Skip to main content
Top
Published in: Journal of Assisted Reproduction and Genetics 5/2020

01-05-2020 | Fertility | Fertility Preservation

Impaired reproductive function and fertility preservation in a woman with a dyskeratosis congenita

Authors: LeRoy G. Robinson Jr, Ricardo Pimentel, Fang Wang, Yael G. Kramer, Damla C. Gonullu, Suneet Agarwal, Paula A. Navarro, David McCulloh, David L. Keefe

Published in: Journal of Assisted Reproduction and Genetics | Issue 5/2020

Login to get access

Abstract

Purpose

To determine the impact of accelerated telomere shortening on the fertility parameters and treatment outcomes of a woman with dyskeratosis congenita (DKC).

Methods

A case study of the clinical data, blood, discarded oocytes, and arrested embryos of a woman with DKC and donated cryopreserved embryos from unaffected patients. Mean telomere length in blood cells was analyzed by flow cytometry–fluorescence in situ hybridization (flow-FISH) and qPCR. The load of short telomeres in blood cells was measured by universal single telomere length analysis (Universal STELA). The mean telomere length in embryos was analyzed by single-cell amplification of telomere repeats (SCATR) PCR.

Results

Comparison of clinical parameters revealed that the DKC patient had reduced anti-Mullerian hormone (0.3 vs 4.1 ± 5.7 ng/ML), reduced oocytes retrieved (7 vs 18.5 ± 9.5), reduced fertilization rate, and reduced euploidy rate relative to unaffected patients. Additionally, mean telomere length in DKC embryos were shorter than unaffected embryos. However, hormone treatment led to increased leukocyte telomere length, while the load of short telomeres was also shown to decrease during the course of treatment.

