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Dr Steven Fleming Honorary Associate University of Sydney Human Gametogenesis and Fertilisation Human Gametogenesis and Fertilisation UNSW Embryology Course 2013 August 2013 August 2013 Gametogenesis & Fertilisation Gametogenesis & Fertilisation

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Page 1: Human Gametogenesis and Fertilisation - Embryology · Dr Steven Fleming Honorary Associate University of Sydney Human Gametogenesis and Fertilisation UNSW Embryology Course 2013 August

Dr Steven FlemingHonorary Associate

University of Sydney

Human Gametogenesisand Fertilisation

Human Gametogenesisand Fertilisation

UNSW Embryology Course 2013

August 2013August 2013 Gametogenesis & FertilisationGametogenesis & Fertilisation

Page 2: Human Gametogenesis and Fertilisation - Embryology · Dr Steven Fleming Honorary Associate University of Sydney Human Gametogenesis and Fertilisation UNSW Embryology Course 2013 August

Learning ObjectivesLearning Objectives

MeiosisGametogenesis and aneuploidyCapacitation and hyperactivationOvulation and oocyte maturationFertilisation and polyspermyIUI, IVF, ICSI, PICSI and IMSIAssisted reproduction and society

MeiosisGametogenesis and aneuploidyCapacitation and hyperactivationOvulation and oocyte maturationFertilisation and polyspermyIUI, IVF, ICSI, PICSI and IMSIAssisted reproduction and societyAugust 2013August 2013 Gametogenesis & FertilisationGametogenesis & Fertilisation

Page 3: Human Gametogenesis and Fertilisation - Embryology · Dr Steven Fleming Honorary Associate University of Sydney Human Gametogenesis and Fertilisation UNSW Embryology Course 2013 August

Meiosis 1Meiosis 1

August 2013August 2013 Gametogenesis & FertilisationGametogenesis & Fertilisation

Elder, K. and Fleming, S. (2002) Gametogenesis and Preimplantation Embryo Developmentin Preimplantation Genetic Diagnosis (eds J. C. Harper, J. D.A. Delhanty and A. H. Handyside)

Page 4: Human Gametogenesis and Fertilisation - Embryology · Dr Steven Fleming Honorary Associate University of Sydney Human Gametogenesis and Fertilisation UNSW Embryology Course 2013 August

Meiosis 1 (continued)Meiosis 1 (continued)

August 2013August 2013 Gametogenesis & FertilisationGametogenesis & Fertilisation

Elder, K. and Fleming, S. (2001) Gametogenesis and Preimplantation Embryo Developmentin Preimplantation Genetic Diagnosis (eds J. C. Harper, J. D.A. Delhanty and A. H. Handyside)

Page 5: Human Gametogenesis and Fertilisation - Embryology · Dr Steven Fleming Honorary Associate University of Sydney Human Gametogenesis and Fertilisation UNSW Embryology Course 2013 August

Meiosis 2Meiosis 2

August 2013August 2013 Gametogenesis & FertilisationGametogenesis & Fertilisation

Elder, K. and Fleming, S. (2001) Gametogenesis and Preimplantation Embryo Developmentin Preimplantation Genetic Diagnosis (eds J. C. Harper, J. D.A. Delhanty and A. H. Handyside)

Page 6: Human Gametogenesis and Fertilisation - Embryology · Dr Steven Fleming Honorary Associate University of Sydney Human Gametogenesis and Fertilisation UNSW Embryology Course 2013 August

Why is meiosis a highly risky cell division?

Why is meiosis a highly risky cell division?

Which aneuploidies result in subfertility or infertility?

Which aneuploidies increase with increased maternal age?

Which aneuploidies result in subfertility or infertility?

Which aneuploidies increase with increased maternal age?

