Patent Description:
Today, assisted reproductive technology is available throughout most of the developed countries and the practice is largely different from that used during the early days. Refinements in laboratory technology and clinical practice have allowed in vitro fertilization (IVF) to evolve into a medical procedure that is efficient, safe, readily accessible, and relatively affordable.

IVF is the joining of a woman's egg and a man's sperm in a laboratory dish. In vitro means outside the body. Fertilization means the sperm has attached to and entered the egg. The fertilized egg is an embryo. Embryo development involves a series of cell divisions. Said embryo is cultured and is checked to make sure it is developing properly.

The culture of embryos is a key and critical step for selection of viable and genetically normal embryos. Therefore, an improved culture of mammalian embryos should enable the transfer of embryos and resulting in an increased implantation rate. Trying to improve the culture media is arguably the most common approach to promote embryo development in vitro.

Several factors affect the success of IVF. Proper embryo culture conditions and medium formulation, in particular, are two indispensable requirements (<NPL>; <NPL>; <NPL>; <NPL>). Thus, to obtain mammalian embryos that successfully implant into the uterus, an improved embryo culture medium is required that mimics the phisiological conditions. In general, two possible formulations have been considered in the prior art for culture media: one is based on a sequential embryo culture medium and the other is based on a single culture medium.

The sequential embryo culture medium involves switching the embryo sequentially to two different media, the first one can drive the embryo from the one-cell stage up to the <NUM>-cell stage, the second one from <NUM>-cell to the blastocyst stage. The sequential medium tries to mimic the variable environmental conditions meet by the embryo first in the Fallopian tubes and later in the uterus.

The single culture medium provides the embryo with all the ingredients required at the different stages of develoment, and therefore does not require to switch the embryo to different plates. Currently, the continuos medium is implemented in most assisted reproduction centers.

When the embryos reach the blastocyst stage, their metabolic requirements are different from the pre-implantation embryos ones. To satisfy these metabolic demands and to ensure a proper embryo development, the culture media must have a higher protein concentration.

Back in the initial years of IVF, human serums were used for embryo culture, although they were discarded due to their low safety against contamination from possible infections from donors (<NPL>; <NPL>). Progressively, both human plasma-derived and recombinant albumin have been used as a protein supplement. Supplementing with purified albumin alone, however, does not allow the development of the embryo beyond the blastocyst stage. Nowadays, there are a number of culture media that allow the transition of pre-implantation embryos (blastocysts) to their post-implantation in vitro development. These culture media are however experimental, or include components such as hormones, xenobiotic serums or human umbilical cord serum which do not ensure GMP quality and, therefore, cannot be approved for clinical use (<NPL>, <NPL>; <NPL>; <NPL>; <NPL>).

In the last few years, assisted reproductive technology has undergone progressive optimization. However the pregnancy rate per embryo transferred is still low (~<NUM> %). The cornerstone to increase the efficiency of IVF is the embryo implantation (<NPL>). Currently, different methods, both experimental and clinical, try to improve the efficiency of embryo implantation, with very moderate or low success.

Successful implantation requires synchronization between the acquisition of implantation competency by the blastocyst and a receptive state in the uterine endometrium (<NPL>; <NPL>; <NPL>).

The use of time-lapse incubators which incorporate a built-in microscope allows the simultaneous and uninterrupted observation of embryos without the need to remove them from the incubator. To accommodate this set-up, a single culture medium was developed, which allows the culture of embryos from the <NUM>-cell stage to blastocyst. This embryo culture medium replaces the sequential culture medium, which requires one or two changes of medium during the process of embryo culture. Although some studies show that the single uninterrupted culture can improve the culture efficiency during the early stages, the benefit of this medium in later stages, from morula to blastocyst, has no statistical support (<NPL>). Retrospective studies suggest that the single-medium culture can globally improve the efficiency of in vitro culture, also improving the implantation rate, but does not have a real, significant impact on pregnancy rates (<NPL>). Time-lapse follow-up of embryo development comprises an undisturbed culture and the application of the visual information to support embryo evaluation. The selection of embryos for transfer in the time-lapse culture is based on image monitoring combined with the image analysis of a morphokinetic algorithm for embryo selection. However, a thorough statistical assesment of these algortims indicates that (i) not all algorithms are equally predictive; external parameters, such as (ii) the initial morphology of the embryo and (iii) the age of the mother have a greater impact in the determination.