Conclusions

We demonstrate for the first time the direct detrimental impacts of short telomeres on female fertility. We further demonstrate positive effects of hormone treatments for people with telomere disorders.
Literature
1.
go back to reference de Lange T. Shelterin: the protein complex that shapes and safeguards human telomeres. Genes Dev. 2005;19(18):2100–10.CrossRefPubMed de Lange T. Shelterin: the protein complex that shapes and safeguards human telomeres. Genes Dev. 2005;19(18):2100–10.CrossRefPubMed
2.
go back to reference Feng J, Funk WD, Wang SS, Weinrich SL, Avilion AA, Chiu CP, et al. The RNA Component of Human Telomerase. Science. 1995;269(5228):1236–41.CrossRefPubMed Feng J, Funk WD, Wang SS, Weinrich SL, Avilion AA, Chiu CP, et al. The RNA Component of Human Telomerase. Science. 1995;269(5228):1236–41.CrossRefPubMed
3.
go back to reference Blackburn EH. Telomeres and telomerase: their mechanisms of action and the effects of altering their functions. FEBS Lett. 2005;579(4):859–62.CrossRefPubMed Blackburn EH. Telomeres and telomerase: their mechanisms of action and the effects of altering their functions. FEBS Lett. 2005;579(4):859–62.CrossRefPubMed
4.
go back to reference Britt-Compton B, Capper R, Rowson J, Baird DM. Short telomeres are preferentially elongated by telomerase in human cells. FEBS Lett. 2009;583(18):3076–80.CrossRefPubMed Britt-Compton B, Capper R, Rowson J, Baird DM. Short telomeres are preferentially elongated by telomerase in human cells. FEBS Lett. 2009;583(18):3076–80.CrossRefPubMed
5.
go back to reference Baker TG. Primordial germ cells. In: Austin CR, Short RV, editors. Reproduction in Mammals, vol. 1:: Germ Cells and Fertilization. Cambridge: Cambridge University Press; 1970. p. 1–13. Baker TG. Primordial germ cells. In: Austin CR, Short RV, editors. Reproduction in Mammals, vol. 1:: Germ Cells and Fertilization. Cambridge: Cambridge University Press; 1970. p. 1–13.
6.
go back to reference Wright DL, Jones EL, Mayer JF, Oehninger S, Gibbons WE, Lanzendorf SE. Characterization of telomerase activity in the human oocyte and preimplantation embryo. Mol Hum Reprod. 2001;7(10):947–55.CrossRefPubMed Wright DL, Jones EL, Mayer JF, Oehninger S, Gibbons WE, Lanzendorf SE. Characterization of telomerase activity in the human oocyte and preimplantation embryo. Mol Hum Reprod. 2001;7(10):947–55.CrossRefPubMed
7.
go back to reference Navot D, Bergh PA, Williams MA, Garrisi GJ, Guzman I, Sandler B, et al. Poor oocyte quality rather than implantation failure as a cause of age-related decline in female fertility. Lancet. 1991;337(8754):1375–7.CrossRefPubMed Navot D, Bergh PA, Williams MA, Garrisi GJ, Guzman I, Sandler B, et al. Poor oocyte quality rather than implantation failure as a cause of age-related decline in female fertility. Lancet. 1991;337(8754):1375–7.CrossRefPubMed
8.
go back to reference Hassold T, Chiu D. Maternal age-specific rates of numerical chromosome abnormalities with special reference to trisomy. Hum Genet. 1985;70(1):11–7.CrossRefPubMed Hassold T, Chiu D. Maternal age-specific rates of numerical chromosome abnormalities with special reference to trisomy. Hum Genet. 1985;70(1):11–7.CrossRefPubMed
9.
go back to reference Plachot M, Veiga A, Montagut J, de Grouchy J, Calderon G, Lepretre S, et al. Are clinical and biological IVF parameters correlated with chromosomal disorders in early life: a multicentric study. Hum Reprod. 1988;3(5):627–35.CrossRefPubMed Plachot M, Veiga A, Montagut J, de Grouchy J, Calderon G, Lepretre S, et al. Are clinical and biological IVF parameters correlated with chromosomal disorders in early life: a multicentric study. Hum Reprod. 1988;3(5):627–35.CrossRefPubMed
10.
go back to reference Kalmbach KH, Fontes Antunes DM, Dracxler RC, Knier TW, Seth-Smith ML, Wang F, et al. Telomeres and human reproduction. Fertil Steril. 2013;99(1):23–9.CrossRefPubMed Kalmbach KH, Fontes Antunes DM, Dracxler RC, Knier TW, Seth-Smith ML, Wang F, et al. Telomeres and human reproduction. Fertil Steril. 2013;99(1):23–9.CrossRefPubMed
11.
go back to reference Keefe DL, Liu L, Marquard K. Telomeres and aging-related meiotic dysfunction in women. Cell Mol Life Sci. 2007;64:139–43. Keefe DL, Liu L, Marquard K. Telomeres and aging-related meiotic dysfunction in women. Cell Mol Life Sci. 2007;64:139–43.
12.
go back to reference Treff NR, Su J, Taylor D, Scott RT Jr. Telomere DNA deficiency is associated with development of human embryonic aneuploidy. PLoS Genet. 2011;7(6):e1002161.CrossRefPubMedPubMedCentral Treff NR, Su J, Taylor D, Scott RT Jr. Telomere DNA deficiency is associated with development of human embryonic aneuploidy. PLoS Genet. 2011;7(6):e1002161.CrossRefPubMedPubMedCentral
