1
|
Le Goff A, Jeffries Hein R, Hart AN, Roberson I, Landecker HL. Anticipating in vitro gametogenesis: Hopes and concerns for IVG among diverse stakeholders. Stem Cell Reports 2024:S2213-6711(24)00144-9. [PMID: 38848715 DOI: 10.1016/j.stemcr.2024.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 05/07/2024] [Accepted: 05/08/2024] [Indexed: 06/09/2024] Open
Abstract
In vitro gametogenesis (IVG), the reconstitution of germ cell development in vitro, is an emerging stem cell-based technology with profound implications for reproductive science. Despite researchers' long-term goals for future clinical applications, little is currently known about the views of IVG held by the stakeholders potentially most affected by its introduction in humans. We conducted focus groups and interviews with 80 individuals with lived experience of infertility and/or LGBTQ+ family formation in the US, two intersecting groups of potential IVG users. Respondents expressed hope that IVG would lead to higher reproductive success than current assisted reproductive technology (ART), alleviate suffering associated with ART use, and promote greater social inclusion, while expressing concerns predominantly framed in terms of equity and safety. These findings underscore the importance of sustained engagement with stakeholders with relevant experience to anticipate the implications of IVG for research and clinical translation.
Collapse
Affiliation(s)
- Anne Le Goff
- The Institute for Society and Genetics, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Robbin Jeffries Hein
- The Institute for Society and Genetics, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Ariel N Hart
- Charles R. Drew University of Medicine and Science, Los Angeles, CA 90059, USA; David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA 90095, USA; Department of Sociology, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Isaias Roberson
- Department of Molecular, Cell and Developmental Biology, Los Angeles, CA 90095, USA; Eli and Edythe Broad Center of Regenerative Medicine and Stem Cell Research, Los Angeles, CA 90095, USA; Molecular Biology Institute, University of California, Los Angeles, Los Angeles, CA 90095, USA; Center for Reproductive Science, Health, and Education, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Hannah L Landecker
- The Institute for Society and Genetics, University of California, Los Angeles, Los Angeles, CA 90095, USA; Department of Sociology, University of California, Los Angeles, Los Angeles, CA 90095, USA; Center for Reproductive Science, Health, and Education, University of California, Los Angeles, Los Angeles, CA 90095, USA.
| |
Collapse
|
2
|
Gallagher S, Kerridge I, Newson A, Attinger S, Norman RJ, Lipworth W. Moral justification for the use of 'add-ons' in assisted reproductive technology: experts' views and experiences. Reprod Biomed Online 2024; 48:103637. [PMID: 38185024 DOI: 10.1016/j.rbmo.2023.103637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 10/12/2023] [Accepted: 10/17/2023] [Indexed: 01/09/2024]
Abstract
RESEARCH QUESTION What factors do assisted reproductive terchnology (ART) providers take into account when they make decisions about offering 'add-ons'? DESIGN A qualitative analysis of interviews with 31 ART professionals, focusing on their views and experiences in relation to add-ons, including the factors that are considered when doctors make decisions about their use. RESULTS The participants reported that a range of considerations are taken into account when it comes to justifying the use of a particular add-on in a given circumstance, including the likelihood of benefit and harm, patients' perceived psychological needs and preferences, and organizational expectations. Importantly, patient preferences, psychological factors and low risk of harm appear to be stronger motivations than increasing the likelihood of a live birth or the desire to innovate. CONCLUSIONS These findings suggest that it cannot be taken for granted that add-ons and innovation are closely linked. One possible response to this would be regulatory reform; for example, only allowing 'unproven' add-ons to be used in the context of formal scientific evaluation. Alternatively, it could be made clear that add-ons that are not undergoing formal evaluation have more in common with other therapies lacking a clear evidence base, such as complementary and alternative medicines, than with conventional medical practice. Practices in relation to add-ons may also require a focus on the responsibilities of corporations, and the standards applying to purveyors of consumer goods and services.
