Vol. 6, No. 1 3 REVIEW Recent achievements in in vitro culture and preservation of ovarian follicles in mammals Lucyna Kątska-Książkiewicz1 Department of Biotechnology of Animal Reproduction, National Research Institute of Animal Production, Balice, Poland Received: 12 December 2005; accepted: 25 February 2006 SUMMARY The mammalian ovary contains a large number of follicles that are in various developmental stages. The largest portion of them are primordial follicles. However, throughout the female reproductive lifespan only a small proportion of these follicles will produce oocytes competent to undergo successful maturation and ovulation. The rest of the ovarian oocytes (>99.9%) undergo atresia. It would be of great practical benefit to rescue some of these follicles by growing them in culture in order to provide an extra source of gametes. There is considerable interest in developing technologies that aim to produce fully-grown, developmentally competent oocytes from a pool of early developmental stages of follicles. Two methods have been used: 1/ long-term in vitro culture of either follicles or oocytes, and 2/ transplantation of ovarian tissue grafts. The development of efficient technologies may provide an additional source of oocytes for livestock production and reproduction in humans and rare or endangered species. The aim of this paper is to present a comprehensive 1 Address for correspondence: Department of Biotechnology of Animal Reproduction, National Research Institute of Animal Production, Krakowska Street 1, 32-083 Balice; e-mail: [email protected] Copyright © 2006 by the Society for Biology of Reproduction 4 Culture and preservation of ovarian follicles review of recent achievements in the utilization of small ovarian follicles (primordial, preantral and early antral) by long-term in vitro culture and/ or transplantation of ovarian tissue grafts (fresh and cryopreserved) in mammals including humans. Reproductive Biology 2006 6 (1): 3–16. Key words: ovary, follicles, long-term culture, ovarian grafts, cryopreservation, transplantation INTRODUCTION Efforts to increase the utilization of reproductive potential in mammals have been made by means of multiple ovulation and embryo transfer procedures and, more recently, by in vitro embryo production (IVP). Both procedures, however, utilized only a small portion of the available follicles. Mammalian ovaries contain thousands of oocytes which are enclosed in non-growing (primordial) and growing follicles that are in various developmental stages. Normal follicular development of an oocyte that is capable of maturation, fertilization and embryonic development depends upon a complex sequence of cellular interactions within the follicle. These interactions create a unique and progressively shifting environment during the development of the oocyte. At any stage during this development, the follicle may continue to develop normally or, more frequently, proceed toward atresia. In cattle, approximately 235 000 small, non-growing and growing oocytes are enclosed in ovarian follicles of a newborn calf and 130 000 in a heifer’s ovaries [19]. However, a population of bovine females, as other mammalians, is characterized by extreme individual variation. The limits of this variation within the population sampled between birth and 24 months of age were zero (sterile) and 700 000 germ cells [19]. The largest and relatively stable pool among them is constituted by primordial follicles. When non-growing oocytes (with a diameter of 30 μm) enclosed in primordial follicles enter the growth phase, their growth to the final size (125 μm) takes a long time [5, 39]. However, throughout the reproductive lifespan of a mammalian female, only a limited number of follicles grow Kątska-Książkiewicz 5 to full size when their oocytes successfully mature and are ovulated. Most ovarian follicles (>99.9%) gradually become atretic [19, 57]. In the ovary, there is a greater number of early antral follicles than follicles at more advanced growth stages. The large store of these follicles creates a potential source of oocytes for biotechnological purposes. It would be of great practical benefit to rescue some of these follicles by growing them in culture in order to provide an extra source of oocytes. Such oocytes can be used, for example, for the multiplication of domestic animals of high genetic merit; conservation programs for rare or endangered animal species; and conservation of fertility and assisted conception in humans. As an alternative to long-term in vitro culture, transplantation of cryopreserved or fresh grafts of ovarian cortical tissue can be applied. Preservation of reproductive potential has been demonstrated in several species with numerous live young produced following transplantation of ovarian tissue in rodents [8, 14, 37, 38, 51-53, 61, 69], small mammals [2, 12, 13, 42], farm animals [1, 24, 29, 56, 58-60] and monkeys [36]. In 2004, the first live birth in humans after orthotopic transplantation of cryopreserved ovarian tissue was reported [15]. Long-term culture of ovarian follicles Predictable production of fully competent oocytes depends on utilization of appropriate biotechnology techniques. Currently, oocyte availability in cattle is limited to a small number of antral follicles (with diameter 2 