Over the past decades, the age at which women have their first pregnancy is increasing. There are many reasons for this, including achieving higher education qualifications, establishing a career, and evolving attitudes toward partner relationships. Higher female age is associated with decreasing fertility and increasing miscarriage rates. Consequently, assisted reproductive technologies (ART), including in vitro fertilisation (IVF), have gained popularity for both women and couples who hope to have a child.
As part of many ART procedures, the quality of both the oocyte and sperm are monitored, and the best possible combination of both from any given pairing is selected. Many techniques have been utilized to provide insight into the potential qualitative markers of oocyte health, fertilization and implantation ability, and development through to live birth. To avoid direct manipulation of the oocyte for health-determining factors, surrounding cells and extracellular matrix have been explored for potential predictive factors. During oocyte development, the preovulatory follicle is surrounded by concentric layers of somatic cells called Granulosa cells. The bi-directional communication between the granulosa cells and the oocyte is maintained throughout the continued development until ovulation. Adopting a bottom-up approach, this study will link oocyte maturation first, then fertilization, embryo evolution and blastocyst formation rate, and finally track if that blastocyst implants or not. The effects of maternal age will also be considered, especially as the number of oocytes collected will normally be less from mothers with advanced age.
This research will examine the correlation of granulosa cell ultrastructure and phenotype with post-fertilization outcomes in ART patients. This will be followed by quantifying cellular ultrastructure using image analysis, artificial intelligence, and stereological methods. This work seeks to provide greater insight into the structural alterations that lead to successful or unsuccessful outcomes for patients undergoing ART.