Collapse
Affiliation(s)
- Siun Gallagher
- The University of Sydney, Faculty of Medicine and Health, Sydney School of Public Health, Sydney Health Ethics, Sydney, NSW, Australia.
| | - Ian Kerridge
- The University of Sydney, Faculty of Medicine and Health, Sydney School of Public Health, Sydney Health Ethics, Sydney, NSW, Australia; Royal North Shore Hospital, Haematology Department, Royal North Shore Hospital, St Leonards, NSW, Australia
| | - Ainsley Newson
- The University of Sydney, Faculty of Medicine and Health, Sydney School of Public Health, Sydney Health Ethics, Sydney, NSW, Australia
| | - Sara Attinger
- The University of Sydney, Faculty of Medicine and Health, Sydney School of Public Health, Sydney Health Ethics, Sydney, NSW, Australia
| | - Robert J Norman
- The Robinson Research Institute, School of Biomedicine, University of Adelaide, Adelaide, Australia
| | - Wendy Lipworth
- Department of Philosophy, Macquarie University, Sydney, New South Wales, Australia
| |
Collapse
|
3
|
van Dijke I, van El CG, Lakeman P, Goddijn M, Rigter T, Cornel MC, Henneman L. Dynamics of reproductive genetic technologies: Perspectives of professional stakeholders. PLoS One 2022; 17:e0269719. [PMID: 35727796 PMCID: PMC9212161 DOI: 10.1371/journal.pone.0269719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 05/26/2022] [Indexed: 11/19/2022] Open
Abstract
Reproductive and genetic medicine are evolving rapidly, and new technologies are already impacting current practices. This includes technologies that can identify a couples' risk of having a child with a genetic disorder. Responsible implementation of new technologies requires evaluation of safety and ethics. Valuable insights for shaping governance processes are provided by various stakeholders involved, including healthcare professionals. Their willingness to adopt these technologies and guide the necessary systemic changes is required for the successful implementation of these technologies. In this study, twenty-one semi-structured interviews were conducted with professionals from different disciplines in the field of reproductive and genetic healthcare in the Netherlands. Three emerging technologies were discussed: expanded carrier screening (ECS), non-invasive prenatal diagnosis (NIPD) and germline genome editing (GGE). By probing stakeholders' views, we explored how culture, structure and practice in healthcare is being shaped by innovations and changing dynamics in genetic and reproductive medicine. The general consensus was that the implementation of reproductive genetic technologies nationwide is a slow process in Dutch healthcare. A "typical Dutch approach" emerged that is characterized by restrictive legislation, broad support for people living with disabilities, values of an egalitarian society and limited commercialisation. Different scenarios for embedding ECS in future practice were envisioned, while implementation of NIPD in clinical practice was considered obvious. Views on GGE varied among stakeholders. Previous implementation examples in the Netherlands suggest introduction of new technology involves an organized collective learning process, with pilot studies and stepwise implementation. In addition, introducing and scaling up new technologies is complex due to perceived barriers from the legislative framework and the complex relationship between the government and stakeholders in this area. This paper describes how the international trends and advances of technologies are expected to manifest itself in a national setting.
