QUALITY FOR IN VITRO FERTILIZATION

CROSS-REFERENCES TO RELATED APPLICATIONS 10001] This application claims benefit of U.S. Provisional Application No. 61/578,666, filed December 21, 201 1 , the disclosure of which is hereby incorporated by reference in its entirety for ail purposes.

STATEMENT AS TO RIGHTS TO INVENTIONS MADE UNDER FEDERALLY SPONSORED RESEARCH AND DEVELOPMENT

[0002] This invention was made with Government support under National Institutes of Health (NIH) Grant Nos. HD052909-01 (29187) and GM080527-01 (29183). The

Government has certain rights to this invention.

BACKGROUND OF THE INVENTION

[Θ0Θ3] In current in vitro fertilization (IVF) methods, multiple embryos are routinely transferred in view of the inability to recognize those embryos that will produce a viable pregnancy. This is a widely accepted practice, particularly in older reproductive-age women, even though it is well established that adverse effects are associated with multiple embryo transfer resulting in multiple gestation [1]. This includes increased maternal complications (e.g., pre-eclampsia) and increased morbidities and mortality of neonates (e.g., pre-term delivery, neuro-developmental disorders). Oocytes traverse two critical maturation steps around the periovulatory period. The nucleus undergoes changes (nuclear maturation) required for the production of gametes with the correct pfoidity and genetic information ([2], [3]). At the same time, additional poorly defined changes collectively called "cytoplasmic maturation", including organelle relocation within the cytoplasm of the egg, must take place in the oocyte ([4], [5]). Both nuclear and cytoplasmic maturation are essential for the oocyte to acquire the competence to develop into an embryo. They must they take place prior to fertilization and also must occur in synchrony [61. As transcription is silent in the fully grown oocyte, developmental competence relies largely on a post-transcriptional program of selective recruitment of maternal mR A to the oocyte polysomes for protein synthesis [3]. Although the importance of transiational regulation for embryonic development is undisputed, very little is known about this program at the molecular level.

[0005] Currently available non-invasive screening methods to identify oocytes that are likely to produce embryos that will be viable are based on morphological observations and embryo scoring or monitoring the rate of cleavage. These assessments are not quantitative, are difficult to standardize, and are subjective. Thus, there is a need to develop new strategies to assess the quality of retrieved oocytes and of embryos that are to be transferred. This invention provides a method to efficiently and reproducibly assess oocyte quality in terms of the abilit of the oocyte to be fertilized and develop as a viable embryo. BRIEF SUMMARY OF THE INVENTION

[0006] This invention relates, in part, to the discovery that in many cases of infertility and rVF failure, complex programs that results in proper translation of a competent RNA repertoire are not correctly executed. Accordingly, the current invention provides methods of evaluating oocyte competency by determining the translation profile of oocytes. The method can be performed using oocytes from any mammal.

[0007] In one aspect, the invention provides a method of identifying an oocyte that is suitable for use in in vitro fertilization, the method comprising: culturing a candidate oocyte in an oocyte culture medium; obtaining a sample of the medium in which the oocyte has been cultured for a defined period of time, e.g., 4 to 12 hours; analyzing a profile of proteins secreted in to the media by the oocyte or embryo, that reflects the translational program. The analysis comprises determining the amounts of multiple proteins selected from a group of secreted proteins consisting of, but not limited to, BMP15, 1L-7, FGFl, ΤΟΡβ2, TGFp3, PTHPIP, Def41b, BMP5, Gremlin 1 , Rspo2, EGF, and CSFl in the culture medium; and comparing the amount of the feast one protein to the amount in the spent medium from a competent oocyte. In some embodiments, the oocyte is fertilized.

[0008] These secreted targets are identified on the basis of measurements of translation at varying states of oocyte maturation and in a model of impaired oocyte competence (see Table 1). In some embodiments, the amounts of at least two proteins selected from BMP 15, IL--7, FGFl , TOFp2, ΤΟΡβ3, PTHPIP, Def41b, BMP5, Gremlin 1, Rspo2, EGF, and CSFl are determined. In some embodiments, the amounts of at least three proteins selected from