August 2013August 2013 Gametogenesis & FertilisationGametogenesis & Fertilisation

Page 7: Human Gametogenesis and Fertilisation - Embryology · Dr Steven Fleming Honorary Associate University of Sydney Human Gametogenesis and Fertilisation UNSW Embryology Course 2013 August

Hunt and Hassold (2001) Nature Reviews Genetics, 2 280-291

Aneuploidy: the scale of the problem

August 2013August 2013 Gametogenesis & FertilisationGametogenesis & Fertilisation

Page 8: Human Gametogenesis and Fertilisation - Embryology · Dr Steven Fleming Honorary Associate University of Sydney Human Gametogenesis and Fertilisation UNSW Embryology Course 2013 August

©Yorgos Nikas©Yorgos NikasEikonicaAthensGreece

EikonicaAthensGreece

August 2013August 2013 Gametogenesis & FertilisationGametogenesis & Fertilisation

Spermatozoa within the seminiferous tubule

Page 9: Human Gametogenesis and Fertilisation - Embryology · Dr Steven Fleming Honorary Associate University of Sydney Human Gametogenesis and Fertilisation UNSW Embryology Course 2013 August

SpermatogenesisSpermatogenesis

August 2013August 2013 Gametogenesis & FertilisationGametogenesis & Fertilisation

Elder, K. and Fleming, S. (2001) Gametogenesis and Preimplantation Embryo Developmentin Preimplantation Genetic Diagnosis (eds J. C. Harper, J. D.A. Delhanty and A. H. Handyside)

Page 10: Human Gametogenesis and Fertilisation - Embryology · Dr Steven Fleming Honorary Associate University of Sydney Human Gametogenesis and Fertilisation UNSW Embryology Course 2013 August

In what ways does meiosis differ during oogenesis?

In what ways does meiosis differ during oogenesis?

What are the mechanisms underlying these differences?

What are the mechanisms underlying these differences?

August 2013August 2013 Gametogenesis & FertilisationGametogenesis & Fertilisation

Page 11: Human Gametogenesis and Fertilisation - Embryology · Dr Steven Fleming Honorary Associate University of Sydney Human Gametogenesis and Fertilisation UNSW Embryology Course 2013 August

Folliculogenesis/OogenesisFolliculogenesis/Oogenesis

August 2013August 2013 Gametogenesis & FertilisationGametogenesis & Fertilisation

Elder, K. and Fleming, S. (2001) Gametogenesis and Preimplantation Embryo Developmentin Preimplantation Genetic Diagnosis (eds J. C. Harper, J. D.A. Delhanty and A. H. Handyside)

Page 12: Human Gametogenesis and Fertilisation - Embryology · Dr Steven Fleming Honorary Associate University of Sydney Human Gametogenesis and Fertilisation UNSW Embryology Course 2013 August

In Vitro Maturation In Vitro Maturation

24-48 hours

Prophase I Metaphase I Metaphase II

August 2013August 2013 Gametogenesis & FertilisationGametogenesis & Fertilisation

Page 13: Human Gametogenesis and Fertilisation - Embryology · Dr Steven Fleming Honorary Associate University of Sydney Human Gametogenesis and Fertilisation UNSW Embryology Course 2013 August

Actin-rich domain during PB formation in mouse oocyte:

MII

GV MI

Maro and Verlhac, 2002 Nature Cell Biology 4, 281-3August 2013August 2013 Gametogenesis & FertilisationGametogenesis & Fertilisation

Page 14: Human Gametogenesis and Fertilisation - Embryology · Dr Steven Fleming Honorary Associate University of Sydney Human Gametogenesis and Fertilisation UNSW Embryology Course 2013 August

Why is the timing of fertilisation regulated?Why is the timing of

fertilisation regulated?What are the mechanisms in

the male and female that regulate fertilisation?

What are the mechanisms in the male and female that

regulate fertilisation?