Collapse
Affiliation(s)
- Ivy van Dijke
- Department of Human Genetics and Amsterdam Reproduction & Development Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam UMC, University of Amsterdam, Center for Reproductive Medicine and Amsterdam Reproduction & Development Research Institute, Amsterdam, The Netherlands
| | - Carla G. van El
- Department of Human Genetics and Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Phillis Lakeman
- Department of Human Genetics and Amsterdam Reproduction & Development Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Mariëtte Goddijn
- Amsterdam UMC, University of Amsterdam, Center for Reproductive Medicine and Amsterdam Reproduction & Development Research Institute, Amsterdam, The Netherlands
| | - Tessel Rigter
- Department of Human Genetics and Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Martina C. Cornel
- Department of Human Genetics and Amsterdam Reproduction & Development Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Lidewij Henneman
- Department of Human Genetics and Amsterdam Reproduction & Development Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| |
Collapse
|
4
|
van Dijke I, van Wely M, Berkman BE, Bredenoord AL, Henneman L, Vliegenthart R, Repping S, Hendriks S. Should germline genome editing be allowed? The effect of treatment characteristics on public acceptability. Hum Reprod 2021; 36:465-478. [PMID: 33242333 PMCID: PMC8453417 DOI: 10.1093/humrep/deaa212] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Revised: 06/25/2020] [Indexed: 01/25/2023] Open
Abstract
STUDY QUESTION To what extent do characteristics of germline genome editing (GGE) determine whether the general public supports permitting the clinical use of GGE? SUMMARY ANSWER The risk that GGE would cause congenital abnormalities had the largest effect on support for allowing GGE, followed by effectiveness of GGE, while costs, the type of application (disease or enhancement) and the effect on child well-being had moderate effects. WHAT IS KNOWN ALREADY Scientific progress on GGE has increased the urgency of resolving whether and when clinical application of GGE may be ethically acceptable. Various expert bodies have suggested that the treatment characteristics will be key in determining whether GGE is acceptable. For example, GGE with substantial risks (e.g. 15% chance of a major congenital abnormality) may be acceptable to prevent a severe disease but not to enhance non-medical characteristics or traits of an otherwise healthy embryo (e.g. eye colour or perhaps in the future more complex traits, such as intelligence). While experts have called for public engagement, it is unclear whether and how much the public acceptability of GGE is affected by the treatment characteristics proposed by experts. STUDY DESIGN, SIZE, DURATION The vignette-based survey was disseminated in 2018 among 1857 members of the Dutch general public. An online research panel was used to recruit a sample representing the adult Dutch general public. PARTICIPANTS/MATERIALS, SETTING, METHODS A literature review identified the key treatment characteristics of GGE: the effect on the well-being of the future child, use for disease or enhancement, risks for the future child, effectiveness (here defined as the chance of a live birth, assuming that if the GGE was not successful, the embryo would not be transferred), cost and availability of alternative treatments/procedures to prevent the genetic disease or provide enhancement (i.e. preimplantation genetic testing (PGT)), respectively. For each treatment characteristic, 2-3 levels were defined to realistically represent GGE and its current alternatives, donor gametes and ICSI with PGT. Twelve vignettes were created by fractional factorial design. A multinominal logit model assessed how much each treatment characteristic affected participants' choices. MAIN RESULTS AND THE ROLE OF CHANCE The 1136 respondents (response rate 61%) were representative of the Dutch adult population in several demographics. Respondents were between 18 and 89 years of age. When no alternative treatment/procedure is available, the risk that GGE would cause (other) congenital abnormalities had the largest effect on whether the Dutch public supported allowing GGE (coefficient = -3.07), followed by effectiveness (coefficient = 2.03). Costs (covered by national insurance, coefficient = -1.14), the type of application (disease or enhancement; coefficient = -1.07), and the effect on child well-being (coefficient = 0.97) had similar effects on whether GGE should be allowed. If an alternative treatment/procedure (e.g. PGT) was available, participants were not categorically opposed to GGE, however, they were strongly opposed to using GGE for enhancement (coefficient = -3.37). The general acceptability of GGE was higher than participants' willingness to personally use it (P < 