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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; 19:933-945. [PMID: 38848715 PMCID: PMC11252480 DOI: 10.1016/j.stemcr.2024.05.002] [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: 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.
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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.
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2
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Frost ER, Gilchrist RB. Making human eggs in a dish: are we close? Trends Biotechnol 2024; 42:168-178. [PMID: 37625913 DOI: 10.1016/j.tibtech.2023.07.007] [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: 05/17/2023] [Revised: 07/05/2023] [Accepted: 07/30/2023] [Indexed: 08/27/2023]
Abstract
In the space of 50 years, we have seen incredible achievements in human reproductive medicine. With these leaps forward, it is no wonder that there is a major interest in women's reproductive health research, including extension of reproductive lifespan. Substantial effort is currently being made to address this challenge, including from the commercial sector. In vitro gametogenesis (IVG) in mice is a spectacular breakthrough and has the potential to offer hope to women with intractable infertility. However, with such lofty goals, some reflection may be called for: mastering all of the techniques required for complete and safe IVG in women is likely to be extraordinarily difficult.
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Affiliation(s)
- Emily R Frost
- Fertility & Research Centre, Discipline of Women's Health, School of Clinical Medicine, University of New South Wales, Sydney, NSW 2052, Australia.
| | - Robert B Gilchrist
- Fertility & Research Centre, Discipline of Women's Health, School of Clinical Medicine, University of New South Wales, Sydney, NSW 2052, Australia.
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3
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Romualdez-Tan MV. Modelling in vitro gametogenesis using induced pluripotent stem cells: a review. CELL REGENERATION (LONDON, ENGLAND) 2023; 12:33. [PMID: 37843621 PMCID: PMC10579208 DOI: 10.1186/s13619-023-00176-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Accepted: 08/28/2023] [Indexed: 10/17/2023]
Abstract
In vitro gametogenesis (IVG) has been a topic of great interest in recent years not only because it allows for further exploration of mechanisms of germ cell development, but also because of its prospect for innovative medical applications especially for the treatment of infertility. Elucidation of the mechanisms underlying gamete development in vivo has inspired scientists to attempt to recapitulate the entire process of gametogenesis in vitro. While earlier studies have established IVG methods largely using pluripotent stem cells of embryonic origin, the scarcity of sources for these cells and the ethical issues involved in their use are serious limitations to the progress of IVG research especially in humans. However, with the emergence of induced pluripotent stem cells (iPSCs) due to the revolutionary discovery of dedifferentiation and reprogramming factors, IVG research has progressed remarkably in the last decade. This paper extensively reviews developments in IVG using iPSCs. First, the paper presents key concepts from groundwork studies on IVG including earlier researches demonstrating that IVG methods using embryonic stem cells (ESCs) also apply when using iPSCs. Techniques for the derivation of iPSCs are briefly discussed, highlighting the importance of generating transgene-free iPSCs with a high capacity for germline transmission to improve efficacy when used for IVG. The main part of the paper discusses recent advances in IVG research using iPSCs in various stages of gametogenesis. In addition, current clinical applications of IVG are presented, and potential future applications are discussed. Although IVG is still faced with many challenges in terms of technical issues, as well as efficacy and safety, novel IVG methodologies are emerging, and IVG using iPSCs may usher in the next era of reproductive medicine sooner than expected. This raises both ethical and social concerns and calls for the scientific community to cautiously develop IVG technology to ensure it is not only efficacious but also safe and adheres to social and ethical norms.
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Affiliation(s)
- Maria Victoria Romualdez-Tan
- Present Address: Repro Optima Center for Reproductive Health, Inc., Ground Floor JRDC Bldg. Osmena Blvd. Capitol Site, Cebu City, 6000, Philippines.
- Cebu Doctors University Hospital, Cebu City, Philippines.
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Cyranoski D, Contreras JL, Carrington VT. Intellectual property and assisted reproductive technology. Nat Biotechnol 2023; 41:14-20. [PMID: 36653491 DOI: 10.1038/s41587-022-01592-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Affiliation(s)
- David Cyranoski
- Institute for the Advanced Studies of Human Biology (WPI-ASHBi), Kyoto University, Kyoto, Japan.
