The bumpy road to human in vitro fertilization

Assisted Reproductive Technologies: A New Player in the Foetal Programming of Childhood and Adult Diseases?

Assisted reproductive technology (ART) is an emerging field in medicine that incorporates complex procedures and has profound ethical, moral, social, religious, and economic implications not just for the individuals who have access to this method but also for society. In this narrative review, we summarise multiple aspects of ART procedures and the possible consequences on the mother and newborn. Moreover, we provide an overview of the possible long-term consequences of ART procedures on the health of newborns, although longitudinal evidence is particularly scant. Users should be informed that ART procedures are not risk-free to prepare them for the possible negative outcomes that may occur in the perinatal period or even in childhood and adulthood. Indeed, risk estimates point to increased liability for major nonchromosomal birth defects; cardiovascular, musculoskeletal, and urogenital (in male newborns) defects; and any other birth defects. Less certainty is present for the risk of neuropsychiatric sequelae in children conceived through ART. Thus, its application should be accompanied by adequate counselling and psychological support, possibly integrated into specific multidisciplinary clinical programmes.

Glucose and glycerol temperature-pressure correlations for the design of cryopreservation protocols in an isochoric system at subfreezing temperature

There is growing interest in the use of isochoric (constant volume) freezing for cryopreservation of biological matter. The goal of this study is to generate fundamental experimental data on the pressure temperature relation during the freezing of an isochoric system of aqueous solutions of two compounds, glucose and glycerol. Glucose and glycerol are commonly used as cryoprotectants in conventional isobaric (constant pressure) cryopreservation protocols. Earlier studies have shown that the increase in pressure during isochoric freezing is detrimental to biological matter and limits the range of temperatures in which isochoric freezing can be used for preservation to temperatures corresponding to pressures below 40 MPa. In physiological saline solution this pressure corresponds to a temperature of - 4 °C. Our new experimental data shows that the addition of 2 M glycerol to the saline solution lowers the temperature at which the isochoric freezing pressure is 40 MPa to -11 °C, 3 M glycerol to - 16.5 °C, and 4 M glycerol to - 24.5 °C, thereby substantially expending the range of temperatures in which cryopreservation by isochoric freezing can be practiced.

Graphene Oxide Improves in vitro Fertilization in Mice With No Impact on Embryo Development and Preserves the Membrane Microdomains Architecture

During the latest years, human infertility worsened all over the world and is nowadays reputed as a global public health issue. As a consequence, the adoption of Assisted Reproductive Technologies (ARTs) such as In Vitro Fertilization (IVF) is undergoing an impressive increase. In this context, one of the most promising strategies is the innovative adoption of extra-physiological materials for advanced sperm preparation methods. Here, by using a murine model, the addition of Graphene Oxide (GO) at a specific concentration has demonstrated to increase the spermatozoa fertilizing ability in an IVF assay, finding that 0.5 μg/ml GO addition to sperm suspensions before IVF is able to increase both the number of fertilized oocytes and embryos created with a healthy offspring given by Embryo Transplantation (ET). In addition, GO treatment has been found more effective than that carried out with methyl-β-cyclodextrin, which represents the gold standard in promoting in vitro fertility of mice spermatozoa. Subsequent biochemical characterization of its interaction with male gametes has been additionally performed. As a result, it was found that GO exerts its positive effect by extracting cholesterol from membranes, without affecting the integrity of microdomains and thus preserving the sperm functions. In conclusion, GO improves IVF outcomes in vitro and in vivo, defining new perspectives for innovative strategies in the treatment of human infertility.

Comprehensive analysis of whole genome methylation in mouse blastocysts cultured with four different constituents following in vitro fertilization

Background

With the development of assisted reproductive technology (ART), diseases believed to be caused by ART have begun to be identified as imprinted disease. However, no conclusion has been reached. So we sought to determine whether ART procedures disturb gene methylation and whether imprinted genes alone are selectively disturbed. To examine whether the constituents of the culture medium contribute to the changes in methylation, we used a mouse model to conduct IVF and comprehensively analyzed 5′–C–phosphate–G–3′ (CpG) by reduced representation bisulfite sequencing (RRBS) using a second-generation sequencer to determine changes in methylation using four types of culture media with different amino acid constituents.

Results

We cultured ova to the blastocyst stage in a mouse model in culture media with four different amino acid constituents. Each culture medium included (1) KSOM culture medium (NoAA), (2) KSOM media + essential amino acids (EAAs), (3) KSOM medium + non-essential amino acids (NEAAs), or (4) KSOM medium + EAAs + NEAAs (AllAA) analyzed by reduced representation bisulfite sequencing. The results showed that (1) there were many regions that maintained hypermethylation with NEAAs, (2) there was little effect of demethylation on reprogramming in the 5′UTR and promoter regions, and (3) specific changes were observed in imprinted genes such as Nnat and Nespas.

Conclusions

Compared with EAAs, NEAAs could protect genes from demethylation caused by reprogramming. On the imprinted genes, methylation of the promoter region of H19 was decreased by NEAAs, suggesting that specific genes were prone to changes in methylation. It was suggested that these changes could provide similar results in humans. Further studies are needed to understand how changes in methylation may affect gene expression profiles.

'The men who made the breakthrough': How the British press represented Patrick Steptoe and Robert Edwards in 1978

This article examines how the British press represented Patrick Steptoe and Robert Edwards in the story of the birth of the first 'test-tube baby', Louise Brown. In 1978, the British press represented the birth of Louise Brown as both a success and a source of hope. The main pairs of protagonists in this story were Steptoe and Edwards and Lesley and John Brown, who metonymically represented British science and infertile couples, respectively. In the dominant 'success' narrative of the birth of Louise Brown as depicted in the British press in 1978, Edwards and Steptoe seemed to embody 'British' values of industriousness, perseverance, altruism, ingenuity and teamwork. Thus, their success was simultaneously a British success. With Louise Brown's birth, in-vitro fertilization came to stand for the potential happiness of infertile people and a bright future for British science and industry.