0.001). When participants considered whether they would personally use GGE, the type of application (disease or enhancement) was more important, whereas effectiveness and costs (covered by national insurance) were less important than when they considered whether GGE should be allowed. Participants who were male, younger and had lower incomes were more likely to allow GGE when no alternative treatment/procedure is available. LIMITATIONS, REASONS FOR CAUTION Some (e.g. ethnic, religious) minorities were not well represented. To limit complexity, not all characteristics of GGE could be included (e.g. out-of-pocket costs), therefore, the views gathered from the vignettes reflect only the choices presented to the respondents. The non-included characteristics could be connected to and alter the importance of the studied characteristics. This would affect how closely the reported coefficients reflect 'real-life' importance. WIDER IMPLICATIONS OF THE FINDINGS This study is the first to quantify the substantial impact of GGE's effectiveness, costs (covered by national insurance), and effect on child well-being on whether the public considered GGE acceptable. In general, the participants were strikingly risk-averse, in that they weighed the risks of GGE more heavily than its benefits. Furthermore, although only a single study in one country, the results suggests that-if sufficiently safe and effective-the public may approve of using GGE (presumably combined with PGT) instead of solely PGT to prevent passing on a disease. The reported public views can serve as input for future consideration of the ethics and governance of GGE. STUDY FUNDING/COMPETING INTEREST(S) Young Academy of the Royal Dutch Academy of Sciences (UPS/RB/745), Alliance Grant of the Amsterdam Reproduction and Development Research Institute (2017-170116) and National Institutes of Health Intramural Research Programme. No competing interests. TRIAL REGISTRATION NUMBER N/A.
Collapse
Affiliation(s)
- I van Dijke
- Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam 1105 AZ, The Netherlands
- Department of Clinical Genetics, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam 1081 HV, The Netherlands
| | - M van Wely
- Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam 1105 AZ, The Netherlands
| | - B E Berkman
- Department of Bioethics, Clinical Center, National Institutes of Health, Bethesda, MD 20814, USA
| | - A L Bredenoord
- Department of Medical Humanities, Julius Center, University Medical Center Utrecht, Utrecht 3584 CG, The Netherlands
| | - L Henneman
- Department of Clinical Genetics, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam 1081 HV, The Netherlands
| | - R Vliegenthart
- Amsterdam School of Communications Research, University of Amsterdam, Amsterdam 1018 WV, The Netherlands
| | - S Repping
- Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam 1105 AZ, The Netherlands
| | - S Hendriks
- Department of Bioethics, Clinical Center, National Institutes of Health, Bethesda, MD 20814, USA
| |
Collapse
|
5
|
Wilkinson J, Malpas P, Hammarberg K, Mahoney Tsigdinos P, Lensen S, Jackson E, Harper J, Mol BW. Do à la carte menus serve infertility patients? The ethics and regulation of in vitro fertility add-ons. Fertil Steril 2019; 112:973-977. [PMID: 31703942 DOI: 10.1016/j.fertnstert.2019.09.028] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 09/18/2019] [Accepted: 09/20/2019] [Indexed: 01/08/2023]
Abstract
Add-on treatments are the new black. They are provided (most frequently, sold) to patients undergoing in vitro fertilization on the premise that they will improve the chances of having a baby. However, the regulation of add-ons is consistently minimal, meaning that they are introduced into routine practice before they have been shown to improve the live birth rate. Debate on the adequacy of this light-touch approach rages. Defenders argue that demands for a rigorous approval process are paternalistic, as this would delay access to promising treatments. Critics respond that promising treatments may turn out to have adverse effects on patients and their offspring, contradicting the clinician's responsibility to do no harm. Some add-ons, including earlier versions of preimplantation genetic testing for aneuploidy, might even reduce the live birth rate, raising the prospect of desperate patients paying more to worsen their chances. Informed consent represents a solution in principle, but in practice there is a clear tension between impartial information and direct-to-consumer advertising. Because the effects of a treatment cannot be known until it has been robustly evaluated, we argue that strong evidence should be required before add-ons are introduced to the clinic. In the meantime, there is an imperative to identify methods for communicating the associated risks and uncertainties of add-ons to prospective patients.