| | - Jorge L Contreras
- S.J. Quinney College of Law, University of Utah, Salt Lake City, UT, USA
- Department of Human Genetics, University of Utah School of Medicine, Salt Lake City, UT, USA
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Mertes H, Goethals T, Segers S, Huysentruyt M, Pennings G, Provoost V. Enthusiasm, concern and ambivalence in the Belgian public's attitude towards in-vitro gametogenesis. REPRODUCTIVE BIOMEDICINE & SOCIETY ONLINE 2022; 14:156-168. [PMID: 35024472 PMCID: PMC8732790 DOI: 10.1016/j.rbms.2021.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 08/24/2021] [Accepted: 10/29/2021] [Indexed: 06/14/2023]
Abstract
Given the controversial nature of research into in-vitro gametogenesis (IVG), this study set out to investigate the current attitudes towards IVG in the general Belgian population in order to anticipate potential future barriers and misunderstandings. A questionnaire was developed and incorporated into a web-based online survey and sent out to Belgians aged ≥ 18 years in September 2018 until a representative sample (by age, gender and region) of 1000 participants was reached. Respondents expressed an overall positive attitude towards IVG and its possible future applications, with the exception of the use of IVG in postmenopausal women. They were ambivalent about the importance of genetic parenthood and about the necessary experiments on animals and embryos to bring IVG to the clinic. While the willingness to accept greater risks for IVG than for other assisted reproductive technology treatments was low (17.5%), the use of spare in-vitro fertilization embryos to study those risks was acceptable for 55.8% of participants; embryo creation was acceptable for 38.1%; and experiments on mice and monkeys were acceptable for 45.3% and 30.4%, respectively. Finally, 85.6% of participants agreed that the Belgian Government should strictly regulate IVG. In conclusion, preclinical research into IVG and other reproductive technologies elicits a great diversity of attitudes towards the importance of genetic parenthood and the acceptability of embryo and animal research. There is a need for public dialogue on these topics.
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Abstract
Increased demand for in vitro fertilization (IVF) due to socio-demographic trends, and supply facilitated by new technologies, converged to transform the way a substantial proportion of humans reproduce. The purpose of this article is to describe the societal and demographic trends driving increased worldwide demand for IVF, as well as to provide an overview of emerging technologies that promise to greatly expand IVF utilization and lower its cost.
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Akatsuka K, Hatta T, Sawai T, Fujita M. Public attitudes in Japan toward the reproductive use of gametes derived from human-induced pluripotent stem cells. Future Sci OA 2021; 7:FSO754. [PMID: 34840811 PMCID: PMC8609981 DOI: 10.2144/fsoa-2021-0065] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 09/30/2021] [Indexed: 11/23/2022] Open
Abstract
PURPOSE To investigate the interests of the Japanese general public in the reproductive use of in vitro derived (IVD)-gametes. METHODS We conducted an online survey and obtained answers from 3096 respondents. RESULTS More than half of the respondents agreed with the reproductive use of IVD-gametes by infertile heterosexual married couples but disagreed with the same use by unmarried or homosexual individuals. Nearly 70.0% disagreed with the use for designing a baby. DISCUSSION In Japan at present, the use of IVD-gametes that deviate from societal values regarding reproduction and family prescribed by the conventional marriage system is unlikely to be accepted. It is also unlikely to be accepted for non-treatment purposes in reproduction.
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Affiliation(s)
- Kyoko Akatsuka
- Uehiro Research Division for iPS Cell Ethics, Center for iPS Cell Research & Application, Kyoto University, Japan, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
| | - Taichi Hatta
- Shizuoka Graduate University of Public Health, Japan, 4-27-2 Kita Ando, Aoi-ku, Shizuoka 420-0881, Japan
| | - Tsutomu Sawai
- Institute for the Advanced Study of Human Biology (WPI-ASHBi), KUIAS Kyoto University, Japan, Yoshida-Konoe-cho, Sakyo-ku, Kyoto 606-8501, Japan
| | - Misao Fujita
- Uehiro Research Division for iPS Cell Ethics, Center for iPS Cell Research & Application, Kyoto University, Japan, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
- Institute for the Advanced Study of Human Biology (WPI-ASHBi), KUIAS Kyoto University, Japan, Yoshida-Konoe-cho, Sakyo-ku, Kyoto 606-8501, Japan
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Sawai T, Hatta T, Akatsuka K, Fujita M. Public attitudes in Japan toward the creation and use of gametes derived from human-induced pluripotent stem cells. Future Sci OA 2021; 7:FSO755. [PMID: 34840812 PMCID: PMC8610011 DOI: 10.2144/fsoa-2021-0066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 09/30/2021] [Indexed: 01/31/2023] Open
Abstract
AIM To ascertain to what extent the Japanese general public accept the creation and use of in vitro derived (IVD)-gametes derived from human-induced pluripotent stem cells. MATERIALS & METHODS We conducted an online survey and obtained answers from 3096 respondents. RESULTS 78.6% of the respondents answered that they would accept the creation and use of IVD-gametes for research purposes, 51.7% answered that they would accept the creation and use of embryos with IVD-gametes for research purposes, and 25.9% answered that they would accept childbirth using embryos with IVD-gametes. DISCUSSION The results that approximately half of the respondents answered that they would accept the creation of embryos with IVD-gametes, which has not been allowed in the current Japanese research guidelines, is astonishing.
