Free Access Articles
Is there a clinical future for GV manipulation?
In this issue of RBMOnline, Zhang and Liu present their latest work involving mammalian germinal vesicle (GV) transfer (Zhang and Liu, 2015). This study extends the prior work of these authors and others in examining this technique (Liu et al., 2003; Takeuchi et al., 2001; Zhang et al., 1999). One finding of developmental interest is the observation that when reciprocal GV transfers between human and mouse oocytes were performed, the maturation process and spindle formation followed the expected form of the species donating the ooplast.A plea for caution and more research in the ‘experimental’ use of ionophores in ICSI
Other than the fear of a negative pregnancy outcome, fear of fertilization failure is probably one of the foremost motives for the growing practice of using ICSI, rather than conventional insemination, for all couples undergoing IVF. However, even with the insertion of a morphologically normal sperm from an individual of known fertility, there are instances, albeit relatively rare, where no fertilization occurs, as indicated by absent pronuclear formation. Artificial oocyte activation, aimed at obtaining at least one zygote, is considered when all mature oocytes are supposedly affected.Regulation of assisted reproduction in the USA – a just target or a target of unfair criticism?
Soon after the first IVF clinics opened their doors, sensible voices within this emerging field contemplated the many facets and complexities of manipulating reproduction. The new reproductive options were often debated publicly, and ethical and safety guidelines were proposed by IVF pioneers, interest groups and legislators. Several decades have passed, yet there has been no uniformity in this international effort. Some countries, most notably Australia, Belgium and the UK, have had effective regulatory systems in place for some time.The time has come to radically rethink assisted reproduction
Results from more than 95% of assisted reproduction studies are rendered unusable by the standards of evidence-based medicine (EBM). Thus, technological or methodological bias in most studies underlies the decision of EBM technocrats to curtail the number of studies that are considered reliable and of acceptable quality for inclusion in systematic reviews. If this outcome seems to constitute a particularly punishing approach to data evaluation, consider the proposition that these technocrats actually may have been generous and that more than 99.9% of comparative studies in IVF should be ignored!Possible conflicts of interest in medical publishing
The issues raised by Norbert Gleicher in his provocative commentary on possible conflicts of interest in medical publishing (Gleicher, 2013) can stir deep-seated emotions. One must give serious attention to his comments, not least because the writer was himself an editor-in-chief for many years of the first specialized IVF journal, published in 1983 (Journal of In Vitro Fertilization and Embryo Transfer, renamed Journal of Assisted Reproduction and Genetics in 1992). Indeed the issues raised are ones with which we and our publishers are regularly in debate.The biological basis for defining bi-parental or tri-parental origin of offspring from cytoplasmic and spindle transfer
The bi-parental genetic state is not a given after assisted reproduction. This is based on a biological definition of parentage that concerns generational inheritance of genetic material. Often three or more individuals may participate in artificial reproduction. Only cytoplasmic and spindle transfer can result in the genetic tri-parental state. All other forms involving three or more assisting persons with no heritable genetic contribution must be considered differently. Can a cytoplasmic donor be a biological parent based on a potential contribution of mitochondrial DNA to the offspring? – only if the mitochondrial DNA sequence can be traced back to the donor, a phenomenon which may not be very common.Embryonic DNA sampling without biopsy: the beginnings of non-invasive PGD?
The clinical usefulness of preimplantation genetic diagnosis (PGD) and screening (PGS) may be imperative, but it is not without its shortcomings. A number of arguments, some reasoned and others not, have been put forth against these technologies. To avoid transmission of genetic disease, patients and their doctors who may consider assisted reproduction, often choose post-conception testing with the option of termination of an affected pregnancy rather than commit to PGD. Moreover, while PGS may offer a method of selection for chromosomally normal embryos, alternative embryo selection modalities are usually favored over this technique.Introduction to Evidence-Based Reproductive Medicine Symposium
The philosopher Plato described knowledge as “justified true belief”. For several millennia this notion has been self-evident. However, clinicians aiming to understand and treat human disease as efficaciously and effectively as possible must follow the Hippocratic oath and adhere to the principle of ‘do no harm’ and show due respect for human life and the medical profession. Although these clinical ideologies are fundamental and appear immutable, numerous attempts have been made to redefine the principles.Exciting futures
Welcome to a new year! As we write we are anticipating ending 2012 on the high of our Futures in Reproduction conference, held to celebrate the second anniversary of the award of the Nobel Prize to our founding emeritus editor, Bob Edwards. The meeting will take place at Churchill College, Cambridge in mid-December co-sponsored by RBM Online and the University of Cambridge. Speakers were asked to capture something of the radical, far-sighted, wide-ranging and challenging spirit of enquiry that characterizes Bob Edwards’ career: a strong focus on the exciting and unconventional being the highest tribute that we could pay to this remarkable man.Past performance of assisted reproduction technologies as a model to predict future progress: a proposed addendum to Moore’s law
The ultimate goal of IVF is to achieve healthy, single, live births following each single-embryo transfer. A timeline for this eventuality has never been defined. National implantation rates from 2003–2010 provided by the Society for Assisted Reproductive Technologies (SART) in the USA were evaluated. Regression analysis was applied to the annual trends. A high correlation was noted showing a linear increase from year to year ranging between 0.3% and 1.5% when maternal age was not higher than 42.Personhood: to be or when to be – is that the question?
The dictionary definition of personhood reads: ‘the quality or condition of being an individual person’, which does not advance our understanding of this term! Indeed, the concept of personhood has exercised philosophers for centuries, the state being variously, and disputedly, accorded the attributes of life, individuality, consciousness, agency, self-awareness, empathy, and/or the capacities to anticipate, remember, plan and choose – the capacity to exercise free will. How personhood is understood is of great significance, as, when conferred socio-legally on an individual, it carries with it privileges, protection and rights, together with responsibilities and liabilities – sometimes incorporated into the political and legal concept of citizenship.The uses and abuses of bibliometrics
Bibliographic databases provide us with easy access to many more journals than was possible when each of us editors started in science. We well remember the treks around libraries, the frustration of the missing volumes and the broken photocopier, the ‘reprint request’ post cards sent and received, and the bundling up of hard copy papers for posting to our colleagues. Now, at the press of a button, papers can be located, paid for (unless freely accessible), down loaded, filed – and sometimes even read! However, with this easy access to databases and papers come problems: notably the increased risk of deliberate or accidental plagiarism (Cohen et al., 2012) and the fact of information overload.Trophoblast tales
The placenta has to be the most complex organ in the body – genetically, functionally and structurally. It is uniquely complex genetically, comprising tissues of both maternal and fetal genotype in close apposition, as well as having a complex gene expression profile according to the parental epigenetic imprint inherited on selected genes. It is complex functionally in its sheer range of hormonal products, combining roles assigned to many or most other endocrine glands, and also in its transport systems, its physical anchoring role, and in its immunological properties.Welcome to the ‘100% Club’!
One of the most important achievements in human assisted reproduction in recent years is the substantial improvement in egg and embryo cryopreservation technologies. With the introduction and fine-tuning of vitrification, it is now possible to vitrify and warm unfertilized eggs at near maximal efficiency, with cell survival rates reaching 80% and even approaching 100% in some clinics. This is quite different to earlier attempts, which routinely led to the loss of a high proportion of eggs to cryodamage, regardless of egg ‘quality’.