BMP 15, TL--7, FGFl, TGFp2, TGFp3, PTHPIP, Def41b, BMP5, Gremlini, Rspo2, EGF, and CSFl are determined. In some embodiments, the amounts of at least four proteins selected from BMP 15, IL-7, FGFl, ΤΟΡβ2, TGFp3, PTHPIP, Def41b, BMP5, Gremlini , Rspo2, EGF, and CSF l are determined, in some embodiments, the amounts of at feast five proteins selected from BMP 15, IL-7, FGF1 , TGF[¾ TGFp3, PTHPIP, Def41b, BMP5, Gremiinl , Rspo2, EGF, and CSFl are determined. In some embodiments, the amounts of at least six proteins selected from BMP 15, IL-7, FGF l, ΤΟΡβ2, TGFp3, PTHPIP, Def41 b, BMP5, Gremiinl , spo2, EGF, and CSFl are determined. In some embodiments, the levels of more than one, e.g., 2, 3, 4, 5, 6, 7, 8, 9, 10, 1 1, or 12, proteins selected from BMP 15, IL-7, FGFl, TGFp2, TGFp3, PTHPIP, Def41b, BMP5, Gremiinl , Rspo2, EGF, and CSFl are determined. In some embodiments, the levels of BMPI 5, IL-7, FGF l , ΤΟΡβ2, ΤΟΡβ3, PTHPIP, Def41b, BMP5, Gremii l , Rspo2, EGF, and CSF l are determined, 1000.9] In a further aspect, the invention also provides a method to detect the levels of a plurality of oocyte secreted proteins in a single assay. In typical embodiments, the kit comprises reagents for detecting at least 2, 3, 4, 5, 6, 7, 8, 9, 10, 1 1 , or 12 more proteins selected from, but limited to, BMP 15, IL-7, FGF l , TGFp2, TGFP3, PTHPIP, Def41 b, BMP5, Gremiinl , Rspo2, EGF, and CSF l . In some embodiments, the kit further comprises reagents for detecting at least one protein selected from the groups of secreted proteins described above. In some embodiments, the kit comprises reagents for a DNA barcode assay, e.g., magnetic beads to which a primary antibody to the protein to be detected is attached and a secondary antibody that binds to the protein, attached to a DNA barcode sequence.

[0010] Other objects, features, and advantages of the present invention will be apparent to one of skill in the art from the following detailed description and figures.

BRIEF DESCRIPTION OF THE DRAWINGS

[0011] Figure !, a, b. Schematic of DNA barcode immunoassay.

[0012] Figure 2. (a). Example of a standard curve for quantifying a barcode qPCR reaction, (b) Increased sensitivity of detection of DNA barcode imunoassay versus conventional Enzyme-finked Immunosorbent Assay (ELISA)

[0013] Figure 3. Translation of mRNA coding for secreted proteins in oocytes from AREG knockout mice compared to normal mice. The two groups compared are oocytes at the Mil stage of development (these are oocytes ready to be fertilized, also called eggs; this is the stage retrieved during IVF). The competent oocytes come from wild type mice, whereas the incompetent oocytes are from a KO model (AREG KQj. These mice have reduced fertility and about 50% of the oocytes do not fertilize when tested in an in vitro fertilization protocol (IVF protocol). [0014] Figure 4, Measurement of Secreted AREG into IVF conditioned media from human cumulus-oocyte (COC) complexes using DNA barcode immunoassay.

DETAILED DESCRIPTION OF THE INVENTION

[0015] As used herein, the following terms have the meanings ascribed to them unless specified otherwise.

[0016] As used herein, the term "oocyte maturation" refers to biochemical events that prepare an oocyte for fertilization. Such processes may include, but are not limited to, the completion of meiosis IL Oocyte cytoplasmic maturation events may include, but are not limited to, inRNA translation and protein accumulation to achieve competence for fertilization. In the present invention, oocytes that are analyzed are arrested at metaphase of meiosis IL

[0017] The term "competent" with respect to an oocyte refers to the ability of the oocyte to be fertilized and produce a viable embryo.

[0018] In the context of this invention, "an amount of a protein that is associated with competence" refers to the amount of secreted protein present in a spent media following a defined period of incubation of an oocyte in the media where the amount is that secreted by a known competent oocyte. In some embodiments, the oocyte may be a fertilized oocyte (i.e., embryo).

[0019] A "patient" in the context of this invention refers to any mammal. [0020] A "translation profile" in the context of this invention refers to the amount of proteins of interest in a secreted into a medium by an oocyte or embryo. In some

embodiments the amounts of at least 7 proteins are determined in a translation profile,

[0021] The term "TGFp2" in the context of the present invention refers to transforming growth factor beta 2. protein, which is a member of the transforming growth factor beta (TGFB) family of growth factors. An example of a human ΤΟΡβ2 protein sequence is available under accession number U iProtKB/Swiss-Prot P61 812. An example of a human nucleic acid sequence encoding TGFp2 is available under accession number NM 001 135599. Human TGFp2 is localized to chromosome lq41. TGFP2 refers to allelic variants that are encoded by the gene at the TGPp2 chromosomal locus. [0022] The term "TGFp3" in the context of the present invention refers to transforming growth factor beta 3 protein, which is a member of the transforming growth factor beta (ΤΟΡβ) family of growth factors. An example of a human ΤΟΡβ3 protein sequence is available under accession number UniProtKB/Swiss-Prot PI 0600. An example of a human DNA sequence encoding TGFB3 is available under accession number NM 003239. Human ΤΟΡβ3 is localized to chromosome 14q24. "ΤΟΡΒβ" also encompasses allelic variants of the exemplar '- references sequence that are encoded by a gene at the ΤΟΡβ3 chromosomal locus.