August 2013August 2013 Gametogenesis & FertilisationGametogenesis & Fertilisation

Page 15: Human Gametogenesis and Fertilisation - Embryology · Dr Steven Fleming Honorary Associate University of Sydney Human Gametogenesis and Fertilisation UNSW Embryology Course 2013 August

Graafian follicle

The follicle maintains the oocyte under meiotic arrest

August 2013August 2013 Gametogenesis & FertilisationGametogenesis & Fertilisation

Page 16: Human Gametogenesis and Fertilisation - Embryology · Dr Steven Fleming Honorary Associate University of Sydney Human Gametogenesis and Fertilisation UNSW Embryology Course 2013 August

RFSH LH

InsP3

Ca2+

Gap junctions

OocyteCumulus

Cells

Granulosa

Cells

FSH EGF?

FF-MAS

?

August 2013August 2013 Gametogenesis & FertilisationGametogenesis & Fertilisation

Page 17: Human Gametogenesis and Fertilisation - Embryology · Dr Steven Fleming Honorary Associate University of Sydney Human Gametogenesis and Fertilisation UNSW Embryology Course 2013 August

LH

Granulosa cells

Primordial oocyte

?

Oogonia

FF-MAS

MI MIIPreovulatoryoocyte

GV

FF-MAS?

Meiotic start and stop signalsMeiotic start and stop signals

August 2013August 2013 Gametogenesis & FertilisationGametogenesis & Fertilisation

Elder, K. and Fleming, S. (2001) Gametogenesis and Preimplantation Embryo Developmentin Preimplantation Genetic Diagnosis (eds J. C. Harper, J. D.A. Delhanty and A. H. Handyside)

Page 18: Human Gametogenesis and Fertilisation - Embryology · Dr Steven Fleming Honorary Associate University of Sydney Human Gametogenesis and Fertilisation UNSW Embryology Course 2013 August

The pathway to fertilisationThe pathway to fertilisationCapacitationHyperactivationOocyte maturationSperm-egg recognitionThe acrosome reactionSperm-egg fusionOocyte activationPronuclei formationSyngamy

CapacitationHyperactivationOocyte maturationSperm-egg recognitionThe acrosome reactionSperm-egg fusionOocyte activationPronuclei formationSyngamy

August 2013August 2013 Gametogenesis & FertilisationGametogenesis & Fertilisation

Page 19: Human Gametogenesis and Fertilisation - Embryology · Dr Steven Fleming Honorary Associate University of Sydney Human Gametogenesis and Fertilisation UNSW Embryology Course 2013 August

Yorgos NikasYorgos NikasEikonikaAthensGreece

EikonikaAthensGreece

August 2013August 2013 Gametogenesis & FertilisationGametogenesis & Fertilisation

Spermatozoa traversing ciliated epithelium

Page 20: Human Gametogenesis and Fertilisation - Embryology · Dr Steven Fleming Honorary Associate University of Sydney Human Gametogenesis and Fertilisation UNSW Embryology Course 2013 August

Yorgos NikasYorgos NikasEikonikaAthensGreece

EikonikaAthensGreece

August 2013August 2013 Gametogenesis & FertilisationGametogenesis & Fertilisation

Acrosome reacted spermatozoa in cumulus

Page 21: Human Gametogenesis and Fertilisation - Embryology · Dr Steven Fleming Honorary Associate University of Sydney Human Gametogenesis and Fertilisation UNSW Embryology Course 2013 August

Sperm penetration of mature egg - DiagramSperm penetration of mature egg - Diagram

Sperm binding

Acrosome-reacting

Acrosome-reacted

Sperm-egg fusion

Sperm incorporation

Acrosome-intact

AR in Cumulus

CR=corona radiataPVS=perivitelline space ZP=zona pellucida

August 2013August 2013 Gametogenesis & FertilisationGametogenesis & Fertilisation

Sathananthan, H. (2008) Human fertilisation after IVF and ICSI in Textbook of Assisted Reproduction for Scientists in Reproductive Technology (eds S. Fleming and S. Cooke)