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Affiliation(s)
- Tsutomu Sawai
- Institute for the Advanced Study of Human Biology (WPI-ASHBi), KUIAS Kyoto University, Japan, Yoshida-Konoe-cho, Sakyo-ku, Kyoto, 606-8501, Japan
| | - Taichi Hatta
- Shizuoka Graduate University of Public Health, Japan, 4-27-2 Kita Ando, Aoi-ku, Shizuoka, 420-0881, Japan
| | - Kyoko Akatsuka
- Uehiro Research Division for iPS Cell Ethics, Center for iPS Cell Research & Application, Kyoto University, Japan, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Misao Fujita
- Institute for the Advanced Study of Human Biology (WPI-ASHBi), KUIAS Kyoto University, Japan, Yoshida-Konoe-cho, Sakyo-ku, Kyoto, 606-8501, Japan
- Uehiro Research Division for iPS Cell Ethics, Center for iPS Cell Research & Application, Kyoto University, Japan, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
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de Araujo M. Human Rights and Assisted Reproductive Technologies (ART): A Contractarian Approach. CANADIAN JOURNAL OF BIOETHICS 2020. [DOI: 10.7202/1073798ar] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
What are human rights? Do they exist? I propose to answer these questions by advancing a contractarian account of human rights. I focus on the human right to found a family and have children. I also show how the contractarian approach to human rights can explain the current relevance of reproductive rights in the human rights discourse, and how the emergence of ART (Assisted Reproductive Technologies) has contributed to this shift. The contractarian account of human rights asks, firstly, the following question: which basic needs and desires can be ascribed to any human being regardless of gender, nationality, sexual orientation, age, ethnicity etc.? Having an interest, for instance, in preserving one’s own bodily integrity, freedom, and private property qualifies as a basic human need or basic desire. But a basic human need or desire does not constitute in itself a human right. Secondly, the contractarian account of human rights asks, then, which basic human needs or basic desires individuals and states representatives would consider so important that they would agree to create institutional frameworks, both at the domestic and international level, in such a way as to enable individuals to pursue the fulfilment of their basic needs or desires without state interference. Human rights exist and can only be claimed in the context of these normative frameworks.
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Affiliation(s)
- Marcelo de Araujo
- Faculty of Law, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
- Department of Philosophy, State University of Rio de Janeiro, Rio de Janeiro, Brazil
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Abstract
Recent research with human embryos, in different parts of the world, has sparked a new debate on the ethics of genetic human enhancement. This debate, however, has mainly focused on gene-editing technologies, especially CRISPR (Clustered Regularly Interspaced Short Palindromic Repeats). Less attention has been given to the prospect of pursuing genetic human enhancement by means of IVF (In Vitro Fertilisation) in conjunction with in vitro gametogenesis, genome-wide association studies, and embryo selection. This article examines the different ethical implications of the quest for cognitive enhancement by means of gene-editing on the one hand, and embryo selection on the other. The article focuses on the ethics of cognitive enhancement by means of embryo selection, as this technology is more likely to become commercially available before cognitive enhancement by means of gene-editing. This article argues that the philosophical debate on the ethics of enhancement should take into consideration public attitudes to research on human genomics and human enhancement technologies. The article discusses, then, some of the recent findings of the SIENNA Project, which in 2019 conducted a survey on public attitudes to human genomics and human enhancement technologies in 11 countries (France, Germany, Greece, the Netherlands, Poland, Spain, Sweden, Brazil, South Africa, South Korea, and United States).
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11
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Adashi EY, Cohen IG. Reproduction reimagined. F S Rep 2020; 1:7-8. [PMID: 34223205 PMCID: PMC8244332 DOI: 10.1016/j.xfre.2020.03.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 03/26/2020] [Indexed: 11/23/2022] Open
Affiliation(s)
- Eli Y. Adashi
- Department of Medical Science, the Warren Alpert Medical School, Brown University, Providence, Rhode Island
| | - I. Glenn Cohen
- James A. Attwood and Leslie Williams Professor of Law, Harvard Law School, and Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics, Harvard University, Cambridge, Massachusetts
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12
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Abstract
Abstract:Research into the development of stem cell-derived (SCD) gametes in humans, otherwise known asin vitrogametogenesis (IVG), is largely motivated by reproductive aims. Especially, the goal of establishing genetic parenthood by means of SCD-gametes is considered an important aim. However, like other applications in the field of assisted reproduction, this technology evokes worries about the possibility of creating so-called ‘designer babies.’ In this paper, we investigate various ways in which SCD-gametes could be used to create such preference-matched offspring, and what this would mean for the acceptability of IVG, if it is premised that it is morally problematic to ‘design’ offspring. We argue that IVG might facilitate the creation of preference-matched offspring, but conclude that this should not undermine the moral acceptability of IVG altogether—even if one concedes the premise that creating ‘designer babies’ is morally problematic. In the light of this, we also point at a possible inconsistency for a position that condemns the creation of ‘designer offspring,’ while accepting the various endeavors to have genetically related offspring.
