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#21

General Discussion / Research: No difference in pre...

Last post by mensfe_admin - 2024-07-30 08:56

The largest study of its kind has found no difference in pregnancy rates between intrauterine insemination (IUI) cycles using fresh or frozen sperm.

The research was presented at the annual meeting of the European Society of Human Reproduction and Embryology by Dr Panagiotis Cherouveim from Massachusetts General Hospital and Harvard Medical School.

'The fact that our data did not reveal any significant difference in success between the utilisation of fresh ejaculated and frozen sperm, except in a subgroup of patients given oral ovulation-inducing agents, is very reassuring to all involved,' said Dr Cherouveim. 'No detrimental effect of sperm cryopreservation on IUI outcomes was noted.'

The study looked at outcomes from 5335 IUI treatments that took place from 2004-2021. Overall there was no significant difference in pregnancy rates, but some differences were observed in patients who had ovarian stimulation prior to insemination, versus those who did not.

'Although, specific subgroups might benefit from fresh sperm utilisation and time-to-pregnancy might be shorter with fresh than frozen sperm, patients should be counselled about the non-inferiority of frozen sperm,' said Dr Cherouveim.

One limitation of the study is that most of the frozen sperm came from anonymous donors, who tend on average to be younger, and healthier than the partners providing fresh sperm, and usually have good quality sperm.

'On the face of it, it's reassuring to find that there is no material difference in the success of fresh or frozen sperm during an IUI procedure,' andrologist Professor Allan Pacey from the University of Sheffield told BioNews. 'However, in this study, the frozen sperm was from donors who are highly selected men precisely because their sperm can survive the freezing process. Therefore, is there really any surprise that the authors found no difference?'

Sources and References
4 July 2022
38th annual meeting of the European Society of Human Reproduction and Embryology

#22

Research / Research: No difference in pre...

Last post by mensfe_admin - 2024-07-30 08:54

The largest study of its kind has found no difference in pregnancy rates between intrauterine insemination (IUI) cycles using fresh or frozen sperm.

The research was presented at the annual meeting of the European Society of Human Reproduction and Embryology by Dr Panagiotis Cherouveim from Massachusetts General Hospital and Harvard Medical School.

'The fact that our data did not reveal any significant difference in success between the utilisation of fresh ejaculated and frozen sperm, except in a subgroup of patients given oral ovulation-inducing agents, is very reassuring to all involved,' said Dr Cherouveim. 'No detrimental effect of sperm cryopreservation on IUI outcomes was noted.'

The study looked at outcomes from 5335 IUI treatments that took place from 2004-2021. Overall there was no significant difference in pregnancy rates, but some differences were observed in patients who had ovarian stimulation prior to insemination, versus those who did not.

'Although, specific subgroups might benefit from fresh sperm utilisation and time-to-pregnancy might be shorter with fresh than frozen sperm, patients should be counselled about the non-inferiority of frozen sperm,' said Dr Cherouveim.

One limitation of the study is that most of the frozen sperm came from anonymous donors, who tend on average to be younger, and healthier than the partners providing fresh sperm, and usually have good quality sperm.

'On the face of it, it's reassuring to find that there is no material difference in the success of fresh or frozen sperm during an IUI procedure,' andrologist Professor Allan Pacey from the University of Sheffield told BioNews. 'However, in this study, the frozen sperm was from donors who are highly selected men precisely because their sperm can survive the freezing process. Therefore, is there really any surprise that the authors found no difference?'

Sources and References
4 July 2022
38th annual meeting of the European Society of Human Reproduction and Embryology

#23

General Discussion / Re: Surrogates more likely to ...

Last post by mensfe_admin - 2024-07-30 08:48

Welcome to this week's BioNews – news, plus comment and reviews curated by our editors.

(To see 'Sources and References' for an article below, click on the article title and then scroll to the bottom of the website version of the article.)

Comment
Surrogacy health risks – Do UK surrogates need to be worried?
by Sarah Jones

As an experienced altruistic surrogate in the UK, I found Marina Ivanova's research paper as presented at the ESHRE 40th Annual Meeting in Amsterdam interesting (see BioNews 1246). The study suggested that gestational carriers (known as surrogates in the UK), face higher risks of maternal morbidity and pregnancy complications in comparison to those who experience pregnancy and childbirth after natural conception or IVF.