Page 22: Human Gametogenesis and Fertilisation - Embryology · Dr Steven Fleming Honorary Associate University of Sydney Human Gametogenesis and Fertilisation UNSW Embryology Course 2013 August

Sperm penetration of the zona - TEMSperm penetration of the zona - TEM

August 2013August 2013 Gametogenesis & FertilisationGametogenesis & Fertilisation

Page 23: Human Gametogenesis and Fertilisation - Embryology · Dr Steven Fleming Honorary Associate University of Sydney Human Gametogenesis and Fertilisation UNSW Embryology Course 2013 August

Yorgos NikasYorgos NikasEikonikaAthensGreece

EikonikaAthensGreece

August 2013August 2013 Gametogenesis & FertilisationGametogenesis & Fertilisation

Spermatozoa penetrating the zona pellucida

Page 24: Human Gametogenesis and Fertilisation - Embryology · Dr Steven Fleming Honorary Associate University of Sydney Human Gametogenesis and Fertilisation UNSW Embryology Course 2013 August

Sperm – egg membrane fusion - TEMSperm – egg membrane fusion - TEM

Fusion

Midpiece

Ooplasm

Fusogenic zone

C

Tail

I

August 2013August 2013 Gametogenesis & FertilisationGametogenesis & Fertilisation

Page 25: Human Gametogenesis and Fertilisation - Embryology · Dr Steven Fleming Honorary Associate University of Sydney Human Gametogenesis and Fertilisation UNSW Embryology Course 2013 August

Yorgos NikasYorgos NikasEikonikaAthensGreece

EikonikaAthensGreece

August 2013August 2013 Gametogenesis & FertilisationGametogenesis & Fertilisation

Spermatozoon binding to the oolemma

Page 26: Human Gametogenesis and Fertilisation - Embryology · Dr Steven Fleming Honorary Associate University of Sydney Human Gametogenesis and Fertilisation UNSW Embryology Course 2013 August

August 2013August 2013 Gametogenesis & FertilisationGametogenesis & Fertilisation

Elder, K. and Fleming, S. (2001) Gametogenesis and Preimplantation Embryo Developmentin Preimplantation Genetic Diagnosis (eds J. C. Harper, J. D.A. Delhanty and A. H. Handyside)

Formation of pronuclei and syngamy

Page 27: Human Gametogenesis and Fertilisation - Embryology · Dr Steven Fleming Honorary Associate University of Sydney Human Gametogenesis and Fertilisation UNSW Embryology Course 2013 August

How does the oocyte know it has been fertilised?

How does the oocyte know it has been fertilised?

What is the mechanism by which the oocyte becomes

activated?

What is the mechanism by which the oocyte becomes

activated?

August 2013August 2013 Gametogenesis & FertilisationGametogenesis & Fertilisation

Page 28: Human Gametogenesis and Fertilisation - Embryology · Dr Steven Fleming Honorary Associate University of Sydney Human Gametogenesis and Fertilisation UNSW Embryology Course 2013 August

Adapted from Developmental Biology , third edition by Scott F. Gilbert

plasma mem brane of egg

sperm, not drawn t o scale

( f irst messenger)

sperm recep t or

G prote in

PLC

phosphoti dy linosit ol bis-phosphate in isolat ion

endoplasmic reticulum

cytoplasm

lumen of the ER

Ca2+

IP3 as second messenger

IP recepto r and calcium channel

3

August 2013August 2013 Gametogenesis & FertilisationGametogenesis & Fertilisation

Role of second messengers in fertilisation

Page 29: Human Gametogenesis and Fertilisation - Embryology · Dr Steven Fleming Honorary Associate University of Sydney Human Gametogenesis and Fertilisation UNSW Embryology Course 2013 August

Mature and pronuclear eggs – Nomarski opticsMature and pronuclear eggs – Nomarski optics

MII 1PN

2PN 3PN

Courtesy Dr.D.Payne, AdelaideAugust 2013August 2013 Gametogenesis & FertilisationGametogenesis & Fertilisation