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Bubela T, Kleiderman E, Master Z, Ogbogu U, Ravitsky V, Zarzeczny A, Knoppers BM. Canada's Assisted Human Reproduction Act: Pragmatic Reforms in Support of Research. Front Med (Lausanne) 2019; 6:157. [PMID: 31355201 PMCID: PMC6636215 DOI: 10.3389/fmed.2019.00157] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 06/24/2019] [Indexed: 12/20/2022] Open
Abstract
Canada's Assisted Human Reproduction Act is long overdue for Parliamentary review. We argue that the current regulation of research using human reproductive materials is not proportionate, not responsive to the uncertain threats posed to human and environmental health and safety, and is not considerate of diverse values in a democratic society. We propose tailored regulatory carve-outs for in vitro research for currently prohibited activities, such as gene editing, and for the exercise of Ministerial Discretion for access by Canadians to experimental in vivo interventions that are currently prohibited, such as mitochondrial replacement therapy. Our recommendations are bounded by constitutional constraints that recognize political and practical challenges in keeping oversight of this research under Federal jurisdiction, whether conducted in academic or private sectors. The proposed nuanced regulatory scheme should be overseen by a new national Agency, modeled on a blend of the Canadian Stem Cell Oversight Committee and Assisted Human Reproduction Canada.
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Affiliation(s)
- Tania Bubela
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - Erika Kleiderman
- Centre of Genomics and Policy, Department of Human Genetics, McGill University, Montreal, QC, Canada
| | - Zubin Master
- Mayo Clinic Center for Regenerative Medicine, Rochester, MN, United States
- Biomedical Ethics Research Program, Mayo Clinic, Rochester, MN, United States
| | - Ubaka Ogbogu
- Faculties of Law, Pharmacy and Pharmaceutical Sciences, University of Alberta, Edmonton, AB, Canada
| | - Vardit Ravitsky
- Department of Social and Preventive Medicine, School of Public Health, University of Montreal, Montreal, QC, Canada
| | - Amy Zarzeczny
- Johnson Shoyama Graduate School of Public Policy, University of Regina, Regina, SK, Canada
| | - Bartha Maria Knoppers
- Centre of Genomics and Policy, Department of Human Genetics, McGill University, Montreal, QC, Canada
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Akahori T, Woods DC, Tilly JL. Female Fertility Preservation through Stem Cell-based Ovarian Tissue Reconstitution In Vitro and Ovarian Regeneration In Vivo. CLINICAL MEDICINE INSIGHTS. REPRODUCTIVE HEALTH 2019; 13:1179558119848007. [PMID: 31191070 PMCID: PMC6540489 DOI: 10.1177/1179558119848007] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/03/2019] [Accepted: 03/27/2019] [Indexed: 12/13/2022]
Abstract
Historically, approaches designed to offer women diagnosed with cancer the prospects of having a genetically matched child after completion of their cytotoxic treatments focused on the existing oocyte population as the sole resource available for clinical management of infertility. In this regard, elective oocyte and embryo cryopreservation, as well as autologous ovarian cortical tissue grafting posttreatment, have gained widespread support as options for young girls and reproductive-age women who are faced with cancer to consider. In addition, the use of ovarian protective therapies, including gonadotropin-releasing hormone agonists and sphingosine-1-phosphate analogs, has been put forth as an alternative way to preserve fertility by shielding existing oocytes in the ovaries in vivo from the side-effect damage caused by radiotherapy and many chemotherapeutic regimens. This viewpoint changed with the publication of now numerous reports that adult ovaries of many mammalian species, including humans, contain a rare population of oocyte-producing germ cells-referred to as female germline or oogonial stem cells (OSCs). This new line of study has fueled research into the prospects of generating new oocytes, rather than working with existing oocytes, as a novel approach to sustain or restore fertility in female cancer survivors. Here, we overview the history of work from laboratories around the world focused on improving our understanding of the biology of OSCs and how these cells may be used to reconstitute "artificial" ovarian tissue in vitro or to regenerate damaged ovarian tissue in vivo as future fertility-preservation options.