Any study that includes nearly 1000 surrogate pregnancies should be looked at closely by the UK surrogacy community and any conclusions considered when looking at the risks to surrogates in the UK. Dr Raj Mathur, a consultant gynaecologist and former chair of the British Fertility Society told BioNews that surrogacy organisations should take on board the need for careful screening and counselling of surrogates 'and ensure that they have criteria to ensure that women at increased risk of complications, such as high blood pressure, are not encouraged to act as surrogates'.

In fact, surrogacy organisations in the UK are already quite diligent about this. The organisation that I undertook my own surrogacy journeys with, SurrogacyUK, who I now work for, carefully consider the health of the surrogates they accept. Historically we have rejected over two-thirds of all applications to be a surrogate that we receive.

SurrogacyUK has implemented a robust admissions policy for several years. The comprehensive risk assessments undertaken during the admissions process evaluates various factors including obstetric health, BMI, age, physical health, emotional health, previous and current medical conditions, and any medications taken.

Social factors such as family composition and support systems are also thoroughly considered. Further checks include background checks on all adults in the household, social services checks, and an assessment of the applicant's understanding and potential vulnerability. This includes identifying any risks of coercion, including financial coercion.

It is important to acknowledge that every pregnancy, whether naturally-conceived, through IVF, or via surrogacy, carries some risks. Some risks may be unpredictable and remain unknown despite comprehensive research and consultation, such as such as low-lying placenta, placenta previa, baby lying in a breach or transverse position, hyperemesis gravidarum or symphysis pubis dysfunction - these can happen in a pregnancy, without ever having been experienced in previous pregnancies. However, many can be mitigated through careful monitoring and adherence to medical advice for example. For example gestational diabetes, can be controlled using diet and medication, or c-sections can be planned if a surrogate has had one previously. However, potential risks can never be entirely eliminated.

As an experienced surrogate, I weighed these risks carefully as part of my decision-making process, just as I did when deciding to have my own children. Surrogacy organisations have an ethical duty to establish criteria that help reduce risks and ensure potential surrogates are given sufficient information to provide informed consent. However, it is equally important that surrogates are not infantilised or stripped of their autonomy. At present SurrogacyUK, Brilliant Beginnings and My Surrogacy Journey all have admissions policies and surrogate eligibility criteria, but they are not required to do so as they are not regulated.

My most recent surrogacy journey resulted in the birth of a wonderful little boy, now aged three, who was born into his genetic family, joining his genetic mum, dad, and siblings. During this pregnancy, two risk factors were identified: I was classified as being of advanced maternal age (over 35) and having a high parity (over five births).

These risks were known to me, and my decision to embark on a surrogacy journey was made after carefully assessing them. Before offering to help my friends complete their family, I discussed the potential risks with my IVF clinic, my GP, and my obstetric consultant. With the support and guidance of medical professionals who evaluated my individual circumstances, I felt confident making an informed choice.

In my case, I was well aware of my risk factors, a blanket ban would have removed my ability to make an informed choice, disregarding my individual history, level of understanding, and the personal medical advice I received. It is essential that policies consider each woman's unique situation and allow for personalised decision-making based on medical advice.

Interestingly, when I decided to have my own children, I did not face the same level of scrutiny. No one evaluated my understanding or ensured I was making an informed choice before expanding my family. My medical history was not reviewed by a medical professional, the stability of my family unit was not considered, nor was my support network or the potential risks to myself. No one questioned my decision to have my own children. In contrast, my decision to be a surrogate was a much safer one to make, as it involved thorough assessments and consultations with medical professionals, ensuring I was fully informed and supported.

The study author Marina Ivanova summarised a number of possible causes for their findings: baseline health, IVF treatment, differing prenatal care and monitoring, as well as the physiological and psychological impact of carrying a pregnancy for someone else. The author floated surrogates' lower socioeconomic status, as a possible reason, but showed that adjusting findings for socioeconomic status did not explain the discrepancies they had found.

Considering the possible causes, and considering if they are relevant to UK surrogates results in more questions: Are Canadian surrogates offered the option of mild or natural IVF like UK surrogates? At SurrogacyUK we advise our surrogates that it may be possible to have a non-medicated cycle, purely because it reduces the risks and side effects. Would this impact the results?

