon and to determine the effect of FSH on baboon preantral follicle culture and oocyte maturation in vitro. Oocytes from small antral follicle COCs with multiple cumulus layers (42%) were more likely to resume meiosis and progress to MII than oocytes with a single layer of cumulus cells, or less (23% vs. 3%, respectively). Twenty-four percent of mature oocytes were successfully fertilized by ICSI, and 25% of these developed to morula stage embryos. Preantral follicles were encapsulated in fibrin-alginate-matrigel (FAM) matrices, and cultured to small antral stage in a FSH-independent manner. FSH negatively impacted follicle health by disrupting the integrity of oocyte and cumulus cells contact. Follicles grown in the absence of FSH produced MII oocytes with normal spindle structure. In conclusions, baboon luteal-phase COCs and oocytes from cultured preantral follicles can be matured in vitro. Oocyte meiotic competence correlated positively with the number of cumulus cell layers. This study clarifies the parameters of the follicle culture system in nonhuman primates and provides foundational data for future clinical development as a fertility preservation option for women with cancer.

Xu M, Fazleabas AT, Shikanov A, Jackson E, Barrett SL, Hirshefeld-Cytron J, Kiesewetter SE, Shea LD, Woodruff TK.

Abstract

In this report, we investigate the fibrin-alginate interpenetrating network (FA-IPN) to provide dynamic cell-responsive mechanical properties, which we apply to the in vitro growth of ovarian follicles. The mechanical properties and polymerization rate of the gels were investigated by rheology, and the fiber structure was imaged by electron microscopy. Using a mouse model, two-layered secondary follicles were encapsulated in FA-IPNs, and growth, morphology, hormone production, fibrin degradation rate and the numbers of competent eggs were assessed. The initial mechanics of the FA-IPN are determined by the composite material, and subsequent degradation of fibrin by the encapsulated cells would produce a material with mechanical properties due to the alginate alone. The rate of meiotically competent oocytes produced by culture in FA-IPN was 82%, which was significantly greater than in alginate alone. This increase in oocyte quality is an important step in identifying 3D culture systems that can provide a fundamental tool to investigate follicle maturation, and may be applied to promote the growth of human follicles, which can be used to provide reproductive options for women facing a cancer diagnosis.

Ariella Shikanov, Min Xu, Teresa K. Woodruff, Lonnie D. Shea; Biomaterials Vol. 29 5476-85 Oct 30, 2009