vaoeh education956

Mitochondrial production of ATP is the main source of energy for many oocyte functions including chromosomal dysjunction, polar body extrusion and subsequent mitoses and cell division related to embryogenesis up to the blastocyst stage. There is evidence that mitochondrial function may decrease with oocyte aging. In this review, I discuss in vivo and in vitro methods of potentially increasing mitochondrial activity and subsequent embryo development in in vitro fertilization. In vivo, dietary supplementation with vitamins that act as mitochondrial nutrients is effective in aged mice but more clinical studies are required. In vitro, injection of recombinant mitochondrial proteins in a murine model of reduced embryo development seems to increase energy metabolism and may add anti-apoptotic activity with improved blastocyst formation. Early work with cytoplasmic injection from donor oocytes into oocytes of women with poor embryo development was found to result in improved embryo development and live births but was associated with mitochondrial DNA heteroplasmy. This technique has now been supplanted by injection of autologous mitochondria, derived from newly discovered oocyte precursor cells. This technique has recently shown clinical promise with improved pregnancy and live birth rates in women with previously failed IVF due to poor embryo development.