Congenital malformations after assisted reproduction: risks and implications for prenatal diagnosis and fetal medicine

Epigenetics, infertility, and cancer: future directions

Although direct correlates between cancer and infertile epigenetic profiles are rare, the general similarities between the two disease processes offer insights into the study of both abnormalities. Foremost among them is the nature of these pathologies, where one disease (cancer) is categorized by an inability to control or inhibit cellular proliferation, and the other (male infertility) is caused by an inability to maintain the normally efficient extreme proliferation of the male germ cell. Based on this similarity alone, the study of epigenetics in both male fertility and cancer has the potential to offer intriguing insights in both fields. The creative application of harmonious studies of both infertility and cancer is likely to yield useful and informative data that may aid in both the understanding and treatment of both pathologies.

Birth defects in singleton versus multiple ART births in Japan (2004-2008)

The purpose of the present study was to evaluate the relative risk (RR) of multiple births for birth defects after assisted reproductive technology (ART) using Japanese nationwide data from 2004 to 2008 with singletons as the reference group. In multiples compared to singletons, the percentage of birth defects per pregnancy were significantly higher (RR = 1.88, 95% confidence interval (CI) 1.60–2.13), the percentage of birth defects per live birth was not significantly higher (RR = 0.90, 95% CI 0.78–1.05 or RR = 0.94, 95% CI 0.81–1.10), and the early neonatal mortality rate was significantly higher (RR = 2.68, 95% CI 1.52–4.70 or RR = 2.80, 95% CI 1.60–4.92). The early neonatal mortality per 10,000 live births was slightly higher in ART (5.09) than in the general population (3.86). We concluded that the impact of birth defects after ART would be larger in families with multiples compared to families with singletons, since the mean number of children would be larger in the former.

Methodology matters: IVF versus ICSI and embryonic gene expression

The use of assisted reproduction treatment, especially intracytoplasmic sperm injection (ICSI), is now linked to a range of adverse consequences, the aetiology of which remains largely undefined. Our objective of this study was to determine differences in gene expression of blastocysts generated by ICSI as well as ICSI with artificial oocyte activation (ICSI-A) versus the less manipulative IVF, providing fundamental genetic information that can be used to aid in the diagnosis or treatment of those adversely affected by assisted reproduction treatment, as well as stimulate research to further refine these techniques. Murine blastocysts were generated by ICSI, ICSI-A and IVF, and processed for a microarray-based analysis of gene expression. Ten blastocysts were pooled for each procedure and three independent replicates generated. The data were then processed to determine differential gene expression and to identify biological pathways affected by the procedures. In blastocysts derived by ICSI versus IVF, the expression of 197 genes differed (P < 0.01). In blastocysts derived by ICSI-A versus IVF and ICSI-A versus ICSI, the expression of 132 and 65 genes differed respectively (P < 0.01). Procedural-induced changes in genes regulating specific biological pathways revealed some consistency to known adverse consequences. Detailed investigation of procedure-specific dysfunction is therefore warranted.