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Affiliation(s)
- Taichi Akahori
- Laboratory for Aging and Infertility Research, Department of Biology, Northeastern University, Boston, MA, USA.,On leave from the Department of Obstetrics and Gynecology, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | - Dori C Woods
- Laboratory for Aging and Infertility Research, Department of Biology, Northeastern University, Boston, MA, USA
| | - Jonathan L Tilly
- Laboratory for Aging and Infertility Research, Department of Biology, Northeastern University, Boston, MA, USA
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Adashi EY, Cohen IG, Hanna JH, Surani AM, Hayashi K. Stem Cell-Derived Human Gametes: The Public Engagement Imperative. Trends Mol Med 2019; 25:165-167. [PMID: 30738627 DOI: 10.1016/j.molmed.2019.01.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 01/14/2019] [Accepted: 01/14/2019] [Indexed: 11/28/2022]
Abstract
The implications of scientific breakthroughs are rarely faced up to in advance of their realization. Stem cell-derived human gametes, a disruptive technology in waiting, are likely to recapitulate this historic pattern absent active intervention. Herein we call for the conduct of thoughtful ante hoc deliberations on the prospect of stem cell-derived human gametes with an eye toward minimizing potential untoward post hoc regulatory or statutory impositions.
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Affiliation(s)
- Eli Y Adashi
- Warren Alpert Medical School, Brown University, 272 George St., Providence, RI 02906, USA.
| | - I Glenn Cohen
- Harvard Law School, Harvard University, Cambridge, MA, USA
| | - Jacob H Hanna
- Department of Molecular Genetics, Weizmann Institute of Science, Rehovot, Israel
| | - Azim M Surani
- Departments of Physiology, Development, and Neuroscience, University of Cambridge, Cambridge, UK
| | - Katsuhiko Hayashi
- Department of Developmental Stem Cell Biology, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
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16
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Martin JJ, Woods DC, Tilly JL. Implications and Current Limitations of Oogenesis from Female Germline or Oogonial Stem Cells in Adult Mammalian Ovaries. Cells 2019; 8:E93. [PMID: 30696098 PMCID: PMC6407002 DOI: 10.3390/cells8020093] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Accepted: 01/16/2019] [Indexed: 12/15/2022] Open
Abstract
A now large body of evidence supports the existence of mitotically active germ cells in postnatal ovaries of diverse mammalian species, including humans. This opens the possibility that adult stem cells naturally committed to a germline fate could be leveraged for the production of female gametes outside of the body. The functional properties of these cells, referred to as female germline or oogonial stem cells (OSCs), in ovaries of women have recently been tested in various ways, including a very recent investigation of the differentiation capacity of human OSCs at a single cell level. The exciting insights gained from these experiments, coupled with other data derived from intraovarian transplantation and genetic tracing analyses in animal models that have established the capacity of OSCs to generate healthy eggs, embryos and offspring, should drive constructive discussions in this relatively new field to further exploring the value of these cells to the study, and potential management, of human female fertility. Here, we provide a brief history of the discovery and characterization of OSCs in mammals, as well as of the in-vivo significance of postnatal oogenesis to adult ovarian function. We then highlight several key observations made recently on the biology of OSCs, and integrate this information into a broader discussion of the potential value and limitations of these adult stem cells to achieving a greater understanding of human female gametogenesis in vivo and in vitro.
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Affiliation(s)
- Jessica J Martin
- Laboratory of Aging and Infertility Research, Department of Biology, Northeastern University, Boston, MA 02115, USA.
| | - Dori C Woods
- Laboratory of Aging and Infertility Research, Department of Biology, Northeastern University, Boston, MA 02115, USA.
| | - Jonathan L Tilly
- Laboratory of Aging and Infertility Research, Department of Biology, Northeastern University, Boston, MA 02115, USA.
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17
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Abstract
Advances in human genome editing, in particular the development of the clustered regularly interspaced palindromic repeats (CRISPR)/Cas9 method, have led to increasing concerns about the ethics of editing the human genome. In response, the US National Academy of Sciences and the National Academy of Medicine constituted a multidisciplinary, international committee to review the current status and make recommendations. I was a member of that committee, and the core of this review reflects the committee's conclusions. The committee's report, issued in February 2017, recommends the application of current ethical and regulatory standards for gene therapy to somatic (nonheritable) human genome editing. It also recommends allowing experimental germline genome editing to proceed if ( a) it is restricted to preventing transmission of a serious disease or condition, ( b) the edit is a modification to a common DNA sequence known not to be associated with disease, and ( c) the research is conducted under a stringent set of ethical and regulatory requirements. Crossing the so-called red line of germline genome editing raises important bioethical issues, most importantly, serious concern about the potential negative impact on individuals with disabilities. This review highlights some of the major ethical considerations in human genome editing in light of the report's recommendations.
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Affiliation(s)
- Barry S Coller
- Allen and Frances Adler Laboratory of Blood and Vascular Biology, Rockefeller University, New York, NY 10065, USA;
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18
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Bredenoord AL, Hyun I. Ethics of stem cell-derived gametes made in a dish: fertility for everyone? EMBO Mol Med 2018; 9:396-398. [PMID: 28279974 PMCID: PMC5376744 DOI: 10.15252/emmm.201607291] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
A timely and thoughtful discussion of the ethical challenges and societal impacts presented by the recent reports demonstrating the successful in vitro generation of functional gametes from somatic and pluripotent stem cells.