Furthermore, preimplantation Genetic Diagnosis (PGD) involves biopsying embryos in culture to get few cells to perform a genetic analysis. This is an invasive method that provides information on whether an embryo is affected by a monogenic disease and/or chromosomal impairments (aneuploidies). PGD however does not offer predictive information on the ability of the embryo to implant (<NPL>). Moreover, most pre-implantation embryos are genetically mosaic, meaning that different cells have different genetic background. This is particularly true for biopsies performed on early embryos (i.e. <NUM>-cell stage). Retroactive studies show that the use of PGD does not significantly improves the embryo implantation rate (<NPL>; <NPL>).

In summary, the embryo culture from zygote stage (one cell) to the blastocyst stage is relatively optimized. However, once the embryos have been transferred to the patient, implantation success is still relatively low. For this reason, it is necessary to develop new culture components that either improve the ability of embryos to implant once transferred to the uterus, or generate robust embryos at the stage of transfer.

The inventors have carried out intensive and extensive research aimed at using different culture media with human plasma fractions and they have found, surprisingly, that by using a composition comprising one or more of the fractions of the Cohn method wherein in said composition HSA is between <NUM> % and <NUM> % of the total proteins in the composition, alfa and beta globulins are between <NUM> % and <NUM> % of the total proteins in the composition, and gamma globulin is between <NUM> % and <NUM> % of the total proteins in the composition, it is possible to improve in vitro embryo culture and to obtain better results in their implantation in comparison with embryos cultured under the conditions of the prior art. For example, these better results are shown by a higher percentage of embryos with complete hatching success.

In the present invention, the term "Cohn method" refers to the method of separating blood plasma proteins developed by Edwin J. Cohn (<NPL>) or to any of its variants.

One further advantage of the composition of the present invention is that it can be obtained from human plasma.

Therefore, the present invention discloses a composition for the culture of mammalian embryos the use of which results in a new therapeutic tool for assisted reproduction technology specialists. The effectiveness of the use of the composition obtained by the method disclosed in the present invention is based on the use of one or more of the fractions of the Cohn method enriched with HSA that, together, induce the adhesion of embryos to the culture plate improving the implantation of said mammalian embryos.

In a first aspect, the present invention discloses a composition for improving the implantation of mammalian embryos comprising the supernatant of Fraction II+III and the Fraction V of the Cohn method wherein in said composition human serum albumin (HSA) is between <NUM> % and <NUM> % of the total proteins in the composition, alfa and beta globulins are between <NUM> % and <NUM> % of the total proteins in the composition, and gamma globulin is between <NUM> % and <NUM> % of the total proteins in the composition wherein said HSA is at a final concentration of <NUM>/ml to <NUM>/ml.

In a particular embodiment, the supernatant of Fraction II+III of the Cohn method can be further processed. Once the supernatant of Fraction II+III is obtained, it is subjected to different stages until the final product is obtained. These stages usually include: dilution, clarification, diafiltration, nanofiltration, concentration by ultrafiltration, sterilisation, filling into vials and final lyophilisation of said vials, prior to submission of said vials to gamma irradiation, or a combination thereof.

In another particular embodiment, the Fraction V of the Cohn method can be further processed. Once Fraction V is obtained, the latter is resuspended in a solution and is subjected to different stages until the final product is obtained. These stages usually include: diafiltration, heat treatment, sterilisation, filling into vials and final pasteurization of said vials, prior to submission of said vials to quarantine, in general during a period of not less than <NUM> days at <NUM>-<NUM>, with the objective of ensuring the sterility of the final product, or a combination thereof.

In another particular embodiment, the supernatant of Fraction II+III and the Fraction V, as such or as further processed production intermediates or final products, are submitted to one or more production steps with capacity to eliminate pathogens.

Preferably, said HSA is present in the composition at a final concentration of <NUM>/ml.

Moreover, the present invention discloses a method for the preparation of a embryo culture medium comprising the composition of the present invention comprising the following steps:.

