title: Viability of cumulus cells is associated with basal AMH levels in assisted reproduction.
abstract: OBJECTIVE
  An interesting non-invasive approach to select embryos for transfer is analyzing the health state of somatic granulosa cells surrounding the oocyte addressing their mutual dependence. This prospective study was set up to analyse whether the DNA integrity of cumulus cells correlates with preimplantation development and basal AMH levels.
  
  
  METHODS
  Therefore, 56 patients who gave written consent were enrolled. Sequential denudation of the cumulus-oocyte-complexes was performed in order to separate corona radiata from outer cumulus cells. DNA integrity of both cell types was analysed using a modified chromatin dispersion test.
  
  
  RESULTS
  The percentage of viable corona radiata cells per patient showed a linear correlation to blastulation (P<0.05). These innermost cells showed significantly lower rates of strand breaks (P<0.01) as compared to outer cumulus cells. Age-corrected AMH was significantly associated with the DNA integrity of outer cumulus cells (P<0.05).
  
  
  CONCLUSIONS
  For the first time it could be shown that in fact clinical embryologists deal with two different entities of cumulus cells, inner and outer ones. It seems that any protective mechanism of the female gamete follows an outward gradient, so that negative effects, e.g. apoptosis, may impair outer cumulus cells first. Age-corrected AMH reflects quality of these outer cumulus cells.
  
  
  BACKGROUND
  AMH; Corona radiata cells; DNA fragmentation; Outer cumulus cells; SCD test.
authors.affiliation: Landes- Frauen- und Kinderklinik, Departement of Gynecological Endocrinology and Kinderwunsch Zentrum Linz, Krankenhausstr. 26-30, Linz, Upper Austria, Austria; Johannes Kepler University, Faculty of Medicine, Altenberger Straße 69, Linz, Upper Austria, Austria; Karl-Franzens-University Graz, Department for Mathematics and Scientific Computing, Heinrichstraße 36, Graz, Styria, Austria. Electronic address: Thomas.ebner@gespag.at.
authors.forename: Thomas
authors.initials: T
authors.lastname: Ebner
authors.affiliation: Landes- Frauen- und Kinderklinik, Departement of Gynecological Endocrinology and Kinderwunsch Zentrum Linz, Krankenhausstr. 26-30, Linz, Upper Austria, Austria; Johannes Kepler University, Faculty of Medicine, Altenberger Straße 69, Linz, Upper Austria, Austria.
authors.forename: Omar
authors.initials: O
authors.lastname: Shebl
authors.affiliation: Technical University of Graz, Institute of Biochemistry, Petersgasse 12, Graz, Styria, Austria.
authors.forename: Sandra
authors.initials: S
authors.lastname: Holzer
authors.affiliation: Landes- Frauen- und Kinderklinik, Departement of Gynecological Endocrinology and Kinderwunsch Zentrum Linz, Krankenhausstr. 26-30, Linz, Upper Austria, Austria; Johannes Kepler University, Faculty of Medicine, Altenberger Straße 69, Linz, Upper Austria, Austria.
authors.forename: Peter
authors.initials: P
authors.lastname: Oppelt
authors.affiliation: Medical University of Graz, Institute of Human Genetics, Harrachgasse 21, Graz, Styria, Austria.
authors.forename: Erwin
authors.initials: E
authors.lastname: Petek
authors.affiliation: Karl-Franzens-University Graz, Department for Mathematics and Scientific Computing, Heinrichstraße 36, Graz, Styria, Austria.
authors.forename: Gudrun
authors.initials: G
authors.lastname: Schappacher-Tilp
authors.affiliation: Landes- Frauen- und Kinderklinik, Departement of Gynecological Endocrinology and Kinderwunsch Zentrum Linz, Krankenhausstr. 26-30, Linz, Upper Austria, Austria; Johannes Kepler University, Faculty of Medicine, Altenberger Straße 69, Linz, Upper Austria, Austria.
authors.forename: Richard B
authors.initials: RB
authors.lastname: Mayer
mesh_terms: D000328:Adult; D054304:Anti-Mullerian Hormone / Q000097:blood*; D017209:Apoptosis; D015415:Biomarkers / Q000097:blood; D002470:Cell Survival / Q000502:physiology; D002478:Cells, Cultured; D054885:Cumulus Cells / Q000166:cytology* / Q000502:physiology*; D053960:DNA Breaks; D004624:Embryo Transfer / Q000379:methods; D005260:Female; D006801:Humans; D066298:In Vitro Techniques; D011446:Prospective Studies; D027724:Reproductive Techniques, Assisted
chemical_list: D015415:Biomarkers; D054304:Anti-Mullerian Hormone