[0023] The term "EGF" in the context of the present invention refers to epidermal growth factor protein protein. An example of a human EGF protein sequence is available under accession number UniProtKB/Swiss-Prot P01 133. An example of a human nucleic acid sequence encoding EGF is available under accession number NM 001 178130. Human EGF is localized to chromosome 4q25. "EGF" also encompasses allelic variants of the exemplary references sequence that are encoded by a gene at the EGF chromosomal locus,

[0024] The term "Defb41 " is mouse beta-defensin 41 precursor, but as used herein also encompasses the human ortholog beta-defensin 1 10 isoform b. An example of a human Defb41 protein sequence is available under accession number Q30KQ9. An example of a human nucleic acid sequence encoding Defb41 is available under accession number

NM_001037497. Human Defb41 is localized to chromosome 6pl2,3 "Defb41" also encompasses allelic variants of the exemplary references sequence that are encoded by a gene at the Defb41 chromosomal locus.

[0025] The term "PTHPIP" or "PTHrP" in the context of the present invention refers to parathyroid hormone like hormone (Pthlh). In the mouse, the gene is referred to as parathyroid hormone like peptide. An example of a human PTHPIP protein sequence is available under accession number UniProtKB: PI 2272. An example of a mouse sequence is NM 008970.3. Examples of human nucleic acid sequences encoding PTHPIP are available under accession numbesr NM 002820.2, NM 198964.1, NM 198965. L and NM 198966, 1. Human PTHPIP is localized to Enirez Gene cytogenetic band: 12pl2. I -pl 1.2. "PTHPIP" also encompasses allelic variants of the exemplary references sequence that are encoded by a gene at the PTHPIP chromosomal locus.

[0026] The tenn "GDF9" in the context of the present invention refers to

growth/differentiation factor 9 protein. An example of a hitman GDF9 protein sequence is available under accession number UniProtKB/Swiss-Prot 060383. An example of a human nucleic acid sequence encoding GDF9 is available under accession number NM_005260. Human GDF9 is localized to cytogenetic band 5q31.1. "GDF9" also encompasses allelic var nts of the exemplary references sequence that are encoded by a gene at the GDF9 chromosomal locus.

[0027] The term "BMP5" in the context of the present invention refers to bone

morphogenetie protein 5 protein. An example of a human BMP5 protein sequence is available under accession number UniProtKB/Swiss-Prot P22003. An example of a human nucleic acid sequence encoding BMP5 is available under accession number NM_021073. Human BMP5 is localized to cytogenetic band 6 l2.1 , "BMP5" also encompasses allelic variants of the exemplary references sequence that are encoded by a gene at the BMP5 chromosomal locus. [0028] The term "BMP 15" in the context of the present invention refers to bone morphogenetie protein 15 protein. An example of a human GDF9 protein sequence is available under accession number UniProtKB/Swiss-Prot 095972. An example of a human nucleic acid sequence encoding BMP 15 is available under accession number NM_005448. Human BMP 15 is localized to cytogenetic band X l l.2. "BMP 15" also encompasses allelic variants of the exemplary references sequence that are encoded by a gene at the BMP 15 chromosomal locus.

[0029] The term "IL-7" or "IL7"in the context of the present invention refers to interleukin- 7 protein. An example of a human IL-7 protein sequence is available under accession number UniProtKB/Swiss-Prot Pi 3232. An example of a human nucleic acid sequence encoding IL-7 is available under accession number NM 000880. Human IL-7 is localized to Entrez Gene cytogenetic band 8ql2-ql3. '"IL-7" also encompasses allelic variants of the exemplary references sequence that are encoded by a gene at the IL-7 chromosomal locus.

[0030] The term "CSFF'in the context of the present invention refers to macrophage colony-stimulating factor protein. An example of a human CSF1 protein sequence is available under accession number UniProtKB/Swiss-Prot P09603. An example of a human nucleic acid sequence encoding CSF1 is available under accession number NM 000757. Human CSF1 is localized to Ensembl cytogenetic band 1 p 13.3 , "CSF l" also encompasses allelic variants of the exemplary references sequence that are encoded by a gene at the CSF l chromosomal locus. [0031] The term "FGFT'in the context of the present invention refers to fibroblast growth factor I protein. An example of a human FGFl protein sequence is available under accession number UniProtKB/Swiss-Prot P05230. An example of a human nucleic acid sequence encoding FGFl is available under accession number NM 000800. Human FGF l is localized to cytogenetic band 5q31. "FGFl" also encompasses allelic variants of the exemplary references sequence that are encoded by a gene at the FGFl chromosomal locus.