Are the risks only higher for surrogates because they are more likely to have had more children before embarking on a surrogacy journey? Those undertaking IVF for themselves are far less likely to have a parity over five. How would the results compare to a similar survey of non-surrogate pregnancies where the mothers had a parity of five or more?

These questions could be addressed by a similar large-scale study in the UK which would ideally include parity and IVF-type comparison groups. We know that maternal morbidity is relatively low within the surrogate community, as most surrogates obtain medical approval for subsequent surrogacy journeys and are deemed fit to receive treatment by UK clinics. Comparing data from both countries could provide much needed information to elucidate mechanisms underpinning increased risks of pregnancy complications, that could lead to real improvements for UK surrogates.

As a surrogate, and CEO at SurrogacyUK, I passionately believe that having access to comprehensive information, including up-to-date research is crucial to being able to make fully informed choices. Every surrogate, like any woman planning a pregnancy, should have absolute clarity on the risks they face before making their decision. At SurrogacyUK, the health and wellbeing of surrogates is, and must remain, the highest priority. Marina Ivanova's study is an important and interesting addition to the research already undertaken on surrogacy. For me, though, it raises as many questions as it answers and highlights the need for UK-specific clinical and academic research.

New fertility law for Australian Capit

#24

General Discussion / Surrogates more likely to have...

Last post by mensfe_admin - 2024-07-23 08:15

Surrogates more likely to have hypertension and postpartum haemorrhage
by Hannah Flynn

Surrogates experience higher levels of complications during and after pregnancy compared to other IVF patients, a non-peer reviewed cohort study in Canada has shown.

The study of 937,938 singleton births, including 956 women acting as surrogates for intended parents, found that these women were more likely to be older, have had children, reside in low-income areas and have chronic hypertension when compared to other women in the cohort. Authors from Canada presented the results at the 40th annual meeting of the European Society of Human Reproduction and Embryology.

Dr Raj Mathur a consultant gynaecologist and former chair of the British Fertility Society who was not involved in the research told BioNews: 'This study shows that gestational surrogates are at increased risk of serious complications in pregnancy. This highlights the importance of careful screening and counselling of surrogates. Surrogacy organisations should take on board this need and ensure that they have criteria to ensure that women at increased risk of complications such as high blood pressure are not encouraged to act as surrogates.'

Surrogates were found to have a 14.9 percent risk of hypertension and postpartum haemorrhage, compared to an 11 percent or 12 percent risk, respectively, for women who have a baby following IVF. Women who conceived naturally experienced a six percent risk of postpartum haemorrhage, and seven percent risk of hypertension. The cohort was followed between 20 weeks' gestation and 42 days after the delivery.

One in 14 surrogates experienced severe health conditions linked to their pregnancy and birth compared to one in 22 women giving birth following IVF, and one in 42 women who conceived naturally. There was no difference in the rate of poor outcomes for babies up to 28 days old, born to women following IVF or natural conception and those born to surrogates.

Authors said that the results could reflect that surrogates are likely to have poorer overall health before pregnancy, despite there being clear calls for only women with 'favourable characteristics for a healthy pregnancy' to be selected for surrogacy.

'Gestational carriers were also less likely to be in the highest income bracket, and we know that lower socioeconomic status is associated with higher serious maternal morbidity rates. However, sociodemographic characteristics were accounted for in the analysis, and the results were similar, which suggest potential different mechanisms,' said Dr Maria Velez, study supervisor and senior author.

Considering that surrogates were more likely to have had previous pregnancies and be older it was important to 'ensure that any woman intending to be a surrogate is both medically assessed as fit for pregnancy and given the opportunity to have implications counselling where all risks, including health risks, are made known to her prior to trying to conceive. If she knows and understands these risks and continues the surrogacy journey, her decision should be respected,' Kirsty Horsey, professor in law at Kent University, who was not involved in the study, told BioNews.

#25

General Discussion / Prolific Dutch sperm donor res...

Last post by mensfe_admin - 2024-07-16 08:02

A Dutch sperm donor is threatening to sue Netflix over allegations made about him in a recent documentary series.

Jonathan Meijer is the subject of the recent Netflix documentary 'The Man with 1000 Kids', which includes interviews with families who have children conceived using his sperm. Some accused him of lying about the number of families he had already helped create.

