Étude de l'expression des gènes dans les cellules du follicule ovarien humain post ovulation afin d'identifier les causes d'échec en fécondation in vitro

Authors: Fortin, Chloé
Advisor: Sirard, Marc-AndréRobert, Claude
Abstract: Since the last few decades, couples tend to postpone parenthood to later in life. As a result, an increasing number of couples are facing infertility problems when it comes to building a family and have children. Consistently, the use of assisted reproductive technologies such as in vitro fertilization is also increasing. Despite all the progress that has been made since the introduction of in vitro fertilization in the 1980s, the success rate of this technique remains low, with a pregnancy rate around 30%. The patient's response to the stimulation treatment that precedes in vitro fertilization is extremely variable and difficult to predict. Moreover, when a cycle fails, most of the time there is no apparent reason. The hypothesis of this thesis is that there is a transcriptomic signature in follicular cells that reflects the ovarian response. Gene expression could be used to characterize the patient's response to the hormonal stimulation in order to adapt the next treatment accordingly and thus potentially improve the chances of success. Our work focuses on the gene expression in granulosa cells coming mainly from stimulated follicles in the context of in vitro fertilization or from an in vitro cell culture model. First, follicular cell samples from women undergoing in vitro fertilization treatment were obtained. We used a microarray to compare gene expression between patients that did not become pregnant following the in vitro fertilization cycle and those that did. We found that there is a different transcriptomic signature in patients who failed to conceive following in vitro fertilization. In addition, the analysis of the differentially expressed genes and the related biological pathways gave us more information on the physiological mechanisms potentially related to IVF failure, such as inflammatory imbalance, abnormal differentiation and increased apoptosis. For the next study, 135 follicular cell samples coming exclusively from patients who failed to conceive following in vitro fertilization (no pregnancy) were used. Genes related to different potential failure causes were analyzed using qRT-PCR and a hierarchical clustering analysis was then performed. The population of non-pregnant patients was divided into three groups, each one having a specific gene expression pattern related to a potential failure cause. The results of this study showed that it is possible to distinguish different failure causes or different follicular responses in patients whose cycle had failed. We finally used an in vitro model of human granulosa cells (KGN cell line) to see if pure granulosa cells were able to respond to different inflammatory stimuli. This preliminary study showed, through the expression of inflammation-related genes, that granulosa cells alone are able to create an inflammatory response and that this response differs depending on the type of stimulus. Taken together, the results of these studies improve the current knowledge and our understanding of in vitro fertilization failure. They also highlight the potential of gene expression to serve as a follicular response diagnostic tool. Finally, they also confirm the importance of inflammation and its control, particularly in the context of assisted reproductive technologies.
Document Type: Thèse de doctorat
Issue Date: 2021
Open Access Date: 10 January 2022
Permalink: http://hdl.handle.net/20.500.11794/71430
Grantor: Université Laval
Collection:Thèses et mémoires

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