[0032] The term "Gremlin 1" or "GREM1" in the context of the present invention refers to Gremlin 1 protein. Alternative names include cell proliferation-inducing gene 2 protein, cysteine knot superfamiiy 1, BMP antagonist 1, DAN domain family member 2, down- regulated in Mos-transformed cells protein, increased in high glucose protein 2, and IHG-2. An example of a human Gremlin 1 protein sequence is available under accession number UniProtKB/Swiss-Prot 060565. An example of a human nucleic acid sequence encoding Gremlin 1 is available under accession numbers NM 0010091323.1 and NM 01337206. Human Gremlin lis localized to cytogenetic band 15ql 3.3, "Gremlin 1 " also encompasses allelic variants of the exemplary references sequence that are encoded by a gene at the Gremlin 1 chromosomal locus.

[0033] The term "Rspo2" in the context of the present invention refers to R-spondin-2 or roof place specific spondin-2 protein. An example of a human Rspo2 protein sequence is available under accession number UniProtKB/Swiss-Prot Q6UXX9. An example of a human nucleic acid sequence encoding Rspo2 is available under accession number NM_0178565.4. Human Rspo2 is localized to cytogenetic band 8q23.1. "Rspo2" also encompasses allelic variants of the exemplary references sequence that are encoded by a gene at the Rspo2 chromosomal locus. [0034] The term "antibody" refers to an immunoglobulin which specifically binds to an antigen. The antibody can be monoclonal or polyclonal and can be prepared by techniques that are well known in the art such as immunization of a host and collection of sera

(polyclonal) or by preparing continuous hybrid cell lines and collecting the secreted protein (monoclonal), or by cloning and expressing nucleotide sequences or mutagenized versions thereof coding at least for the amino acid sequences required for specific binding of natural antibodies. Antibodies may include a complete immunoglobulin or fragment thereof, which immunoglobulins include the various classes and isotypes, such as IgA, IgD, IgE, IgGi, lgG2a, IgG2b and lgG3, IgM, etc. Fragments thereof may include Fab, Fv and F(ab')¾ Fab', and the like. In addition, aggregates, polymers, and conjugates of immunogl obulins or their fragments can be used where appropriate so long as binding affinity for a particular molecule is maintained. Antibodies to the proteins of interest are commercially available or can be obtained using known techniques as noted above. [0035] As used here "barcode", "biochemical barcode", "biobarcode", "barcode oligonucleotide", or "barcode DNA" are used interchangeably.

[0036] The term "particle" or "bead" refers to a small surface, typically composed of a metal, silica, silicon-oxide, or polystyrene to which a substrate may be attached. A "particle" can be any shape, such as spherical or rod-shaped.

Method of identifying competent oocytes

[0037] The present invention relates to methods of identifying oocytes that are competent. The methods comprise evaluating oocytes for secreted proteins that are indicative of oocyte competence. The methods and compositions described herein can be used to evaluate oocytes from any mammal. In some embodiments, the oocytes are from humans. Other mammalian oocytes that can be assessed for secreted proteins include, but are not limited to, bovine, equine, ovine, caprine, porcine, feline, canine, or non-human primate, such as simian, oocytes.

Oocyte retrieval and culture [0038] Oocytes are retrieved using known procedures. In some embodiments, the oocytes are from a human. In other embodiments, oocytes are retrieved from a non-human mammal such as a cow, horse, pig, or sheep. Oocyte retrieval and culture techniques using human oocytes are used here as illustrative examples. One of skill understands that oocytes can be retrieved from non-human mammals using known techniques and similarly cultured. [0039] For purposes of illustration and not limitation, in some embodiments, oocytes are retrieved from human patients undergoing controlled ovarian stimulation during treatment for in vitro fertilization (TVF). In a typical IVF cycle, a hCG bolus is given to complete the final stages of oocyte maturation. Oocyte retrieval is typically performed using ultrasound-guided needle aspiration of the ovarian follicles. Cumulus- oocyte complexes, which are the oocytes and cumulus cells that surround the oocytes, are then isolated from the ovarian follicular fluid.

[0040] Following isolation, individual cumulus-oocyte complexes are cultured in defined medium, following which the medium is collected. The cumulus-oocyte complexes are incubated for at least 3 hours and preferably at least 5 or 6 hours, and in some embodiments at least 7, 8, 9, 10, 1 1 , or 12 hours, in defined medium, preferably at 37°C, At the end of the incubation, the cumulus-oocyte complex is transferred to fresh medium and the incubation medium is collected for analysis. [0041] In embodiments in which the oocyte is fertilized, fertilizing the oocytes to obtain an embryo is performed by standard in vitro fertilization techniques. The oocytes are either directly incubated with spermatozoa for IVF or are stripped of the cumulus cells, scored for the stage of maturation, and mature Mil oocytes are fertilized by intracytoplasmic sperm injection (ICSI). The oocytes are then incubated, typically for about 14-20 hours, and then assessed by microscopy for normal fertilization, as defined by the presence of two pronuclei within the new ly fertilized oocyte. At the end of this second incubation spent media are collected, (embryo spent medium). Embryos may be incubated for an additional time period (e.g., a total of 3-5 days) and scored for morphological and or genetic measures of embryo quality, in the present invention, an assay of secreted proteins present in the culture medium sample (embryo spent media) is also employed to select embryos that will be transferred.