13.
go back to reference Liu L, Keefe DL. Nuclear origin of aging-associated meiotic defects in senescence-accelerated mice. Biol Reprod. 2004;71(5):1724–9.CrossRefPubMed Liu L, Keefe DL. Nuclear origin of aging-associated meiotic defects in senescence-accelerated mice. Biol Reprod. 2004;71(5):1724–9.CrossRefPubMed
14.
go back to reference Keefe DL, et al. Telomere length predicts embryo fragmentation after in vitro fertilization in women—toward a telomere theory of reproductive aging in women. Am J Obstet Gynecol. 2005;192(4):1256–60.CrossRefPubMed Keefe DL, et al. Telomere length predicts embryo fragmentation after in vitro fertilization in women—toward a telomere theory of reproductive aging in women. Am J Obstet Gynecol. 2005;192(4):1256–60.CrossRefPubMed
16.
go back to reference Liu L, Franco S, Spyropoulos B, Moens PB, Blasco MA, Keefe DL. Irregular telomeres impair meiotic synapsis and recombination in mice. Proc Natl Acad Sci U S A. 2004;101(17):6496–501.CrossRefPubMedPubMedCentral Liu L, Franco S, Spyropoulos B, Moens PB, Blasco MA, Keefe DL. Irregular telomeres impair meiotic synapsis and recombination in mice. Proc Natl Acad Sci U S A. 2004;101(17):6496–501.CrossRefPubMedPubMedCentral
17.
go back to reference Keefe DL, Liu L, Marquard K. Telomeres and aging-related meiotic dysfunc-tion in women. Cell Mol Life Sci 2007;64:139–43. Keefe DL, Liu L, Marquard K. Telomeres and aging-related meiotic dysfunc-tion in women. Cell Mol Life Sci 2007;64:139–43.
18.
go back to reference Agarwal S, Loh YH, McLoughlin E, Huang J, Park IH, Miller JD, et al. Telomere elongation in induced pluripotent stem cells from dyskeratosis congenita patients. Nature. 2010;464(7286):292–6.CrossRefPubMedPubMedCentral Agarwal S, Loh YH, McLoughlin E, Huang J, Park IH, Miller JD, et al. Telomere elongation in induced pluripotent stem cells from dyskeratosis congenita patients. Nature. 2010;464(7286):292–6.CrossRefPubMedPubMedCentral
19.
go back to reference Batista LF, Pech MF, Zhong FL, Nguyen HN, Xie KT, Zaug AJ, et al. Telomere shortening and loss of self-renewal in dyskeratosis congenita induced pluripotent stem cells. Nature. 2011;474(7351):399–402.CrossRefPubMedPubMedCentral Batista LF, Pech MF, Zhong FL, Nguyen HN, Xie KT, Zaug AJ, et al. Telomere shortening and loss of self-renewal in dyskeratosis congenita induced pluripotent stem cells. Nature. 2011;474(7351):399–402.CrossRefPubMedPubMedCentral
21.
go back to reference Sklavos MM, Stratton P, Giri N, Alter BP, Savage SA, Pinto LA. Reduced serum levels of anti-Mullerian hormone in females with inherited bone marrow failure syndromes. J Clin Endocrinol Metab. 2015;100(2):E197–203.CrossRefPubMed Sklavos MM, Stratton P, Giri N, Alter BP, Savage SA, Pinto LA. Reduced serum levels of anti-Mullerian hormone in females with inherited bone marrow failure syndromes. J Clin Endocrinol Metab. 2015;100(2):E197–203.CrossRefPubMed
24.
go back to reference Bendix L, Horn PB, Jensen UB, Rubelj I, Kolvraa S. The load of short telomeres, estimated by a new method, universal STELA, correlates with number of senescent cells. Aging Cell. 2010;9(3):383–97.CrossRefPubMed Bendix L, Horn PB, Jensen UB, Rubelj I, Kolvraa S. The load of short telomeres, estimated by a new method, universal STELA, correlates with number of senescent cells. Aging Cell. 2010;9(3):383–97.CrossRefPubMed
25.
go back to reference Liu L, Bailey SM, Okuka M, Muñoz P, Li C, Zhou L, et al. Telomere lengthening early in development. Nat Cell Biol. 2007;9(12):1436–41.CrossRefPubMed Liu L, Bailey SM, Okuka M, Muñoz P, Li C, Zhou L, et al. Telomere lengthening early in development. Nat Cell Biol. 2007;9(12):1436–41.CrossRefPubMed
26.
go back to reference Townsley DM, Dumitriu B, Liu D, Biancotto A, Weinstein B, Chen C, et al. Danazol treatment for Telomere diseases. N Engl J Med. 2016;374(20):1922–31.CrossRefPubMedPubMedCentral Townsley DM, Dumitriu B, Liu D, Biancotto A, Weinstein B, Chen C, et al. Danazol treatment for Telomere diseases. N Engl J Med. 2016;374(20):1922–31.CrossRefPubMedPubMedCentral
Metadata
Title
Impaired reproductive function and fertility preservation in a woman with a dyskeratosis congenita
Authors
LeRoy G. Robinson Jr
Ricardo Pimentel
Fang Wang
Yael G. Kramer
Damla C. Gonullu
Suneet Agarwal
Paula A. Navarro
David McCulloh
David L. Keefe
Publication date
01-05-2020
Publisher
Springer US
Keyword
Fertility
Published in
Journal of Assisted Reproduction and Genetics / Issue 5/2020
Print ISSN: 1058-0468
Electronic ISSN: 1573-7330
DOI
https://doi.org/10.1007/s10815-020-01758-x

Other articles of this Issue 5/2020

Journal of Assisted Reproduction and Genetics 5/2020 Go to the issue