Page 30: Human Gametogenesis and Fertilisation - Embryology · Dr Steven Fleming Honorary Associate University of Sydney Human Gametogenesis and Fertilisation UNSW Embryology Course 2013 August

Pronuclear ova - DiagramPronuclear ova - Diagram

Normal 2PN Dispermy

DigynyPartheno-genesis

August 2013August 2013 Gametogenesis & FertilisationGametogenesis & Fertilisation

Page 31: Human Gametogenesis and Fertilisation - Embryology · Dr Steven Fleming Honorary Associate University of Sydney Human Gametogenesis and Fertilisation UNSW Embryology Course 2013 August

How does the oocyteprevent polyspermy?How does the oocyteprevent polyspermy?How might polyspermy occur

unwittingly in vitro?How might polyspermy occur

unwittingly in vitro?

August 2013August 2013 Gametogenesis & FertilisationGametogenesis & Fertilisation

Page 32: Human Gametogenesis and Fertilisation - Embryology · Dr Steven Fleming Honorary Associate University of Sydney Human Gametogenesis and Fertilisation UNSW Embryology Course 2013 August

Fertilisation events - DiagramFertilisation events - Diagram

A: sperm-egg fusion B: second maturation division C: cortical reactionD: zona reactionE: association of male & female pronuclei

a: Sperm aster forms after sperm incorporation

activation

August 2013August 2013 Gametogenesis & FertilisationGametogenesis & Fertilisation

Sathananthan, H. (2008) Human fertilisation after IVF and ICSI in Textbook of Assisted Reproduction for Scientists in Reproductive Technology (eds S. Fleming and S. Cooke)

Page 33: Human Gametogenesis and Fertilisation - Embryology · Dr Steven Fleming Honorary Associate University of Sydney Human Gametogenesis and Fertilisation UNSW Embryology Course 2013 August

Cortical reaction at fertilisation - TEMCortical reaction at fertilisation - TEM

Zona

Ooplasm

CG

August 2013August 2013 Gametogenesis & FertilisationGametogenesis & Fertilisation

Page 34: Human Gametogenesis and Fertilisation - Embryology · Dr Steven Fleming Honorary Associate University of Sydney Human Gametogenesis and Fertilisation UNSW Embryology Course 2013 August

Block to polyspermy – nature’s way - TEMBlock to polyspermy – nature’s way - TEM

Zona

CR

Ooplasm

August 2013August 2013 Gametogenesis & FertilisationGametogenesis & Fertilisation

Page 35: Human Gametogenesis and Fertilisation - Embryology · Dr Steven Fleming Honorary Associate University of Sydney Human Gametogenesis and Fertilisation UNSW Embryology Course 2013 August

Yorgos NikasYorgos NikasEikonikaAthensGreece

EikonikaAthensGreece

August 2013August 2013 Gametogenesis & FertilisationGametogenesis & Fertilisation

Zona morphology following fertilisation

Page 36: Human Gametogenesis and Fertilisation - Embryology · Dr Steven Fleming Honorary Associate University of Sydney Human Gametogenesis and Fertilisation UNSW Embryology Course 2013 August

Adapted from Developmental Biology, third edition by Scott F. Gilbert

Sperm binds egg receptor

G protein activated

Membrane potential changed

FAST BLOCK OF POLYSPERMY

phospholipase C activated (PLC)

diacylglycerol produced (DAG)

protein kinase C activated (PK-C)

cortical reaction

SLOW BLOCK OF POLYSPERMY

increase in intracellular pH

Ca released from ER

2+IP produced

3

IP as a second messenger in fertilization3

Na ion influx

+

Na /H exchanger activated

+ +

activation of egg

August 2013August 2013 Gametogenesis & FertilisationGametogenesis & Fertilisation

