OBJECTIVE: There is a significant reduction in both the quantity and quality of oocytes in women with diminished ovarian reserve. These patients often turn to egg donation. Germline nuclear transfer may improve egg quality and embryo development, offering these patients the opportunity to maintain their genetic lineage.

MATERIALS AND METHODS: This study involved 52 patients of advanced maternal age, averaging 41.2 years, with diminished ovarian reserve (AMH: 0.2-1.4), who had gone through 5 or more unsuccessful IVF/ICSI attempts without achieving blastocysts or euploid blastocysts. Oocyte donors, proven fertile with at least 2 live births, underwent Carrier Screening and Karyotype tests. Nuclear and spindle transfer techniques were performed using single-step cell culture media enriched with Cytochalasin B and Nocodozalo. HVJ-E transfection reagent facilitated the fusion of nuclei. Post-procedure, blastocyst development was monitored in the same culture medium and incubator, followed by PGT-A on all embryos.

 

RESULTS: The average oocyte count of the patients was 5.2, with a fertilization rate of 92.59%. The blastocyst formation rate was 56.21%, and the euploid blastocyst rate after PGT-A was 67.7%. The initial clinical pregnancy rate following nuclear transfer was 49.4%. For the 12 patients who underwent spindle transfer, the clinical pregnancy rate was 44.71%. There were 19 live births, and 7 pregnancies were ongoing.

 

CONCLUSION: Decreased ovarian reserve adversely impacts oocyte quality and fertilization rates. The likelihood of oocyte aneuploidy increases as mitochondrial activity declines with age, affecting embryo development. These findings underscore the potential of nuclear transfer and spindle transfer techniques in improving reproductive outcomes for this patient population.

Uliana Dorofeyeva is a Director of International Cooperation at IVMED, Ukraine, and a Medical Director at OVOGENE Egg Donor Bank. She is a multi-talented, engaging and results-oriented fertility specialist with significant experience in ART. She is trained in all aspects of andrology and reproductive endocrinology with exceptional knowledge in the areas of laboratory quality control, vitrification of oocytes, cryopreservation of gametes, embryos and unique ovarian tissue, micromanipulation of gametes including Intracytoplasmic Sperm Injection and Assisted Hatching. Worth mentioning that she is a member of ASRM and ESHRE (American and European Society of Reproductive Medicine).