'Technically I did not lie. I followed the guidelines of every large commercial international sperm bank that does not inform the recipients about the amount of offspring one donor will produce,' Meijer told NBC News. 'I gave the parents an estimated number, this was better and more info than they would ever get at any clinic.'

The number of donations made by Meijer had already been the subject of potential legal action, after a district court in The Hague banned him from making further donations earlier this year (see BioNews 1188) in response to a lawsuit brought by an organisation representing donor-conceived people in the Netherlands (see BioNews 1185). As many as 11 sperm banks holding his samples have also been asked to destroy them.

Dutch guidelines limit sperm donors to a maximum of 25 genetic offspring, and allow donation at only one sperm bank. Warnings about the number of donations made by Meijer go back to 2017 when he had already contributed to the creation of over 100 children (see BioNews 915). Meijer told the Independent that he stopped donating to new families in 2019, and estimates that he has around 550 donor children, not 1000 as the Netflix title suggests.

The documentary also contains allegations that Meijer mixed his sperm with that of another prolific donor before giving it to a recipient, in a competition to see whose sperm would 'win'. Meijer denied this ever happened and said in a YouTube video he will sue Netflix for defamation if the claim is not removed.

#26

General Discussion / Ten families and counting

Last post by mensfe_admin - 2024-07-15 09:21

Ten Families and Counting: Time for Global Limits on Donor-Created (Half-) Siblings?
by Dr Thomas Hopkins

The latest event produced by PET (the Progress Educational Trust) focused on the issue of limits on the number of people and families, worldwide, who can be created from the sperm or eggs of the same donor.

Current practice is to limit the number of donor-created families to ten in the UK, although back in 1984 it was a ten-child limit that was originally recommended in the Warnock Report. The limit was intended originally to prevent 'inadvertent incest', and to manage the social and psychological implications of donor conception.

Sarah Norcross, director of PET, opened the event by discussing how circumstances have changed. She highlighted that the Warnock Committee did not envisage a global market for sperm donation, evolving over decades. Different countries have varying regulations and practices, which can complicate the tracking and tracing of donors. Nor was it possible, at the time of the Warnock Report, to trace donors through direct-to-consumer genetic testing.

An ability to trace genetic connections across borders necessitates a careful reevaluation of existing limits and practices. Is having dozens (or even hundreds) of half-siblings a problem?

The first speaker was Professor Jackson Kirkman-Brown, chair of the Association of Reproductive and Clinical Scientists and a professor of reproductive biology at the University of Birmingham. He opened his presentation by illustrating the scale of donor conception: 4100 donor-conceived babies are born annually in the UK, approximately 1 in every 170 births. He highlighted a tripling in children born from donor sperm between 2006 and 2019, a trend largely driven by single patients and same-sex couples seeking donor sperm.

Professor Kirkman-Brown pointed out that donor anonymity is increasingly untenable in the age of widespread genetic testing. Additionally, gametes can now be kept in storage for up to 55 years (see BioNews 1111), potentially resulting in future half-siblings with significant age gaps and related emotional and psychological impacts on children seeking donors who may be deceased.

Professor Kirkman-Brown also pointed out logistical issues, noting that travel from London to central Europe can now be quicker than travel from London to Scotland, making the utility of UK-only family limits questionable. Furthermore, over half of the sperm used in UK clinics is imported, primarily from countries like Denmark and the USA where different rules apply.

He concluded by emphasising the need for better data on the psychological impact of donor conception on children, and called for the Human Fertilisation and Embryology Authority (HFEA) to take a definitive stance and advocate for internationally policed family limits.

Next to speak was Christina Sommerlund, business development manager at Born Donor Bank. She opened her presentation by citing a paper recommending a global limit of 100 families per donor, and described how Born works to a maximum of 75 families per donor, making this very clear on its website. To ensure that this is not exceeded, Born allocates 'pregnancy slots', permitting a recipient to use the same donor for multiple children.

Sommerlund argued that sperm banks should be actively responsible, to make sure that the limits are adhered to. However, she also argued that clinics, donors and recipients share the responsibility for preventing an excessive number of families being created per donor.

She raised an interesting point, regarding the shifting definition of families to highlight the layers of complexity that need to be considered in the regulation of donor limits.  She said that the HFEA's Code of Practice now covers scenarios such as if a female same-sex couple splits up, whether both parties would be allowed to continue using the same donor sperm after separation and whether this counts as one family or two.