[0042] Any number of defined media are used for oocyte or embryo incubation. For example, commercially available mammalian cell culture media may be used. Examples of media that are suitable for incubating oocytes or embryos include formulations using minimal media such as MEMcc, Ham's F 12, DMEM, with supplements, and the like. In typical embodiments, the oocytes or embryos are cultured in commercially available in vitro fertilization medium. As understood in the art, when spent medium is collected to be evaluated for the presence of secreted proteins to identify competent oocytes or to select embryos, serum or other complex mixtures of proteins are not included in the culture medium. Examples of commercially available media include Vitrolife G-i medium (Vitro life Goteborg, Sweden), In some embodiments, the media are supplemented with a serum substitute, e.g., serum substitute supplement, Irvine Scientific, or HSA (human serum albumin).

Assay of oocyte and embryo secretory products

[0043] In the present invention, oocyte and embryo quality determination is based on their secretion of proteins being synthesized during oocyte maturation and early embryo development. Examples of secretory products affected by oocyte quality mclude EGF, TGF[32, ΤΟΡβ3, PTHPIP, IL-7, De†b41 , Rspo2, CSFi, and BMP5. There are also secreted proteins where the level of protein in the medium is not affected, which can be used as controls. Secretory products not affected and that can be used as control reference levels of secreted proteins include Gremlin! , BMP 15 and FGF1.

[0044] Table I shows representative genes coding for proteins secreted by the oocytes and their pattern of translation during maturation, as well as the changes that can occur in oocytes or embryos with compromised developmental competence. The list of genes expressed by the oocyte was derived from microarray data. Changes in translation in the mRNA during maturation were assessed by measuring the level of corresponding mR As in the polysome fraction using array hybridization or qPCR. Changes in oocytes with compromised quality were derived from the analysis of the Areg knockout mouse or from available human data. As understood in the art, there may be alterations to these patterns. However, in the embodiments of the inv ention, evaluation of a secreted protein panel comprising one or more of BMP 15, IL7, FGF1 , TGFp3, ΤΟΡβ2, PTHPTP, Def41b, BMP5, Gremlin 1 , Rspo2, EOF, or CSFI , preferably two, three, four, five, six, seven, eight, or nine or more of these secreted proteins in comparison to normal allows one of skill to determine the likelihood of an oocyte having comprised competence, in some embodiments, evaluation of secreted proteins to assess oocyte competence comprises determining the amount of secretion of at least one protein selected from IL-7; CSF I , PTFiPIP, TGF|32, and EGF. In some embodiments, evaluation of secreted proteins to assess oocyte competence comprises determining the amounts of secretion of at least two proteins selected from IL-7; CSFI , PTHPIP, ΤΟΡβ2, and EGF. In some embodiments, evaluation of secreted proteins to assess oocyte competence comprises determining the amounis of secretion of at least three proteins selected from IL-7; CSF I , ΡΤΉΡΙΡ, TGFp2, and EGF. . In some embodiments, evaluation of secreted proteins to assess oocyte competence comprises determining the amounts of secretion of at least four proteins selected from IL-7; CSFI , PTHPIP, TGFp2, and EGF. In some embodiments, evaluation of secreted proteins to assess oocyte competence comprises determining the amounts of secretion of at least five proteins, wherein the at least five proteins are IL-7; CSFI , PTHPIP, TGFP2, and EGF. In some embodiments, evaluation of secreted proteins to assess oocyte competence comprises determining the amounts of secretion of at leas t four proteins, wherein the at least four proteins are IL-7: CSF I , PTHPIP, , and EGF.

Table i Genes of secreted proteins and mRNA changes in oocy tes

[0045] Although levels of secreted proteins may be measured individually, in typical assays, more than one secreted protein is measured simultaneously using a multiplex assay. In a preferred embodiment, the assay of oocyte- or embryo-secreted factors in spent media from oocytes or embryos takes advantage of a method termed "bio-barcode" amplification, which allows for detecting amount of target proteins with attomolar sensitivity. Bio-barcode assays are known. See, e.g. , U.S. Patent Application Publication No. 20100081 134,

WO/2006/078289, WO/2006/125050, and WO2007/084192, each of which is incorporated by references. An illustrative schematic providing an example of this type of assay is provided in Figure 1.

[0046] Other highly sensitive assay methods may also be employed to analyze proteins secreted by oocytes into culture medium. For example, cumulus cells may be transformed with a luciferase or a fluorescent reporter to detect growth factors, e.g., ΤΟΡβ2, Τ(3Ρβ3, EGF, present in oocyte culture medium using an assay analogous to the TopFlash assay used to measure Wnt signals (see, e.g., reference [7]).