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Affiliation(s)
- Annelien L Bredenoord
- Department of Medical Humanities, Julius Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Insoo Hyun
- Department of Bioethics, Case Western Reserve University School of Medicine, Cleveland, OH, USA
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Gleicher N. Expected advances in human fertility treatments and their likely translational consequences. J Transl Med 2018; 16:149. [PMID: 29866181 PMCID: PMC5987489 DOI: 10.1186/s12967-018-1525-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 05/26/2018] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Due to rapid research progress in reproductive biology and reproductive clinical endocrinology, many human infertility treatments are close to potential breakthroughs and translational applications. We here review current barriers, where such breakthroughs will likely come from, what they will entail, and their potential clinical applications. MAIN TEXT The radical nature of change will primarily benefit older women, reduce fertility treatment costs and thereby expand access to treatment. A still widely overlooked prerequisite for implantation and normal pregnancy maintenance is timely development of maternal immunological tolerance toward an implanting paternal semi-allograft, if malfunctioning associated with implantation failure and pregnancy loss, while premature termination of tolerance appears associated with premature labor, pre-eclampsia/eclampsia and gestoses of pregnancy. Common denominators between pregnancy and invasive malignancies have again been attracting attention, suggesting that, like in malignant tumors, degrees of embryo aneuploidy may affect invasiveness and ability to "disarm" the immune system's innate response against implanting embryos. Linking tolerance to implantation, we offer evidence that the so-called "implantation window" is likely immunological rather than hormonally defined. CONCLUSIONS Because many here outlined treatment changes will disproportionally benefit older women, they will exert a pronounced effect on society, as increasing numbers of women at grandparental ages will become mothers.
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Affiliation(s)
- Norbert Gleicher
- The CHR, 21 East 69th Street, New York, NY, 10021, USA.
- The Foundation for Reproductive Medicine, New York, NY, 10021, USA.
- Laboratory for Stem Cell Biology and Molecular Embryology, Rockefeller University, New York, NY, 10065, USA.
- Department of Obstetrics and Gynecology, Vienna Medical School, 1090, Vienna, Austria.
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20
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Woods DC, Khrapko K, Tilly JL. Influence of Maternal Aging on Mitochondrial Heterogeneity, Inheritance, and Function in Oocytes and Preimplantation Embryos. Genes (Basel) 2018; 9:E265. [PMID: 29883421 PMCID: PMC5977205 DOI: 10.3390/genes9050265] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Revised: 05/11/2018] [Accepted: 05/14/2018] [Indexed: 12/15/2022] Open
Abstract
Contrasting the equal contribution of nuclear genetic material from maternal and paternal sources to offspring, passage of mitochondria, and thus mitochondrial DNA (mtDNA), is uniparental through the egg. Since mitochondria in eggs are ancestral to all somatic mitochondria of the next generation and to all cells of future generations, oocytes must prepare for the high energetic demands of maturation, fertilization and embryogenesis while simultaneously ensuring that their mitochondrial genomes are inherited in an undamaged state. Although significant effort has been made to understand how the mtDNA bottleneck and purifying selection act coordinately to prevent silent and unchecked spreading of invisible mtDNA mutations through the female germ line across successive generations, it is unknown if and how somatic cells of the immediate next generation are spared from inheritance of detrimental mtDNA molecules. Here, we review unique aspects of mitochondrial activity and segregation in eggs and early embryos, and how these events play into embryonic developmental competency in the face of advancing maternal age.
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Affiliation(s)
- Dori C Woods
- Laboratory for Aging and Infertility Research, Department of Biology, Northeastern University, Boston, MA 02115, USA.
| | - Konstantin Khrapko
- Laboratory for Aging and Infertility Research, Department of Biology, Northeastern University, Boston, MA 02115, USA.
| | - Jonathan L Tilly
- Laboratory for Aging and Infertility Research, Department of Biology, Northeastern University, Boston, MA 02115, USA.
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21
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Adashi EY, Cohen IG. Preventing Mitochondrial Diseases: Embryo-Sparing Donor-Independent Options. Trends Mol Med 2018; 24:449-457. [PMID: 29605176 DOI: 10.1016/j.molmed.2018.03.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2018] [Revised: 03/04/2018] [Accepted: 03/05/2018] [Indexed: 12/26/2022]
Abstract
Mutant mitochondrial DNA gives rise to a broad range of incurable inborn maladies. Prevention may now be possible by replacing the mutation-carrying mitochondria of zygotes or oocytes at risk with donated unaffected counterparts. However, mitochondrial replacement therapy is being held back by theological, ethical, and safety concerns over the loss of human zygotes and the involvement of a donor. These concerns make it plain that the identification, validation, and regulatory adjudication of novel embryo-sparing donor-independent technologies remains a pressing imperative. This Opinion highlights three emerging embryo-sparing donor-independent options that stand to markedly allay theological, ethical, and safety concerns raised by mitochondrial replacement therapy.