The third speaker Kevin Moore shared his personal experience as both a donor-conceived person and as a sperm donor. He described being part of a WhatsApp group with seven half-siblings and their donor, emphasising that finding out about their genetic relationships at different times and through various methods was a complex experience.

Some of the siblings in the group discovered their connections through genetic testing, which came as a surprise to them. Moore reflected that emotional bonds are easier to maintain when the number of siblings is relatively small, and acknowledged that larger numbers could be overwhelming emotionally, particularly when trying to maintain a level of contact with such large groups.

He pointed out the potential challenges posed by cultural and language differences among siblings from different countries, which can complicate relationship-building. Despite these challenges, he noted the rewarding aspects of having a large network of siblings, such as providing mutual support and discussing similar experiences.

The fourth speaker was Dr Astrid Indekeu, a research fellow at the Catholic University of Leuven and who has published research and commentary on kinship, psychosocial challenges and voluntary DNA databases in relation to donor-conceived half-siblings and donors.

Dr Indekeu discussed her findings concerning the psychosocial dynamics of having multiple donor family connections. This included the positive aspects of discovering similarities among donor-conceived siblings, such as shared physical traits and interests.

However, she also highlighted several challenges, including the transition from individual identities to forming a cohesive group. Regulating closeness and distance within the group, and balancing individual needs against group dynamics, are significant hurdles that need to be overcome. She asked how donor-conceived individuals transition from being strangers to forming a sense of belonging within a group. Factors such as resemblance, shared genetics, beliefs, values and humour all play a role.

Dr Indekeu quoted a participant from her research who preferred not to be forced into a group identity based solely on shared DNA, emphasising that group dynamics should evolve naturally and not through any expectation. She also raised the issue of managing expectations within growing groups, noting that some participants feel overwhelmed by the expanding number of siblings, and the realisation that maintaining contact with everyone is not possible.

She concluded by pointing out practical challenges such as language and cultural barriers, and physical distance between half-siblings in a global context. Dr Indekeu stressed that these psychosocial aspects should be actively considered, when setting limits on the number of offspring per donor.

The final presentation was from Dr Grace Halden, co-director of the Centre for Medical and Health Humanities at Birkbeck University of London. She shared her experience as a solo mother using donor sperm, and highlighted the lack of transparency regarding the exportation of sperm after a donor has reached the ten-family limit within the UK. She said that she and other donor recipients were surprised to find out that their donors' profiles had changed, to note that the donor's sperm is unavailable for further UK recipients but is still available for export (see BioNews 1222).

Dr Halden called for clearer communication about the possibility of sperm being exported to create more families after the UK limit is reached, suggesting that this information should be prominently displayed in relevant sections of donor profiles, clinic websites and FAQs. She also suggested that differences between UK limits and global limits should be raised at the point of consultation, and that the possibility of export should be mentioned every time a UK family limit comes up.

She concluded that transparency is crucial, in order for recipients to make informed decisions and manage their expectations about the potential size and distribution of their donor-conceived family network.

A lively question-and-answer session followed, underscoring the complexities and ever evolving nature of donor conception practices in the UK, and the difficulty of establishing global limits. Key themes included the need for continuous review and updates to donor limits, considering global markets and advances in practice. The speaker panel also emphasised the importance of international consensus, better data collection, and addressing the psychosocial impacts on donor-conceived children.

Overall, the event highlighted that while donor conception offers significant benefits to many families, it also presents complex challenges that require careful regulation, ongoing research into the impact on all involved, and – most importantly – regard for to the needs and wellbeing of donor-conceived people.

PET is grateful to the Association of Reproductive and Clinical Scientists for supporting this event.

The next free-to-attend online events from PET will be:

IVF Add-Ons: Building Bridges between Clinics, Regulators and Patients, taking place online next week (on Wednesday 5 June 2024) – register here.
Where Art Meets ART: Creative Exploration of Fertility Research and Treatment, taking place online on Wednesday 12 June 2024 – register here.
News
US senators propose bill to protect IVF access
by Ryan Au

Two republican senators have proposed a bill to protect IVF, after some states' abortion laws created uncertainty.

