Development of artificial gametes

Biotechnologies that empower transgender persons to self-actualize as individuals, partners, spouses, and parents are defining new ways to conceive a child: psychological considerations and ethical issues

Today, thanks to biomedical technologies advances, some persons with fertility issues can conceive. Transgender persons benefit also from these advances and can not only actualize their self-identified sexual identities but also experience parenthood. Based on clinical multidisciplinary seminars that gathered child psychiatrists and psychoanalysts interested in the fields of assisted reproduction technology (ART) and gender dysphoria, philosophers interested in bioethics, biologists interested in ART, and endocrinologists interested in pubertal suppression, we explore how new biotechnical advances, whether in gender transition or procreation, could create new ways to conceive a child possible. After reviewing the various medical/surgical techniques for physical gender transition and the current ART options, we discuss how these new ways for persons to self-actualize and to experience parenthood can not only improve the condition of transgender persons (and the human condition as a whole through greater equity) but also introduce some elements of change in the habitual patterns of thinking especially in France. Finally, we discuss the ethical issues that accompany the arrival of these children and provide creative solutions to help society handle, accept, and support the advances made in this area.

Past performance of assisted reproduction technologies as a model to predict future progress: a proposed addendum to Moore's law

The ultimate goal of IVF is to achieve healthy, single, live births following each single-embryo transfer. A timeline for this eventuality has never been defined. National implantation rates from 2003-2010 provided by the Society for Assisted Reproductive Technologies (SART) in the USA were evaluated. Regression analysis was applied to the annual trends. A high correlation was noted showing a linear increase from year to year ranging between 0.3% and 1.5% when maternal age was not higher than 42. This relationship can be retrospectively applied to earlier SART data reports. This incline may be partly technology driven and resembles Moore's law, which describes annual improvements in microchip performance. Based on the assumption that technology will continue to drive progress, the length of time required to reach 100% implantation was calculated. The interval varied between 43 years (AD 2053) for the youngest age group (<35 years old) and 294 years for the 41-42-year age group. The timeframe is shifted for the younger patients to an earlier date of 2027 if a subset of clinics with high implantation regression slopes and low variance is selected. The implications of these findings for infertility treatment and fertility preservation are discussed. Success after IVF has steadily improved. Data from US-based clinics are annually collected by the Society for Assisted Reproductive Technologies (SART; www.sart.org). Through SART, individual clinic's outcomes may be assessed. Although live birth and pregnancy are considered the gold standard of success, the investigators took the approach that those outcomes are often biased due to transfer of multiple embryos. The present analysis was therefore performed on individual embryos, by using the implantation rate to compare national and individual clinic datasets. National implantation rates show a linear increase from year to year ranging between 0.3% and 1.5% for patients aged <43 years. We postulate that this linear trend can be traced back to 1985 even though statistical analysis could only be applied to the implantation data from 2003-2010. We expect that this annual incline is partly technology driven. This is an intriguing effect also seen in the computer industry where there has been a doubling of computer speed and memory for the past 47 years, a phenomenon anticipated by Moore's law. We predict that the annual increase in implantation will also continue as new technologies become available. Based on current trends, the length of time for 100% implantation rates was calculated. Time to achieving 100% implantation varied between 43 years (AD 2053) for the youngest age group (<35 years old) to 294 years for women 41-42 years old. Some clinics may report a perfect success earlier than others. However, implantation does not guarantee birth.

The ethics of fertility preservation in transgender body modifications

In some areas of clinical medicine, discussions about fertility preservation are routine, such as in the treatment of children and adolescents facing cancer treatments that will destroy their ability to produce gametes of their own. Certain professional organizations now offer guidelines for people who wish to modify their bodies and appearance in regard to sex traits, and these guidelines extend to recommendations about fertility preservation. Since the removal of testicles or ovaries will destroy the ability to have genetically related children later on, it is imperative to counsel transgender people seeking body modifications about fertility preservation options. Fertility preservation with transgender people will, however, lead to unconventional outcomes. If transgender men and women use their ova and sperm, respectively, to have children, they will function as a mother or father in a gametic sense but will function in socially reversed parental identities. There is nothing, however, about fertility preservation with transgender men and women that is objectionable in its motives, practices, or outcomes that would justify closing off these options. In any case, novel reproductive technologies may extend this kind of role reversal in principle to all people, if sperm and ova can be derived from all human beings regardless of sex, as has happened with certain laboratory animals.

Interventions in the prolongation of reproductive life in women

Women may seek to prolong their reproductive span for a variety of reasons. For many this implies reproduction at a late age, possibly driven by lifestyle decisions, but for others affected by a natural or a cancer treatment-induced premature ovarian failure it may simply mean seeking to achieve the normal reproductive span. The range of interventions now available to address the issue of prolonging reproductive life has never been greater, although several of the approaches discussed remain in the realm of future application through being dependent on ongoing scientific developments.

Oocyte-like structures arising from cells of follicular fluid are not captured in aspirates

Recently, cells from ovarian surface epithelium (OSE) of post-menopausal women and women with premature ovarian failure were investigated and oocyte-like cells with diameters up to 95 microm were found to arise after a certain time in culture. In addition, it seems that a mixed population of germ cells and germline stem cells exists in non-follicle ovarian structures. Relating to an earlier publication, where it was shown that pre-antral follicles with immature oocytes could be captured in follicular fluid (FF) aspirates due to the incorporated tissue in the puncture needle, it was reasoned that OSE or otherwise germline stem cells, possibly captured equally through ovarian puncture, might give rise to oocyte-like cells. The aim of this study was therefore to try to derive such oocyte-like cells from FF aspirates of patients undergoing IVF after culture. Additionally, FF-derived cells were aggregated with human embryonic stem cells to see if an embryonic environment had the ability to enable cells from the FF aspirate to acquire an oocyte-like morphology. Investigations could not confirm the development of oocyte-like cells from cells of FF aspirates.

Reproductive biotechniques in buffaloes (Bubalus bubalis): status, prospects and challenges

The swamp buffalo holds tremendous potential in the livestock sector in Asian and Mediterranean countries. Current needs are the faster multiplication of superior genotypes and the conservation of endangered buffalo breeds. Recent advances in assisted reproductive technologies, including in vitro embryo production methodologies, offer enormous opportunities to not only improve productivity, but also to use buffaloes to produce novel products for applications to human health and nutrition. The use of molecular genomics will undoubtedly advance these technologies for their large-scale application and resolve the key problems currently associated with advanced reproductive techniques, such as animal cloning, stem cell technology and transgenesis. Preliminary success in the application of modern reproductive technologies warrants further research at the cellular and molecular levels before their commercial exploitation in buffalo breeding programmes.