A small field for fertile science: the low visibility of reproductive science in high impact journals

PURPOSE

Our success as a field and as individuals in reproductive science and medicine relies on our ability to produce high quality work that has broad visibility and impact. A common metric for assessing such success is the quantity of publications that are published in journals with high impact factors. It is unclear, however, how frequently work related to reproductive science and medicine actually appears in what are considered the highest impact journals.

METHODS

To address this gap in knowledge, we first determined how the field of reproductive biology in general compared to other research areas in terms of composite journal impact factor. Second, using a targeted search approach in the PubMed database, we examined the relationship between a journal's impact factor and the number of reproductive research articles published per journal issue.

RESULTS

We found that compared to other major scientific disciplines, our field lacks journals with impact factors above 4. In addition, primary original research articles on reproduction-irrespective of male or female search terms-do not appear often in high impact journals. Instead, there is an increased percentage of secondary reproductive literature in high impact journals compared to topic-specific journals of lower impact.

CONCLUSIONS

There are likely several explanations for why reproductive science and medicine has low visibility, including the field's small relative size, its lack of a specific disease and associated strong advocacy, and its surrounding social, ethical, and political unease. Nevertheless, there are concrete actions we can take to minimize the role of impact factor in our evaluation while simultaneously increasing influence through global awareness of the importance and need for reproductive research.

The health risks of ART

Assisted reproductive technologies enable subfertile couples to have children. But there are health risks attached for both mothers and children that need to be properly understood and managed.

Fertilization studies and assisted fertilization in mammals: their development and future

Studies of mammalian fertilization progressed very slowly in the beginning because of difficulties in obtaining a large quantity of fully mature eggs at one time. With progression of techniques to collect and handle eggs and spermatozoa, research in mammalian fertilization advanced rapidly. Today, far more papers are published on mammalian gametes and fertilization than those of all other animals combined. The development of assisted fertilization and related technologies revolutionized basic research as well as human reproductive medicine and animal husbandry. Reproduction is fundamental to human and animal lives. The author lists a few subjects of his personal interest for further development of basic and applied research of gametes and fertilization. Each reader will probably have more exciting subjects of future investigation.

IVF and embryo transfer: historical origin and development

IVF and embryo transfer for the treatment of human infertility has now resulted in the birth of over 4 million babies. The technique did not arise as a quantum event but was built on the efforts of many earlier workers in the fields of reproductive endocrinology and development. One should remember the famous saying of Isaac Newton: 'If I have seen further than most, it is because I have stood on the shoulder's of giants'. Ethical and moral issues have always arisen when investigators study early mammalian development, particularly human development. This paper documents these earlier studies and also draws attention to the ethical and moral arguments that inevitably arose.

Why the Medical Research Council refused Robert Edwards and Patrick Steptoe support for research on human conception in 1971

BACKGROUND

In 1971, Cambridge physiologist Robert Edwards and Oldham gynaecologist Patrick Steptoe applied to the UK Medical Research Council (MRC) for long-term support for a programme of scientific and clinical 'Studies on Human Reproduction'. The MRC, then the major British funder of medical research, declined support on ethical grounds and maintained this policy throughout the 1970s. The work continued with private money, leading to the birth of Louise Brown in 1978 and transforming research in obstetrics, gynaecology and human embryology.

METHODS

The MRC decision has been criticized, but the processes by which it was reached have yet to be explored. Here, we present an archive-based analysis of the MRC decision.

RESULTS

We find evidence of initial support for Edwards and Steptoe, including from within the MRC, which invited the applicants to join its new directly funded Clinical Research Centre at Northwick Park Hospital. They declined the offer, preferring long-term grant support at the University of Cambridge, and so exposed the project to competitive funding mode. Referees and the Clinical Research Board saw the institutional set-up in Cambridge as problematic with respect to clinical facilities and patient management; gave infertility a low priority compared with population control; assessed interventions as purely experimental rather than potential treatments, and so set the bar for safety high; feared fatal abnormalities and so wanted primate experiments first; and were antagonized by the applicants' high media profile. The rejection set MRC policy on IVF for 8 years, until, after the birth of just two healthy babies, the Council rapidly converted to enthusiastic support.

CONCLUSIONS

This analysis enriches our view of a crucial decision, highlights institutional opportunities and constraints and provides insight into the then dominant attitudes of reproductive scientists and clinicians towards human conception research.

'Crook' pipettes: embryonic emigrations from agriculture to reproductive biomedicine

While cloning, stem cells, and regenerative medicine are often imagined in a futurial idiom--as expectations, hype, hope and promises--this article approaches the remaking of genealogy in such contexts from a historical route. Through a series of somewhat disparate historical connections linking Australian sheep to the development of clinical IVF and the cloning of Dolly at the Roslin Institute in Scotland in 1996, this article explores the linkages through which agriculture, embryology, and reproductive biomedicine are thickly intertwined. Key to this examination is not only the history of experimental sheep breeding, and its somewhat unexpectedly genealogical connections to (Australian) national identity ('wool in the veins'), but also the re-emergence of a distinctive frontier ethos in the context of assisted conception, and later human embryonic stem cell derivation. I have set this scene of genealogical interconnection against the criss-crossing traffic between Britain and Australia, and the wool trade, to emphasise the importance of global, as well as local, connections in the bloodlines of animals such as Dolly. In sum, this article examines the idea of the 'biological frontier' by exploring its histories as a means to offset the assumption that this frequently encountered idiom describes a future that is, or must be, by definition, unknown and unknowable.