Preferably, the composition of the present invention is present in the embryo culture medium at <NUM> %.

Finally, the present invention discloses the use of a composition as described above for the culture of pre-implantation mammalian embryos. The implantation of the embryo is not part of the method of the invention.

Hereinafter, the present invention is described with reference to examples, which, however, are not intended to limit the present invention.

The present invention will be described below in reference to the figures, in which:.

Hereinafter, the present invention is described with reference to examples, which however are not intended to limit the present invention.

EXAMPLE <NUM>: Preparation and characterization of the composition of the present invention and comparative compositions.

Composition I (table I) differs from composition III in that it has a higher amount of albumin and a lower amount of alpha-<NUM> globulin. On the other hand, composition II differs from composition III in that it has a lower amount of albumin and a lower amount of alpha-<NUM> globulin.

The composition of the majority components of said compositions is shown in the table below:.

EXAMPLE <NUM>: Evaluation of the development of mouse embryos in the presence of the composition of the present invention and comparative compositions (shown in <FIG>).

For determining the efficiency of the embryo culture, different protein formulations were prepared using as a reference the final concentration of HSA. KSOMAA (Millipore; USA) was used as a base medium with bovine serum albumin (BSA, <NUM>/ml) for bringing the mouse embryo culture E0. <NUM> to the blastocyst stage (E3. Upon arrival at the blastocyst stage some embryos remained as a control in KSOMAA (BSA <NUM>/ml) and the rest of the embryos were transferred to a new KSOMAA medium without BSA and supplemented with:.

Embryos at the blastocyst stage (E3. <NUM>) were left in culture in the incubator until day E6. <NUM> to allow complete hatching. Their morphology was recorded daily through photographs. At the end of the incubation period (E6. <NUM>), the stage of development of the embryos in culture was evaluated.

As shown in <FIG>, the highest percentage of embryos with complete hatching success were those cultured in the presence of the composition of Group III which is the composition of the present invention. Specifically, <NUM> % of embryos in the presence of the composition of Group III managed to hatch, while in the presence of the composition of Group I <NUM> % did. Embryos cultured in the presence of BSA (<NUM>/ml) or in the presence of the composition of Group II hatched with an efficiency of <NUM> % and <NUM> %, respectively. The distribution of embryos at different stages of development shows that embryos grown in the presence of the composition of Group III have two preferential stages, either they are still in blastocyst, or most progress directly to complete hatching. Under these conditions, few embryos were at intermediate steps, for example they were not detected at bleb stage. These results suggest that the composition of the present invention allows progress in the development of viable embryos more efficiently than under the other conditions.

EXAMPLE <NUM>: Evaluation of the adhesion of the embryos hatched in the culture (shown in <FIG>).

In this example, hatched mouse embryos are able to adhere to the culture plate and proliferate if they are grown under optimal conditions. The adhesion involves an outgrowth of the embryo trophoblast attaching to the glass or plastic surface, which cannot be re-attached by flushing with a pippete. In <FIG>, measurements of the adhesion capacity of blastocysts cultured from stage E3. <NUM> to E7. <NUM> in the presence of the composition of Group I were compared to embryos cultured with the composition of Group III. The results showed a surprising increase in the adhesion of hatched blastocysts when they were cultured in the presence of the composition of Group III. Specifically, <NUM> % of the embryos cultured in the composition of Group III adhered to the plate, while, at most, <NUM> % of embryos were able to adhere in the presence of the composition of Group I. Under the other two conditions only a marginal or zero percentage managed to adhere to the plate.

EXAMPLE <NUM>: Implantation of embryos in collagen hydrogels (shown in <FIG>).

Claim 1:
Composition for improving the implantation of mammalian embryos, comprising the supernatant of Fraction II+III and the Fraction V of the Cohn method wherein in said composition human serum albumin (HSA) is between <NUM>% and <NUM>% of the total proteins in the composition, alfa and beta globulins are between <NUM>% and <NUM>% of the total proteins in the composition, and gamma globulin is between <NUM>% and <NUM>% of the total proteins in the composition wherein said HSA is at a final concentration of <NUM>/ml to <NUM>/ml.