Following the Alabama Supreme Court's ruling earlier this year that embryos created via IVF are considered children (see BioNews 1228), Senator Ted Cruz of Texas and Senator Katie Britt of Alabama have introduced a bill called the IVF Protection Act that seeks to ensure no state prohibits access to IVF services.

'Families across the US are understandably worried that in vitro fertilisation is under threat', wrote Cruz and Britt in a Wall Street Journal article, adding: 'This is an opportunity to unite on a shared bipartisan commitment to life, family, and personal liberty by protecting access to IVF treatments in every corner of America'.

The issue of access to IVF has arisen following the overturning of Roe v Wade in 2022, which returned the power of regulating abortions to individual states. This triggered a wave of bans and restrictions on abortion in some states, some of which contain language affecting the legal status of human embryos.

The Alabama Supreme Court ruling caused many IVF clinics in Alabama to suspend their services out of fear of prosecution. In response, the Alabama legislature passed a new law to protect fertility clinics from criminal charges (see BioNews 1230).

A previous attempt to protect IVF at a federal level, the Access to Family Building Act introduced by
Democratic Senator Tammy Duckworth of Illinois, sought to establish a federal right to IVF and allow healthcare providers the ability to provide such care without fear of prosecution. This bill was blocked because Republicans saw it as a 'backdoor in broader abortion legislation,' Cruz explained in an interview with Bloomberg.

The proposed IVF Protection Act would not compel any person or organisation to provide IVF services but would make states ineligible to receive some federal healthcare funding if IVF access was banned. Cruz hopes that both parties can agree on this approach:

'Every senator says they support IVF,' said Cruz. 'We should be able to come together 100 to nothing to say we stand with the ability of parents who want to love their kids to bring those children into the world'.

Genetic control of the brain – comprehensive cell maps published
by Dr Paige Mumford

Fifteen studies comprehensively mapping the genes responsible for regulation of activity and development of the brain have been published.

Neurodevelopmental conditions such as autism, and mental illnesses such as schizophrenia are common, yet their underlying mechanisms are poorly understood. The PsychENCODE Consortium is a multi-institutional collaboration funded by the US National Institute of Mental Health (NIMH) aimed at understanding gene regulation's impact on brain function and dysfunction, including what occurs during neuropsychiatric diseases. It published 11 papers in 2018, and this publication of 15 new papers, represents the second phase of the project.

Dr Daniel Geschwind, senior author of one of the studies from the University of California Los Angeles, said: 'This collection of manuscripts from PsychENCODE, both individually and as a package, provides an unprecedented resource for understanding the relationship of disease risk to genetic mechanisms in the brain.'

The studies were published across Science, Science Advances, and Scientific Reports, included characterisation of donated human brain tissue across different brain regions, studied several neuropsychiatric diseases as well as the neurotypical developing human brain, and used standardised methods to create multidimensional maps of gene regulation networks.

In one study published in Science, researchers developed a transcriptomic atlas of the prefrontal cortex from individuals with and without schizophrenia and identified cell type-specific transcriptional changes associated with schizophrenia, revealing that genetic risk variants for schizophrenia predominantly target genes in cells known as excitatory neurons.

For a study on autism, researchers analysed genetic expression in the brain tissues of 66 people, 33 people with autism and 33 controls to better understand the mechanisms underpinning genetic risk factors associated with autism. They discovered known risk genes played a role in regulating transcription of genes associated with stress response in immune cells found in the brain, and synaptic gene expression. Overall they found substantial gene expression changes across 35 different cell types in the brain. Results were published in Science.

Researchers characterised molecular alterations across three different brain regions from individuals with post-traumatic stress disorder and major depressive disorder compared with control subjects, in another study published in Science. They identified brain region-specific molecular differences.

Lastly, researchers presented a new tool called PsychSCREEN, an interactive web-based platform to allow for easy visualisation of the data from diverse brain cell types in individuals with and without mental disorders generated by the PsychENCODE consortium, in a paper in Science Advances.

The director of the NIMH, Dr Joshua Gordon, said: 'These groundbreaking findings advance our understanding of where, how, and when genetic risk contributes to mental disorders such as schizophrenia, post-traumatic stress disorder, and depression... Moreover, the critical resources, shared freely, will help researchers pinpoint genetic variants that are likely to play a causal role in mental illnesses and identify potential molecular targets for new therapeutics.'