to 8 mm) present in the ovary. An alternative option is to recover smaller follicles, which are not developmentally competent at the time of recovering ovaries, and carry out in vitro culture of these follicles or oocytes. Studies involving isolation of ovarian follicles and analysis of the culture requirements, metabolism, and differentiation processes in in vitro conditions have already been undertaken using rodents as experimental models [6, 9, 17, 18, 47, 63, 72]. Preantral and early antral follicles. Several culture systems have been successfully used to support long-term culture of follicles in mice [9, 17, 6 Culture and preservation of ovarian follicles 18, 47, 63, 72]. The first live mouse pup was obtained from the culture of oocyte-granulosa cell complexes isolated from neonatal primordial follicles using a complex two-step culture system developed by Eppig and O’Brien [18]. However, the birth of offspring derived from primordial and preantral follicles cultured entirely in vitro has been reported only for mice [17, 18, 47]. Many attempts have been made to apply these methods in farm animals in order to establish a complete in vitro system for preantral follicles. In contrast to the variety of systems established for production of mouse oocytes, the developmental competence in vitro of oocytes originating from preantral follicles of human or domestic animals ovaries has not yet been so successful. The reason is that the ovulatory size of a mouse follicle is only 0.5 mm in diameter, whereas in cattle the ovulatory size is larger than 1.6 cm. Secondly, the length of time taken for cultured murine preantral follicles to grow to Graafian follicles is six days, which corresponds to the length of time taken by follicles in vivo. In contrast, follicular development in cattle and sheep from the preantral stages to ovulatory size can take a number of months [5, 39]. Luissier et al [39] showed that a bovine follicle which has formed an antrum needs 40 days to reach ovulatory size. By extrapolation of these data it was estimated that the preantral stage follicle (primary or secondary) requires at least 60 to 80 days to reach maturity and the primordial stage requires at least 100 days [5, 39]. Thirdly, various factors might influence the culture of farm animal follicles such as age of animal, species, stage of follicle development and size, as well as the presence of a thick theca, which restricts the transport of nutrients and gases during the long-term culture period required for follicle growth. Finally, other factors affecting the culture of preantral follicles of farm animals are related to the technique of follicles isolation which has appeared to be more time consuming and difficult than that in rodents, mainly due to the tough, fibrous structure of the ovary. The above limitations may partly explain why the research was primary focused on the growth of follicles but not on the quality of their oocytes. In cattle, as in other farm animals, in vitro follicle culture conditions are not yet optimal, as the meiotic and developmental competence of oocytes Kątska-Książkiewicz 7 from cultured follicles is far below what one would expect from healthy in vivo grown follicles. Up to now, embryos have been produced from in vitro-grown oocytes of porcine preantral follicles with diameter 0.3 mm [71], and live births have been reported from in vitro-grown oocytes of bovine small antral follicles, with a diameter larger than 0.5 mm [27, 73]. However, when bovine follicles smaller than 0.5 mm in diameter were used, only limited success was achieved [10, 11, 24-33, 41, 46, 67, 68, 73]. Problems may arise because these bovine preantral follicles require a longer growth period and different culture conditions in order to achieve complete growth and development. Obtaining meiotically competent oocytes from cultured preantral and early antral follicles requires not only the viable oocyte and the granulosa cells, but also the presence of gap junctions and metabolic cooperation between these cells. This is essential for oocyte growth and development. Indeed, the oocyte development depends on the surrounding granulosa cells which provide nutrients via extensive gap junctions. Also, granulosa cell contact with oocyte is essential to the maintenance of the oocyte in meiotic arrest. The removal of granulosa cells or disruption of the gap junction communications between granulosa cells and the oocyte, results in spontaneous germinal vesicle breakdown and leads to degeneration [16]. In studies with ovine oocyte-granulosa cell complexes [46] it has been demonstrated that cells migrated away from the oocytes in the complexes that had lost their spherical shape. These findings and my personal observation on the culture of bovine oocyte-granulosa complexes [30-33] suggest that it is more difficult in in vitro conditions to maintain the proper association between the oocyte and granulosa cells in large animal species than in mice. During the long-term culture of bovine oocyte-granulosa complexes, the majority of granulosa cells migrate out of the follicle or follicle-like structures. The oocyte becomes denuded of cumulus cells, which could drastically reduce its quality and competence [32, 43, 73]. Unfortunately, some recent reports describing preantral follicle culture have given no information concerning oocyte quality and competence [25, 28, 72]. In sheep, Newton et al [46] analyzed the capacity of enzymatically isolated cumulus-oocyte complexes (COCs) to form antrum and to release 8 Culture and preservation of ovarian follicles estradiol. There is no information provided on the oocyte meiotic or developmental competence. In cattle, it has been shown [55, 67, 68] that preantral follicles with a diameter of 35 to 100 μm survived in culture for six or seven days, but the quality of oocyte ultrastructure appeared to be unsatisfactory, not only after culture but even immediately after follicle isolation [55, 67, 68]. Bovine late preantral and early antral follicles with a diameter approx. 