Senin, 23 Oktober 2017

'Testy Time' for Assisted Reproduction

'Testy Time' for Assisted Reproduction


SAN ANTONIO — Technologic advances in the preimplantation genetic testing of embryos, which can prevent the transfer of aneuploid embryos and improve the efficiency of assisted reproductive technology, will be among the scientific breakthroughs featured at the upcoming American Society for Reproductive Medicine (ASRM) 2017 Scientific Congress.



Dr Richard Paulson

“It turns out that you can transfer embryos that appear to have some abnormalities, and yet they produce normal pregnancies,” said ASRM President Richard Paulson, MD, director of USC Fertility in Los Angeles.

“This is very novel scientific information and gives us great insight into the biology of the preimplantation embryo,” he told Medscape Medical News.

Mitochondrial replacement and the use of CRISPR technology to prevent the transmission of heritable human diseases will be addressed by Shoukhrat Mitalipov, PhD, a gene therapy expert from Oregon Health and Science University in Portland.



Dr Sue Gitlin

“His talk represents a piece of the puzzle to help people have healthy babies, which fits into our theme of building healthy families,” said Sue Gitlin, PhD, from Eastern Virginia Medical School in Norfolk, who is chief scientific officer of the ASRM.

Another highlight will be a presentation on the use of chromosome studies to select the best embryo to transfer.

Determining Which Embryo to Transfer

“If a woman goes through in vitro fertilization and has eight embryos, we are not going to transfer all eight; we are going to transfer one and freeze the rest,” Dr Gitlin explained.

“So how do we determine which one to transfer?” This is “a hot topic that attendees always want to hear more about,” she noted.

Fertility preservation for women who lose their ability to have children — often through illness, such as cancer — will be another popular topic at the meeting. “Over the past few years, our ability to cryopreserve embryos and eggs has improved to the point that the success rate is in the 90% survival range from the freeze–thaw process,” said Dr Gitlin.

Infertility is very common, said Dr Paulson. “Now, virtually everyone has someone in their family who needed IVF to have a baby. More than 1% of all births in the United States are the result of IVF.”

First In Vitro Baby

Louise Brown, the first baby in the world born with the help of in vitro fertilization, will be flying in from London.

“It just so happens that her visit here will coincide with the fortieth anniversary of her conception, when her mother was undergoing IVF. She will speak at a reception in the evening; it’s a ticketed event, but it’s open to all,” Dr Gitlin said.

During the President’s Guest Lecture, Cecile Richards, president of Planned Parenthood, will speak about reproductive autonomy and how it can ensure global access to healthcare.

“We are really excited to have her speaking,” said Dr Gitlin. President Trump “has said he wants to defund Planned Parenthood, so there’s been a lot of animosity toward this kind of science,” Dr Paulson pointed out.

“We focus on fertility and helping people have babies, but I think it is important to understand that reproductive autonomy is reproductive autonomy, and the people who want to abridge access to contraception and other forms of reproductive care are also, in fact, abridging people’s right to in vitro fertilization,” he explained.

Protecting Human Life

For the first time, the 4-year strategic plan of the US Department of Health and Human Services talks about protecting human life at the beginning of conception, he told Medscape Medical News. “If the government does decide that life begins at the moment the egg and sperm are fertilized, this could put a damper on in vitro fertilization.”

If the government does decide that life begins at the moment the egg and sperm are fertilized, this could put a damper on in vitro fertilization.

“This is going to be potentially a testy time for assisted reproduction,” said Dr Paulson. “There is a law on the books, the Dicky–Wicker amendment, that prohibits any kind of federal funding for any research that involves embryos, so we’ve always had to contend with the federal government. But for the first time, we have an administration that is, frankly, hostile.”

“We think it is important to make sure that people understand that this is not just about banning abortions. They are, in fact, banning access to fertility care,” he explained. “It would be very hard to make any kind of progress with IVF if we have this kind of toxic attitude toward embryo research.”

Dr Paulson and Dr Gitlin have disclosed no relevant financial relationships.

Follow Medscape on Twitter @Medscape



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