[0047] Other examples of techniques that can be used to measure protein secretion into culture medium include magnetic nanotag sensing, (see, e.g., reference [8]).

[0048] in this section, a bio-barcode assay is described to illustrate, but not to limit, the invention. In performing a bio-barcode assay, target capture molecules and barcode DNA strands are conjugated, and either linked or not linked to microparticles, e.g., magnetic or silica bead. In some embodiments, magnetic beads are conjugated to a primary antibody directed against a protein to be analyzed. Beads, e.g., silica beads, are conjugated to a secondary antibody that binds to the protein, and to an oligonucleotide complementary to a bar code DNA. After extensive washing, the coupled silica beads are incubated in hybridization conditions with the DNA barcode. Barcode DNA sequences are well known in the art (see, e.g., U.S. Patent Application Publication No. 20100081 134, WO/2006/078289, WO/2006/125050, and WO2007/084192). Any barcode sequence may be used. Primary antibodies are available commercially or ma be generated using well known techniques. A secondary antibody may bind to the protein directly or to the primary antibody. For example, a primary antibody may additionally be conjugated to another molecule that provides for amplification of a signal generated by binding of the protein to a primary antibody..

[0049] After hybridization, the conjugated antibody/DNA barcode beads and the conjugated primary antibody magnetic beads are washed and may be stored. [0050] As noted above, antibodies to the proteins of interest are commercially available or can be prepared using known methodology.

Target protein capture

[0051] Spent media from oocytes and embryos are -incubated with a defined amount of primary antibody-conjugated beads and the secondary antibody/barcode. A standard curve of .known concentration of the protein of interest is also typically prepared for quantification. Following incubation, complexes comprising the bead having the primary antibody conjugated to it and ihe secondar antibody/barcode are formed when the protein of interest is present. In embodiments, in which a magnetic bead is used for the conjugation of the primar '- antibody, a magnetic separator may be used to obtain the complexes with the magnetic particles along with captured proteins and the DNA barcode-coupled secondary- antibody. Supernatants are removed and the magnetic bead pellet washed. After the last wash, complexes are resuspended and incubated to release the DNA barcode from the complex.

Detection of released barcode DMA [0052] Aiiquots of supernatant released from the complexes are subjected to standard qPCR using pairs of primers specific for each barcode DNA. An example of a standard curve is provided in Figure 2a and b. The amount of protein secreted by the oocytes or embryos into the spent medium is then computed by comparing the G values from the standard curve to the C; values from the samples being analyzed. These protein levels are then used in combination to assess overall oocyte and embryo health.

[0053] The methods of the invention comprise determining the amounts of at least one, and preferably more than one of the secreted proteins including, but not limited to, BMP15, TL-7, FGF1 , TGFp2, ΤΟΡβ3, ΡΤΉΡΐΡ, Def41b, BMP5, Gremlin !, Rspo2, EGF, and CSF1 in the spent medium. For example, oocytes that are not competent may secrete very little PTHPIP, Defb41, ΤΟΡβ3ΐη spent media compared to competent oocytes and about 50% less ΤΟΡβ2 and EGF. Oocytes that are selected for in vitro fertilization preferably show an amount in spent media for at least one, e.g., 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 1 1, or 12 proteins that is associated with competence. In some embodiments, oocytes are selected for in viiro fertilization that have amounts of secreted proteins in spent media for nine of the proteins, described above, that are associated with competence. In some embodiments, oocytes are selected for in vitro fertilization that have amounts of secreted proteins in spent media for seven of the proteins that are associated with competence, in some embodiments, oocytes are selected for in viiro fertilization that have amounts of secreted proteins in spent media for five of the proteins that are associated with competence. For example, in some embodiments, oocytes that are selected for in vitro fertilization are selected for in vitro fertilization that secrete levels of Defb41 , PTHPIP, TGF[¾, TGFp3, JL-7, CSF1, and EGF that are associated with competence. In some embodiments, oocyies are selected for in vitro fertilization that secrete levels of IL-7, PTHPIP, ΤΟΡβ2, CSF1 , and EGF that are associated with competence. In some embodiments, oocytes are selected for in vitro fertilization that secrete levels of IL-7, CSF 1 , PTHPIP, and EGF that are associated with competence. In some embodiments, the levels of IL-7, CSF1, PTHPIP, TGF ¾, and EGF associated with competence reflect the pattern observed in T able 1 .

Controls

[0054] A standard curve is typically also run as a control for determining the amounts of the proteins of interest in incubation media. In some embodiments, the values for the amounts of protein obtained in an analysis are compared to reference values obtained from analyzing protein levels in secreted media from competent oocytes.

10055] In some embodiments, the values for the amounts of protein obtained in an analysis are compared to reference values obtained from analyzing protein levels in secreted media from oocytes that are not competent.

[0056] Those skilled in the art are familiar with various ways of using reference values. The reference values may be determined using a concurrent analysis of competent or not competent occytes, but in typical embodiments, are from known values. Thus, in some embodiments, the value representing the amount of secreted protein in the culture medium is compared to one or more reference values, and optionally correlated to oocyte competence.