170 μm can grow and survive in vitro even up to 23 days [30, 33]. After 14 days of intact follicle culture, meiotic arrest was preserved in 71.9% of enclosed oocytes [33]. Frequency of the germinal vesicle stage did not significantly differ among oocytes evaluated immediately after follicle dissection from the ovary and those cultured in the intact follicle for 6, 8, 11 or 14 days [33]. The comparison of meiotic competence of oocytes from early antral follicles with diameter 0.2 to 0.4 mm and 0.4 to 0.7 mm subjected to in vitro maturation (IVM) following long-term growth culture [31, 32] showed that a higher proportion of oocytes from the larger follicles mature to metaphase-I (30.9%), telophase I (1.8%) and metaphase-II (18.2%) compared to oocytes from follicles 0.2 to 0.4 mm that mature only to metaphase-I (15.4%). Up to now the greatest degree of success in in vitro growth culture of bovine oocytes has been associated with the culture of cumulus-oocyte complexes surrounded with parietal granulosa cells (COCGs), isolated from relatively large, early antral follicles with a diameter of 0.5 to 0.7 mm, followed by maturation of isolated COCs and in vitro fertilization (IVF; [26, 27, 33, 43, 73]). Harada et al [26] reported that 70% of bovine oocytes isolated from early antral follicles 0.5-0.7 mm in diameter showed normal morphology after eight days of culture, and increased in diameter (from 95.9±2.8 to 117.7±9.7 µm). The overall maturation potential (percentage of metaphase II oocytes) was 7 and 11% after 7 and 11 days of culture, respectively. Furthermore, using a similar follicle culture system, Miyano [43] reported that only 5% of the oocytes showed developmental competence to the blastocyst stage after IVF. In a recent study by Hirao et al [27] bovine oocytes (with a mean diameter of 95 μm) originating from follicles Kątska-Książkiewicz 9 of 0.5-0.7 mm in diameter were cultured on the flat substratum in medium supplemented with polyvinylpyrrolidione (PVP). The described culture system [27] allowed improving the efficiency of oocyte development to the blastocyst stage to 12%. The calves were only born from the cultured COCGs originating from early antral follicles with diameter 0.5 to 0.7 mm [27, 73]. When preantral follicles from prepubertal sheep were cultured, only 4 to 5% of oocytes from these follicles reached metaphase II after subsequent in vitro maturation [10]. Porcine preantral follicles (200 to 310 µm in diameter) have been cultured to the antral stage, and after culture for four days, 51% of oocytes from these follicles were capable of reaching metaphase II after subsequent IVM [71]. Therefore, a variable efficiency in acquisition of maturational competence by in vitro grown oocytes of different species has been observed. Primordial follicles. The largest proportion of ovarian follicles are resting, primordial follicles. Presently, the complete methods of in vitro growth of these follicles in large animals have not been developed. The first successful experiment in which a mouse pup was obtained from an oocyte in primordial follicle has been carried out by Eppig and O’Brien [18]. In this experiment primordial follicles were grown to full-grown stage by two culture methods: organ culture followed by 14-day in vitro culture of isolated complexes of oocyte-granulosa cells. The resulting fully grown oocytes were used for in vitro maturation and fertilization, then developing embryos were transferred to recipient females and one pup was born. Regardless of the low efficiency of the procedure (1 mouse out of 190 embryos) this result opened the possibility of utilizing primordial follicles as a potential source of oocytes in mice, as well as other mammalian species. It is also convenient and important that cryostorage of ovarian tissue can be successfully applied [24, 44, 46, 48, 49, 54]. Our understanding of primordial follicle activation and early follicle and oocyte growth has progressed to some extent using organ culture of ovarian cortical slices in large animal species [5] and whole ovary culture in rodents [18]. These culture systems remain poorly defined because they contain a wide range 10 Culture and preservation of ovarian follicles of cell types. In addition, because of the size of the tissue samples being cultured, oxygen and nutrient exchange problems may be difficult to overcome with culture of cortical slices. On the other hand, culture of isolated primordial follicles requires a culture system that is considerably extended in time. Muruvi et al [44] recently conducted investigations on