Epigenetic reprogramming aids development of human gametes in vitro
by David Cansfield

For the first time, human stem cells that were originally skin cells have been reprogrammed into early-stage sperm and egg precursors.

Published in Nature, by a team of Japanese researchers at Kyoto University, the study describes the method used to produce large quantities of early-stage sperm and egg cells from stem cells by erasing the epigenetic 'memory' that determines which genes are expressed. In future this could help people who are infertile or in same-sex couples to have a biologically-related child.

'Epigenetic reprogramming is key to making the next generation,' said developmental biologist Professor Mitinori Saitou from the Institute for the Advanced Study of Human Biology who led this research.

The team set out to bridge the gap between previous research which was able to grow mouse eggs using stem-cell-like cells generated from skin (see BioNews 1231). Crucial to the team's success was discovering that the addition of a protein called bone morphogenetic protein (BMP2) was essential to promote epigenetic reprogramming. The cells advanced one step further in their development compared to cells in cultures without added BMP2.

'The results of this research are an important milestone in clarifying the mechanism of human germ cell development and the promotion of research on the in vitro development of human germ cells,' the researchers said.

After this epigenetic reprogramming, the cells' development stopped and Professor Saitou acknowledged that there are still further steps to be taken to perfect this process. The researchers also found that in the cells the reprogramming was incomplete. This could have serious consequences if such cells were used for reproduction, highlighting the need for discussion on how to conduct this type of biomedical research safely and ethically.

'This involves many technical problems and ethical questions, and that is still a long way off. But in mice it has already been possible to fertilise an egg cell obtained in this way with a natural sperm cell,' commented Dr Arend Overeem, a stem cell biologist at the Leiden University Medical Centre who was not involved in the study (see BioNews 1104).

Understanding how eggs and sperm develop can provide researchers with insights into some causes of infertility. It also opens up possibilities for creating sperm and egg cells in a lab in future, which could significantly advance reproductive medicine and aid individuals with fertility issues.

#27

Research / Psychosocial outcomes of child...

Last post by mensfe_admin - 2024-02-21 11:23

Salomeh Salari, Seungho Lee, Joshua Mangels, Rebecca Flyckt, Jody Madeira, John Gordon, Jeffrey Keenan, Miryoung Lee, Paul Lin, Guido Pennings ... Show more
Human Reproduction, deae023, https://doi.org/10.1093/humrep/deae023
Published: 19 February 2024 Article history
 
Abstract
STUDY QUESTION
What are parents' perceptions of their relationships with and the psychosocial adjustments of their children who are born via embryo donation?

SUMMARY ANSWER
Families created through embryo donation have well-adjusted parent–child relationships and reassuring child psychosocial outcomes.

WHAT IS KNOWN ALREADY
Embryo donation is an effective and growing form of third-party reproduction, but there is limited research in this field. Prior studies suggest that families created through gamete donation function well regarding parent–child relationship quality and child behavioral and socioemotional adjustment.

STUDY DESIGN, SIZE, DURATION
This is a cross-sectional survey study with 187 total participants.

PARTICIPANTS/MATERIALS, SETTING, METHODS
Parents of children born via embryo donation were recruited nationally by contacting all embryo donation programs registered with the Society for Assisted Reproductive Technology Clinic Outcome Reporting System (SART CORS) as well as medically directed embryo donation or 'embryo adoption' centers. Participants completed three online Qualtrics questionnaires. The first was a survey including 33 questions on demographics, the procurement process, and self-reported obstetric outcomes. Participants also completed two standardized measures assessing children's behavior and parents' adjustment to parenthood: the Strengths and Difficulties Questionnaire (SDQ) and the Parental Acceptance-Rejection Questionnaire (PARQ). Scoring of the SDQ and PARQ was totaled and compared to standardized values (SDQ) or previously published results on other forms of gamete donation (PARQ), such as oocyte donation and sperm donation.

MAIN RESULTS AND THE ROLE OF CHANCE
On the SDQ (n = 46), the average total difficulties scores by age were: 8.2 ± 0.98 for ages 2–4, 7.6 ± 0.93 for ages 5–10, and 3.5 ± 0.77 for ages 11–17; this is compared to the normal reported range of 0–13, which indicates that clinically significant psychosocial problems are unlikely. Across all ages and individual categories (emotional symptoms, conduct problem, hyperactivity, peer problem, prosocial), scores on the SDQ were within the normal ranges. The average PARQ score (n = 70) for all respondents was 27.5 ± 1.18 (range: 24–96), suggesting perceived parental acceptance.