Fast and slow blocks to polyspermy

Page 37: Human Gametogenesis and Fertilisation - Embryology · Dr Steven Fleming Honorary Associate University of Sydney Human Gametogenesis and Fertilisation UNSW Embryology Course 2013 August

August 2013August 2013 Gametogenesis & FertilisationGametogenesis & Fertilisation

Ovulation inductionand

Intrauterine insemination

Ovulation inductionand

Intrauterine inseminationPatent fallopian tubesOvulatory menstrual cyclesSuccess rate = 10% - 15%Increases up to 4 attemptsTotal motile sperm count≥ 10 million

Patent fallopian tubesOvulatory menstrual cyclesSuccess rate = 10% - 15%Increases up to 4 attemptsTotal motile sperm count≥ 10 million

Page 38: Human Gametogenesis and Fertilisation - Embryology · Dr Steven Fleming Honorary Associate University of Sydney Human Gametogenesis and Fertilisation UNSW Embryology Course 2013 August

August 2013August 2013 Gametogenesis & FertilisationGametogenesis & Fertilisation

In vitro fertilisation (IVF)In vitro fertilisation (IVF)

Success rate = 25% - 30%

Page 39: Human Gametogenesis and Fertilisation - Embryology · Dr Steven Fleming Honorary Associate University of Sydney Human Gametogenesis and Fertilisation UNSW Embryology Course 2013 August

August 2013August 2013 Gametogenesis & FertilisationGametogenesis & Fertilisation

What if the sperm concentration or sperm

motility is too poor for IUI or IVF?

What if the sperm concentration or sperm

motility is too poor for IUI or IVF?

Page 40: Human Gametogenesis and Fertilisation - Embryology · Dr Steven Fleming Honorary Associate University of Sydney Human Gametogenesis and Fertilisation UNSW Embryology Course 2013 August

August 2013August 2013 Gametogenesis & FertilisationGametogenesis & Fertilisation

Intra-Cytoplasmic Sperm Injection (ICSI)

Intra-Cytoplasmic Sperm Injection (ICSI)

• Only one sperm required per egg

• Success rate = 25% - 30%

• Only one sperm required per egg

• Success rate = 25% - 30%

Page 41: Human Gametogenesis and Fertilisation - Embryology · Dr Steven Fleming Honorary Associate University of Sydney Human Gametogenesis and Fertilisation UNSW Embryology Course 2013 August

August 2013August 2013 Gametogenesis & FertilisationGametogenesis & Fertilisation

What if there are no sperm being ejaculated?

What if there are no sperm being ejaculated?

Retrograde ejaculation?Genital tract obstruction?Very low sperm production?

Retrograde ejaculation?Genital tract obstruction?Very low sperm production?

Page 42: Human Gametogenesis and Fertilisation - Embryology · Dr Steven Fleming Honorary Associate University of Sydney Human Gametogenesis and Fertilisation UNSW Embryology Course 2013 August

August 2013August 2013 Gametogenesis & FertilisationGametogenesis & Fertilisation

Surgical Sperm Recovery

Testicular sperm extraction

Page 43: Human Gametogenesis and Fertilisation - Embryology · Dr Steven Fleming Honorary Associate University of Sydney Human Gametogenesis and Fertilisation UNSW Embryology Course 2013 August

PICSIPICSI

August 2013August 2013 Gametogenesis & FertilisationGametogenesis & Fertilisation

Jakab et al (2005) Fertil Steril 84: 1665-1673

Page 44: Human Gametogenesis and Fertilisation - Embryology · Dr Steven Fleming Honorary Associate University of Sydney Human Gametogenesis and Fertilisation UNSW Embryology Course 2013 August

Acridine Orange FluorescenceAcridine Orange Fluorescence

Fixation with methanol and glacial acetic acid (9:1)Staining with Acridine Orange

solution for 10 minutesMetachromatic shift in

fluorescenceGreen (native, double-stranded DNA)Red (single stranded DNA breaks)