enzymatically isolated neonatal sheep primordial follicles. The cryopreserved follicles, after thawing, were cultured on lectin-aggregates in a serum-free culture system over 28 days and showed long-term survival and oocyte growth. This achievement creates the basis for an in vitro growth system of oocytes from primordial follicles of large animals, but it needs further investigations and improvement. Up to now the only possible way of utilizing primordial follicles can be achieved by a combination of xenografting and in vitro culture. Cryopreservation and transplantation of ovarian grafts Xenotransplantation of ovarian tissue grafts to nude or severe combined immunodeficient (SCID) mice can be applied as a substitute for long-term in vitro culture system. Mice homozygous for the SCID mutation lack both humoral and cell-mediated immunity due to the absence of T and B lymphocytes [3, 4]; therefore they readily accept ovarian tissue explants from other mammalian species. It was first reported by Gosden et al in 1994 [24] that sheep and cat follicles in ovarian xenografts survived and developed to the antral stage in immunodeficient mice after several months. Recently, xenografting of the ovaries of 3-week-old mice into rats was successful in the generation of pups [61]. Cross-species transplantation of ovaries from large mammals, including humans [21-23, 35, 70], monkeys [7], cows [60], pigs [29], dogs [42] and marsupials [40] to recipient mice resulted in the development of antral follicles and even mature oocytes. Preservation of reproductive potential has been demonstrated in several mammalian species with numerous live young produced following transplantation of fresh or cryopreserved ovarian cortical tissue in mice [8, 14, 37, 38, 52, 61, 62, 69], hamsters [51], rabbits [53], domestic cats [2], wombats [12, 13], sheep [1, 24, 56], pigs [29], cows [58-60] and monkeys [7]. Kątska-Książkiewicz 11 In humans, it has been known for several years that many young women are likely to suffer ovarian failure as a consequence of aggressive chemotherapy or radiotherapy treatments of malignant disease. The possibility of circumventing this loss of fertility by cryopreserving ovarian tissue prior to treatment has appeared to be possible. The preservation of morphological integrity, growth and development of follicles in transplanted grafts has been reported by several investigators [21-23, 34, 54, 65, 66]. In contrast to the ovarian grafts used in animal studies, which were generally obtained from juvenile animals and exhibited uniform follicle density, the human ovarian tissue is likely to be more variable with respect to number of follicles, their distribution and fibrous content. All these parameters may impact the cryopreservation and transplantation outcome. Moreover, it is well established that there is a negative correlation between primordial follicle density and patient’s age [20]. Therefore a major factor in determining the likelihood of successful application of ovarian graft transplantation is a collection of sufficient surface of grafts for cryopreservation and storage. In order to cryopreserve approximately 1000 primordial and primary follicles it is necessary to dissect an ovarian cortex with the thickness of approximately 1 mm and the surface area of at least 3 mm2 before 10 years of age, 15 mm2 between 10 and 15 years and 50 mm2 from 15 to 34 years [54]. It has been established that the follicle survival rate was 74% after freezing, thawing and xenografting [45]. Therefore approximately 700 follicles may be available from each fragment. The size and number of ovarian tissue grafts should be adapted accordingly to patient’s age. Recently follicular growth from the primordial to the antral stage has been observed within cryopreserved human ovarian tissue following xenografting [21, 65, 66] and these follicles can undergo a normal response to hormonal treatment [22, 35]. The autotransplantation of human ovarian tissue may be done to the pelvic side wall [49], forearm and beneath the skin of the abdomen [50]. In 2004, the first live birth after orthotopic transplantation of cryopreserved ovarian tissue in humans was reported [15]. This approach opens new perspectives for young cancer patients facing premature ovarian failure. Ovarian tissue cryopreservation should 12 Culture and preservation of ovarian follicles be an option offered to young women diagnosed with cancer, in conjunction with other existing biotechnological methods for fertility preservation such as immature oocyte retrieval, in vitro maturation of oocytes, in vitro fertilization and embryo cryopreservation. Candidates for ovarian tissue banking cannot have cancer, but, if they do, the malignancy must not involve the ovaries or be in remission. Nevertheless, it may never be possible to adopt a zero-risk policy with transplantation, and this conclusion will continue to drive efforts to develop follicle culture technology. There have been significant scientific advances in the field of preservation and utilization of a pool of small ovarian follicles in mammals. It has been expected that the emergent technologies may provide an additional source of oocytes for livestock production and reproduction in humans and endangered species. 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