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Affiliation(s)
- Eli Y Adashi
- The Warren Alpert Medical School, Brown University, Providence, RI 02905, USA.
| | - I Glenn Cohen
- Harvard Law School, Cambridge, MA 02138, USA; Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics, Harvard University, 1563 Massachusetts Avenue, Cambridge, MA 02138, USA
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22
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Feldman EA. Baby M Turns 30: The Law and Policy of Surrogate Motherhood. AMERICAN JOURNAL OF LAW & MEDICINE 2018; 44:7-22. [PMID: 29764324 DOI: 10.1177/0098858818763811] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
This article marks the 30th anniversary of the Supreme Court of New Jersey's Baby M decision by offering a critical analysis of surrogacy policy in the United States. Despite fundamental changes in both science and society since the case was decided, state courts and legislatures remain bitterly divided on the legality of surrogacy. In arguing for a more uniform, permissive legal posture toward surrogacy, the article addresses five central debates in the surrogacy literature. First, should the legal system accommodate those seeking conception through surrogacy, or should it prohibit such arrangements? Second, if surrogacy is permitted, what steps can be taken to minimize the potential exploitation of women who are willing to rent their wombs for income? Third, what criteria should govern the eligibility to serve as a surrogate mother and an intended parent? Fourth, what principle(s) should serve as the basis for determining the parentage of children born through surrogacy? Fifth, is regulatory uniformity in the surrogacy realm desirable? Is it achievable? The article concludes that courts and legislatures should accept the validity of surrogacy contracts, determine parentage according to intent, and identify transparent criteria for the eligibility of both surrogates and intended parents.
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Affiliation(s)
- Eric A Feldman
- JD, PhD; Professor of Law and Professor of Health Policy and Medical Ethics at the University of Pennsylvania Law School. I would like to thank Arthur Caplan and two anonymous reviewers for their helpful comments on this article, as well as Shintaro Suzuki for encouraging me to work on this topic. Support was provided by a University of Pennsylvania Law School Summer Research Grant
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23
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Greenfield A, Braude P, Flinter F, Lovell-Badge R, Ogilvie C, Perry ACF. Assisted reproductive technologies to prevent human mitochondrial disease transmission. Nat Biotechnol 2017; 35:1059-1068. [PMID: 29121011 DOI: 10.1038/nbt.3997] [Citation(s) in RCA: 72] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Accepted: 10/02/2017] [Indexed: 12/31/2022]
Abstract
Mitochondria are essential cytoplasmic organelles that generate energy (ATP) by oxidative phosphorylation and mediate key cellular processes such as apoptosis. They are maternally inherited and in humans contain a 16,569-base-pair circular genome (mtDNA) encoding 37 genes required for oxidative phosphorylation. Mutations in mtDNA cause a range of pathologies, commonly affecting energy-demanding tissues such as muscle and brain. Because mitochondrial diseases are incurable, attention has focused on limiting the inheritance of pathogenic mtDNA by mitochondrial replacement therapy (MRT). MRT aims to avoid pathogenic mtDNA transmission between generations by maternal spindle transfer, pronuclear transfer or polar body transfer: all involve the transfer of nuclear DNA from an egg or zygote containing defective mitochondria to a corresponding egg or zygote with normal mitochondria. Here we review recent developments in animal and human models of MRT and the underlying biology. These have led to potential clinical applications; we identify challenges to their technical refinement.
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Affiliation(s)
- Andy Greenfield
- MRC Harwell Institute, Mammalian Genetics Unit, Harwell Campus, Harwell, Oxfordshire, UK
| | - Peter Braude
- Division of Women's Health, King's College, London, UK
| | - Frances Flinter
- Clinical Genetics Department, Guy's Hospital, Great Maze Pond, London, UK
| | | | - Caroline Ogilvie
- Genetics Department, Guy's & St Thomas' NHS Foundation Trust and Division of Women's Health, King's College, London, UK
| | - Anthony C F Perry
- Laboratory of Mammalian Molecular Embryology, Department of Biology and Biochemistry, University of Bath, Bath, UK
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24
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Ilic D, Ogilvie C, Noli L, Kolundzic N, Khalaf Y. Human embryos from induced pluripotent stem cell-derived gametes: ethical and quality considerations. Regen Med 2017; 12:681-691. [PMID: 28976837 DOI: 10.2217/rme-2017-0052] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Protocols for successful differentiation of male and female gametes from induced pluripotent stem cells have been published. Although culture of precursor cells in a natural microenvironment remains necessary to achieve terminal differentiation, the creation of human preimplantation embryos from induced pluripotent stem cell-derived gametes is technically feasible. Such embryos could provide a solution to the scarcity of human cleavage-stage embryos donated for research. Here, we discuss current technology, major research-related ethical concerns and propose the norms that would assure the quality and reliability of such embryos.