Collapse
Affiliation(s)
- Jack Wilkinson
- Centre for Biostatistics, Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom.
| | - Phillipa Malpas
- Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Karin Hammarberg
- Jean Hailes Research Unit, School of Public Health and Preventative Medicine, Monash University, Clayton, Victoria, Australia
| | | | - Sarah Lensen
- Cochrane Gynecology and Fertility Group, University of Auckland, Auckland, New Zealand
| | - Emily Jackson
- Law Department, London School of Economics and Political Science, London, United Kingdom
| | - Joyce Harper
- Department of Reproductive Health, Institute for Women's Health, University College London, London, United Kingdom
| | - Ben W Mol
- Evidence-based Women's Health Care Research Group, Department of Obstetrics and Gynaecology, Monash University, Clayton, Victoria, Australia
| |
Collapse
|
6
|
Farquhar CM, Bhattacharya S, Repping S, Mastenbroek S, Kamath MS, Marjoribanks J, Boivin J. Female subfertility. Nat Rev Dis Primers 2019; 5:7. [PMID: 30679436 DOI: 10.1038/s41572-018-0058-8] [Citation(s) in RCA: 76] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Subfertility is common and affects one in six couples, half of whom lack an explanation for their delay in conceiving. Developments in the diagnosis and treatment of subfertility over the past 50 years have been truly remarkable. Indeed, current generations of couples with subfertility are more fortunate than previous generations, as they have many more opportunities to become parents. The timely access to effective treatment for subfertility is important as many couples have a narrow window of opportunity before the age-related effects of subfertility limit the likelihood of success. Assisted reproduction can overcome the barriers to fertility caused by tubal disease and low sperm count, but little progress has been made in reducing the effect of increasing age on ovarian function. The next 5-10 years will likely see further increases in birth rates in women with subfertility, a greater awareness of lifestyle factors and a possible refinement of current assisted reproduction techniques and the development of new ones. Such progress will bring challenging questions regarding the potential benefits and harms of treatments involving germ cell manipulation, artificial gametes, genetic screening of embryos and gene editing of embryos. We hope to see a major increase in fertility awareness, access to safe and cost-effective fertility care in low-income countries and a reduction in the current disparity of access to fertility care.
Collapse
Affiliation(s)
- Cynthia M Farquhar
- Department of Obstetrics and Gynaecology, University of Auckland, Auckland, New Zealand.
| | - Siladitya Bhattacharya
- College of Biomedical and Life Sciences, Cardiff University School of Medicine, Cardiff, UK
| | - Sjoerd Repping
- Amsterdam UMC, University of Amsterdam, Center for Reproductive Medicine, Amsterdam Reproduction & Development research institute, Amsterdam, Netherlands
| | - Sebastiaan Mastenbroek
- Amsterdam UMC, University of Amsterdam, Center for Reproductive Medicine, Amsterdam Reproduction & Development research institute, Amsterdam, Netherlands
| | - Mohan S Kamath
- Department of Reproductive Medicine, Christian Medical College, Vellore, India
| | - Jane Marjoribanks
- Department of Obstetrics and Gynaecology, University of Auckland, Auckland, New Zealand
| | - Jacky Boivin
- School of Psychology, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
| |
Collapse
|
7
|
Wilkinson J, Bhattacharya S, Duffy JMN, Kamath MS, Marjoribanks J, Repping S, Vail A, Wely M, Farquhar CM. Reproductive medicine: still moreARTthan science? BJOG 2018; 126:138-141. [DOI: 10.1111/1471-0528.15409] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/28/2018] [Indexed: 10/28/2022]
Affiliation(s)
- J Wilkinson
- Centre for Biostatistics University of Manchester Manchester UK
| | - S Bhattacharya
- College of Biomedical and Life Sciences Cardiff University School of Medicine Cardiff UK
| | - JMN Duffy
- Primary Care Health Sciences University of Oxford Oxford UK
- Balliol College University of Oxford Oxford UK
| | - MS Kamath
- Reproductive Medicine Unit Christian Medical College Vellore India
| | - J Marjoribanks
- Cochrane Gynecology and Fertility Group University of Auckland Auckland New Zealand
| | - S Repping
- Centre for Reproductive Medicine Academic Medical Centre University of Amsterdam Amsterdam the Netherlands