[0057] The information obtained from the secreted protein analysis may be stored in a computer readable form. Such a computer system typically comprises major subsystems such as a central processor, a system memory (typically RAM), an input output (I/O) controller, an external device such as a display screen via a display adapter, serial ports, a keyboard, a fixed disk drive via a storage interface, and, for example, a CD-ROM (or DVD- ROM) device operative to receive a CD-RDM. Many other devices can be connected, such as a network interface connected via a serial port.

[0058] The computer system also be linked to a network, comprising a plurality of computing devices linked via a data link, such as an Ethernet cable (coax or l OBaseT), telephone line, ISDN line, wireless network, optical fiber, or other suitable signal transmission medium, whereby at least one network device (e.g., computer, disk array, etc.) comprises a pattern of magnetic domains (e.g., magnetic disk) and/or charge domains (e.g., an array of DRAM cells) composing a bit pattern encoding data acquired from an assay of the invention. [0059] The computer system can comprise code for interpreting the results of a study evaluating the amount of secreted protein in an analysis. Thus in an exemplary embodiment, the secreted protein analysis results are provided to a computer where a central processor executes a computer program for determining the likelihood of having a competent oocyte.

Kits [0060] The invention additionally provides compositions and kits comprising sensitive assays, e.g., bio-barcode assays to detect the levels of secreted proteins in oocyte or embryo incubation media. In some embodiments, the kit comprises reagents to detect at least two, often at least three, four, five, six, seven, eight, nine, ten, eleven secreted proteins selected from a group consisting of BMP15, IL-7, FGFI, TGFp2, TGF(33, PTHPIP, Def41b, BMP5, Gremlml , Rspo2, EGF, and CSFl , or combinations thereof. In some embodiments, the kit comprises reagents to detect secreted BMP 15, IL-7, FGFI, ΤΟΡβ2, ΤΟΙ· ^' β3, PTHPIP, Def4ib, BMP5, Gremlin 1, Rspo2, EGF, and CSFl . In some embodiments, the kit comprises reagents to detect secreted IL-7, EGF, TGFp2, TGF[¾, PTHPIP, CSFl, BMP5, Rspo@, or Defb41, or combinations thereof comprising at least two, three, four, five, six, seve, or eight of the proteins. In some embodiments, the kit further comprises reagents to detect secretion of one or more of the proteins BMP15, FGFI, and Gremlin 1. In some embodiments, the kit comprises reagents to detect secreted IL-7; CSFl, PTHPIP, ΤΟΡβ2 and EGF. In some embodiments, the kit comprises reagents to detect secreted IL-7; CSF l, PTHPIP, and EGF. These are examples of the secreted proteins used, and other secreted proteins not specifically mentioned above may also be used, since it is known that the oocyte and early embryo have mRN A encoding for many different secreted proteins. EXAMPLE

Example 1. Characterization of secreted proteins in oocyte spent medium.

[0061] Oocyte maturation takes place in an environment maintained by bidirectional interactions of the gamete with the surrounding somatic ceils. Oocytes control this environment by releasing factors that act on cumulus and mural granulosa cells ([9], [10]) , but the somatic cell signals affecting the oocyte are less well understood. Although the effects of EGF on oocyte maturation and cumulus expansion have long been established ([1 1],[12]), the physiological relevance of the EGF network during ovulation has only recently come into focus. Biochemical, genetic and pharmacological evidence now support the concept that LH action during ovulation is mediated by secretion of EGF-like factors

([13], [14], [15], [16]). EGF-like growth factor expression is dramatically increased prior to ovulation and these growth factors mimic many of the LH effects on oocyte maturation and cumulus expansion i vitro [14]. The presence of these growth factors in the preovulatory follicle is not restricted to rodents but also found in other species ([17], [18]). In humans, Amphiregulin (Areg) and Epiregulin (Ereg) mRNA have also been detected in granulosa ceils [19] and found in the follicular fluid (FF) after hCG stimulation [20]. More importantly, decreased accumulation of AREG in the FF was observed in follicles yielding an immature oocyte [20]. Thus, the induction of these factors plays a critical role at the time of ovulation in all species thus far investigated. It should be noted that in mice, several reports have indicated secretion of EGF-like growth factors by the deeidua, implying that embryos are exposed to these growth factors also during implantation ([21], [22]).

[0062] In vitro exposure of cumulus oocyte complexes to EGF improves the progression of the oocyte through Ml and Mil as well as promoting the competence for pre-implantation emb ryo development. This is true for rodents ([23], [24], [25]), as well as for numerous other species. Exposure of bovine oocytes to EGF during maturation permits the

development to blastocysts in a chemically-defined medium, and, importantly, promotes protein synthesis ( [26], [27]). In zebrafish, EGF and TGFa promote oocyte maturation, possibly by regulation of activin [28]. We used mice in which Areg is knocked out to evaluated oocyte competence. Our preliminary studies in the Areg-null mice indicated that these growth factors are important for oocyte translation and to establish developmental competence of the oocyte. The AREG measurement in follicular fluid from women undergoing IVF further supports this concept [20].