Fixation with methanol and glacial acetic acid (9:1)Staining with Acridine Orange

solution for 10 minutesMetachromatic shift in

fluorescenceGreen (native, double-stranded DNA)Red (single stranded DNA breaks)

August 2013August 2013 Gametogenesis & FertilisationGametogenesis & Fertilisation

Page 45: Human Gametogenesis and Fertilisation - Embryology · Dr Steven Fleming Honorary Associate University of Sydney Human Gametogenesis and Fertilisation UNSW Embryology Course 2013 August

HA selection of spermHA selection of sperm

August 2013August 2013 Gametogenesis & FertilisationGametogenesis & FertilisationYagci et al (2010) J Androl 31: 566-572

Page 46: Human Gametogenesis and Fertilisation - Embryology · Dr Steven Fleming Honorary Associate University of Sydney Human Gametogenesis and Fertilisation UNSW Embryology Course 2013 August

DNA integrity of HA selected spermatozoaDNA integrity of HA

selected spermatozoa

August 2013August 2013 Gametogenesis & FertilisationGametogenesis & Fertilisation

Yagci et al (2010) J Androl 31: 566-572

Variable Mean ± SD (%)Green sperm in semen 54.9 ± 2.0Green sperm outside HA spot 56.1 ± 1.9Green sperm inside HA spot 99.1 ± 0.2Red sperm in semen 45.0 ± 1.9Red sperm outside HA spot 43.9 ± 1.9Red sperm inside HA spot 0.9 ± 1.9

Page 47: Human Gametogenesis and Fertilisation - Embryology · Dr Steven Fleming Honorary Associate University of Sydney Human Gametogenesis and Fertilisation UNSW Embryology Course 2013 August

PICSI vs Sperm SlowPICSI vs Sperm Slow

August 2013August 2013 Gametogenesis & FertilisationGametogenesis & Fertilisation Parmegiani et al (2012) Fertil Steril

Mean ICSI procedure duration (s)

PICSI = 450.0 ± 30.5SSlow = 284.1 ± 10.1p < 0.001

Page 48: Human Gametogenesis and Fertilisation - Embryology · Dr Steven Fleming Honorary Associate University of Sydney Human Gametogenesis and Fertilisation UNSW Embryology Course 2013 August

Intracytoplasmic Morphologically Selected Sperm Injection (IMSI)Intracytoplasmic Morphologically Selected Sperm Injection (IMSI)

August 2013August 2013 Gametogenesis & FertilisationGametogenesis & Fertilisation

Bartoov et al (2002) J Androl 23: 1-8

Page 49: Human Gametogenesis and Fertilisation - Embryology · Dr Steven Fleming Honorary Associate University of Sydney Human Gametogenesis and Fertilisation UNSW Embryology Course 2013 August

RCT of ICSI vs IMSIRCT of ICSI vs IMSI

August 2013August 2013 Gametogenesis & FertilisationGametogenesis & Fertilisation

Balaban et al (2011) RBM Online 22: 472-476)

Page 50: Human Gametogenesis and Fertilisation - Embryology · Dr Steven Fleming Honorary Associate University of Sydney Human Gametogenesis and Fertilisation UNSW Embryology Course 2013 August

August 2013August 2013 Gametogenesis & FertilisationGametogenesis & Fertilisation

Balaban et al (2011) RBM Online 22: 472-476

Page 51: Human Gametogenesis and Fertilisation - Embryology · Dr Steven Fleming Honorary Associate University of Sydney Human Gametogenesis and Fertilisation UNSW Embryology Course 2013 August

ART, Ethics & SocietyART, Ethics & Society

Mitochondrial disease and ooplasmic transferHaploidisation of somatic cells to

derive gametesMicroarray CGH and sperm

selection

Mitochondrial disease and ooplasmic transferHaploidisation of somatic cells to

derive gametesMicroarray CGH and sperm

selection

August 2013August 2013 Gametogenesis & FertilisationGametogenesis & Fertilisation