| | - A Vail
- Centre for Biostatistics University of Manchester Manchester UK
| | - M Wely
- Centre for Reproductive Medicine Academic Medical Centre University of Amsterdam Amsterdam the Netherlands
| | - CM Farquhar
- Cochrane Gynecology and Fertility Group University of Auckland Auckland New Zealand
| |
Collapse
|
8
|
Mulder CL, Serrano JB, Catsburg LAE, Roseboom TJ, Repping S, van Pelt AMM. A practical blueprint to systematically study life-long health consequences of novel medically assisted reproductive treatments. Hum Reprod 2018; 33:784-792. [PMID: 29635479 PMCID: PMC5925779 DOI: 10.1093/humrep/dey070] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 02/27/2018] [Indexed: 01/27/2023] Open
Abstract
In medicine, safety and efficacy are the two pillars on which the implementation of novel treatments rest. To protect the patient from unnecessary or unsafe treatments, usually, a stringent path of (pre) clinical testing is followed before a treatment is introduced into routine patient care. However, in reproductive medicine several techniques have been clinically introduced without elaborate preclinical studies. Moreover, novel reproductive techniques may harbor safety risks not only for the patients undergoing treatment, but also for the offspring conceived through these techniques. If preclinical (animal) studies were performed, efficacy and functionality the upper hand. When a new medically assisted reproduction (MAR) treatment was proven effective (i.e. if it resulted in live birth) the treatment was often rapidly implemented in the clinic. For IVF, the first study on the long-term health of IVF children was published a decade after its clinical implementation. In more recent years, prospective follow-up studies have been conducted that provided the opportunity to study the health of large groups of children derived from different reproductive techniques. Although such studies have indicated differences between children conceived through MAR and children conceived naturally, results are often difficult to interpret due to the observational nature of these studies (and the associated risk of confounding factors, e.g. subfertility of the parents), differences in definitions of clinical outcome measures, lack of uniformity in assessment protocols and heterogeneity of the underlying reasons for fertility treatment. With more novel MARs waiting at the horizon, there is a need for a framework on how to assess safety of novel reproductive techniques in a preclinical (animal) setting before they are clinically implemented. In this article, we provide a blueprint for preclinical testing of safety and health of offspring generated by novel MARs using a mouse model involving an array of tests that comprise the entire lifespan. We urge scientists to perform the proposed extensive preclinical tests for novel reproductive techniques with the goal to acquire knowledge on efficacy and the possible health effects of to-be implemented reproductive techniques to safeguard quality of novel MARs.
Collapse
Affiliation(s)
- Callista L Mulder
- Center for Reproductive Medicine, Amsterdam Research Institute Reproduction and Development, Academic Medical Centre, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - Joana B Serrano
- Center for Reproductive Medicine, Amsterdam Research Institute Reproduction and Development, Academic Medical Centre, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - Lisa A E Catsburg
- Center for Reproductive Medicine, Amsterdam Research Institute Reproduction and Development, Academic Medical Centre, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - Tessa J Roseboom
- Department of Obstetrics and Gynaecology, Amsterdam Reproduction and Development Research Institute, Academic Medical Centre, Meibergdeef 9, 1105 AZ, Amsterdam, The Netherlands
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam Public Health Research Institute, Academic Medical Centre, Meibergdeef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Sjoerd Repping
- Center for Reproductive Medicine, Amsterdam Research Institute Reproduction and Development, Academic Medical Centre, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - Ans M M van Pelt
- Center for Reproductive Medicine, Amsterdam Research Institute Reproduction and Development, Academic Medical Centre, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| |
Collapse
|