[0063] We characterized of the patterns of maternal mRNA translation during oocyte maturation [29]. The translation dataset was then analyzed using Panther GO and searched for signal peptides using Ensembl or scanned manually. A significant number of transcripts translated in the oocytes code for secreted proteins. We compared proteins in two groups of oocytes at the Mil stage of development (these are oocytes ready to be fertilized and are the stage retrieved during IVF). Competent oocytes were from wild type mice, whereas the incompetent oocytes were from Areg knockout mice. These mice have reduced fertility and about 50% of the oocytes do not fertilize when tested in an in vitro fertilization protocol (IVF protocol). The results (Figure 3) showed that incompetent oocytes secreted very little PTHPIP, Del l, TGFB3, and about 50% less TGFB2 and EGF (see asterisk). FGF8 and FGF1 levels were similar in the two oocytes groups. These results show that the amount of protein can be used as a signature for oocyte de velopmental competence. For example, decreased secretion of PTHPIP, Defb41, ΤΟΡβ3, ΤΟΡ ^' β2, and EGF can be used as a signature for an oocyte with compromised developmental competence.

Example 2. Validation of the secretion patterns b EOS A

[0064] To confirm that the pattern of translation reflects secretion of the encoded protein, we tested IL-7 secretion by cultured oocytes. IL--7 mR A is detected in rat oocytes, and is significantly decreased in human follicular fluid of patients who failed IVF ([30], [31 ]). We showed that IL-7 mRNA was recruited to the polysomes during mouse oocyte maturation (6.5 fold increase, P<0,01), IL-7 was detected by ELISA (B&D) in the spent medium in a pool of 40-50 of mouse oocytes matured to Mil in vitro (-10-20 pg/50 μΐ). On average, denuded oocytes released 8.3 ± 2 fg IL-7/oocyte. Confirming the translation data, IL7 secretion by Mil oocytes was 5-fold higher than oocytes maintained in GV. IL-7 secretion was also detected in oocytes enclosed by cumulus cells. Thus, these data validated that recruitment to the polysomes is associated with increased release of secretory products.

Example 3. Validation of DNA barcode assay on human cumulus oocytes [0065] This example illustrates the use of the present invention with human biological in vitro fertilization conditioned media specimens. We employed a DNA barcode assay to measure secreted proteins from media inc bated with human cumulus oocytes complexes from patients undergoing in vitro fertilization treatment. Human cumulus oocyte complexes were incubated with standard IVF media in a volume of 500 microliters for a period of 4-6 hours immediately after oocyte retrieval. The conditioned media was then analyzed using the D A barcode assay protocol as described above. The DNA oligomer was functionalized by a 5' attachment of an amino-modified group and then conjugated to an antibody recognizing AREG (R&D Systems, Inc.) using a commercially available kit (Soluiink Cat # A-9202-001). A second antibody recognizing a different AREG epitope (R&D Systems, lnc) was conjugated to magnetic beads using a commercially available coupling kit (Invitrogen Cat # 1431 ID). The assay was optimized for amount of aniibody preparations and type of tubes (DNA LoBind tubes, Eppendorf) using a recombinant purified AREG protein (R&D

Systems, Inc.) The conditioned media was mixed and incubated with the antibody linked to the DNA oligomer for 2 hours. The magnetic beads conjugated to the other antibody were then added and the mixture mixed by rotation for an additional hour. The complexes were then isolated by magnetic separation and washed extensively to remove the residual unbound antibody-DNA oligomer. The samples were then resuspended in uhrapure water and the complexes dissociated. The supernatant was then quantitaied by qPCR using standard conditions. The concentration of AREG was determined by interpolation on a standard curve, with the standard curve being generated by simultaneously assaying samples with known amounts of recombinant AREG protein. The data in Figure 4 demonstrate that methods of the present invention detected secreted proteins at levels sensitive enough to measure single cumulus-oocyte complexes.

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[0066] While the present invention has been described with reference to the specific embodiments thereof, it should be understood by those skilled in the art that various changes can be made and equivalents can be substituted without departing from the scope of the invention. In addition, many modifications can be made to adapt a particular situation, material, composition of matter, process, process step or steps, to achie v e the benefits provided by the present invention without departing from the scope of the present invention. All such modifications are intended to be within the scope of the claims appended hereto.

[0067] All publications, patent documents, and accession numbers cited herein are incorporated herein by reference as if each such publication or document was specifically and individually indicated to be incorporated herein by reference. Citation of publications and patent documents is not intended as an indication that any such document is pertinent prior art, nor does it constitute any admission as to the contents or date of the same.