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Affiliation(s)
- Dusko Ilic
- Division of Women's Health, Faculty of Life Sciences and Medicine, King's College London and Assisted Conception Unit, Guy's Hospital, London SE1 9RT, UK
| | | | - Laila Noli
- Division of Women's Health, Faculty of Life Sciences and Medicine, King's College London and Assisted Conception Unit, Guy's Hospital, London SE1 9RT, UK
| | - Nikola Kolundzic
- Division of Women's Health, Faculty of Life Sciences and Medicine, King's College London and Assisted Conception Unit, Guy's Hospital, London SE1 9RT, UK
| | - Yacoub Khalaf
- Division of Women's Health, Faculty of Life Sciences and Medicine, King's College London and Assisted Conception Unit, Guy's Hospital, London SE1 9RT, UK
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Vanni VS, Viganò P, Papaleo E, Mangili G, Candiani M, Giorgione V. Advances in improving fertility in women through stem cell-based clinical platforms. Expert Opin Biol Ther 2017; 17:585-593. [PMID: 28351161 DOI: 10.1080/14712598.2017.1305352] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
INTRODUCTION Due to their regenerative ability, stem cells are looked at as a promising tool for improving infertility treatments in women. As the main limiting factor in female fertility is represented by the decrease of ovarian reserve, the main goals of stem cell-based clinical platforms would be to obtain in vitro or in vivo neo-oogenesis. Refractory endometrial factor infertility also represents an obstacle for female reproduction for which stem cells might provide novel treatment strategies. Areas covered: A systematic search of the literature was performed on MEDLINE/PubMed database to identify relevant articles using stem-cell based clinical or research platforms in the field of female infertility. Expert opinion: In vitro oogenesis has not so far developed beyond the stage of oocyte-like cells whose normal progression to mature oocytes and ability to be fertilized was not proved. Extensive epigenetic programming of gamete precursors and the complex interactions between somatic and germ cells required for human oogenesis likely represent the main obstacles in stem-cell-based neo-oogenesis. Also resuming oogenesis in vivo in adulthood still appears a distant hypothesis, as there is still a lack of consensus about the existence and functionality of adult ovarian stem cells.
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Affiliation(s)
- Valeria Stella Vanni
- a Obstetrics and Gynaecology Unit , IRCCS San Raffaele Hospital , Milano , Italy.,b Obstetrics and Gynaecology Unit , Vita-Salute San Raffaele University , Milano , Italy
| | - Paola Viganò
- c Division of Genetics and Cell Biology , IRCCS San Raffaele Hospital , Milano , Italy
| | - Enrico Papaleo
- a Obstetrics and Gynaecology Unit , IRCCS San Raffaele Hospital , Milano , Italy
| | - Giorgia Mangili
- a Obstetrics and Gynaecology Unit , IRCCS San Raffaele Hospital , Milano , Italy
| | - Massimo Candiani
- a Obstetrics and Gynaecology Unit , IRCCS San Raffaele Hospital , Milano , Italy.,b Obstetrics and Gynaecology Unit , Vita-Salute San Raffaele University , Milano , Italy
| | - Veronica Giorgione
- a Obstetrics and Gynaecology Unit , IRCCS San Raffaele Hospital , Milano , Italy.,b Obstetrics and Gynaecology Unit , Vita-Salute San Raffaele University , Milano , Italy
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26
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Hough SH, Ajetunmobi A. The Future of CRISPR Applications in the Lab, the Clinic and Society. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2017; 1016:157-178. [PMID: 29130159 DOI: 10.1007/978-3-319-63904-8_9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
CRISPR (clustered regularly interspaced short palindromic repeats) has emerged as one of the premiere biological tools of the century. Even more so than older genome editing techniques such as TALENs and ZFNs, CRISPR provides speed and ease-of-use heretofore unheard of in agriculture, the environment and human health. The ability to map the function of virtually every component of the genome in a scalable, multiplexed manner is unprecedented. Once those regions have been explored, CRISPR also presents an opportunity to take advantage of endogenous cellular repair pathways to change and precisely edit the genome [1-3]. In the case of human health, CRISPR operates as both a tool of discovery and a solution to fundamental problems behind disease and undesirable mutations.
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Affiliation(s)
- Soren H Hough
- Department of Microbiology, University of Massachusetts Amherst, 418 Morrill Science Center IVN, 649 North Pleasant Street, Amherst, MA, 01003, USA.
| | - Ayokunmi Ajetunmobi
- Department of Clinical Medicine, St. James' Hospital, Dublin, Ireland, James's Street, Dublin 8, Dublin, Leinster, D08 NHY1, Ireland
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