LIMITATIONS, REASONS FOR CAUTION
Because this study was cross-sectional, it could not capture familial relationships over time. This survey-based study design allows for potential selection bias (parents of well-adjusted children may be more likely to participate). Additionally, the overall sample size is relatively small; however, it remains one of the largest published to date. Another significant limitation to this study is the lack of generalizability: most participants were recruited from private, faith-based, embryo donation programs who are demographically similar.

WIDER IMPLICATIONS OF THE FINDINGS
Though embryo donation is an established form of third-party reproduction, it is significantly less robustly studied compared to other forms of gamete donation (oocyte or sperm donation). This study provides a larger data set with a more expanded age range of children compared to the limited number of previously published studies. Furthermore, these findings indicate a high parental disclosure rate with respect to the use of embryo donation which contrasts previous findings.

STUDY FUNDING/COMPETING INTEREST(S)
No external funding source was utilized for the completion of this study. No conflicts are disclosed.

#28

General Discussion / Psychosocial outcomes of child...

Last post by mensfe_admin - 2024-02-21 11:22

Salomeh Salari, Seungho Lee, Joshua Mangels, Rebecca Flyckt, Jody Madeira, John Gordon, Jeffrey Keenan, Miryoung Lee, Paul Lin, Guido Pennings ... Show more
Human Reproduction, deae023, https://doi.org/10.1093/humrep/deae023

Published: 19 February 2024 Article history
 
Abstract
STUDY QUESTION
What are parents' perceptions of their relationships with and the psychosocial adjustments of their children who are born via embryo donation?

SUMMARY ANSWER
Families created through embryo donation have well-adjusted parent–child relationships and reassuring child psychosocial outcomes.

WHAT IS KNOWN ALREADY
Embryo donation is an effective and growing form of third-party reproduction, but there is limited research in this field. Prior studies suggest that families created through gamete donation function well regarding parent–child relationship quality and child behavioral and socioemotional adjustment.

STUDY DESIGN, SIZE, DURATION
This is a cross-sectional survey study with 187 total participants.

PARTICIPANTS/MATERIALS, SETTING, METHODS
Parents of children born via embryo donation were recruited nationally by contacting all embryo donation programs registered with the Society for Assisted Reproductive Technology Clinic Outcome Reporting System (SART CORS) as well as medically directed embryo donation or 'embryo adoption' centers. Participants completed three online Qualtrics questionnaires. The first was a survey including 33 questions on demographics, the procurement process, and self-reported obstetric outcomes. Participants also completed two standardized measures assessing children's behavior and parents' adjustment to parenthood: the Strengths and Difficulties Questionnaire (SDQ) and the Parental Acceptance-Rejection Questionnaire (PARQ). Scoring of the SDQ and PARQ was totaled and compared to standardized values (SDQ) or previously published results on other forms of gamete donation (PARQ), such as oocyte donation and sperm donation.

MAIN RESULTS AND THE ROLE OF CHANCE
On the SDQ (n = 46), the average total difficulties scores by age were: 8.2 ± 0.98 for ages 2–4, 7.6 ± 0.93 for ages 5–10, and 3.5 ± 0.77 for ages 11–17; this is compared to the normal reported range of 0–13, which indicates that clinically significant psychosocial problems are unlikely. Across all ages and individual categories (emotional symptoms, conduct problem, hyperactivity, peer problem, prosocial), scores on the SDQ were within the normal ranges. The average PARQ score (n = 70) for all respondents was 27.5 ± 1.18 (range: 24–96), suggesting perceived parental acceptance.

LIMITATIONS, REASONS FOR CAUTION
Because this study was cross-sectional, it could not capture familial relationships over time. This survey-based study design allows for potential selection bias (parents of well-adjusted children may be more likely to participate). Additionally, the overall sample size is relatively small; however, it remains one of the largest published to date. Another significant limitation to this study is the lack of generalizability: most participants were recruited from private, faith-based, embryo donation programs who are demographically similar.

WIDER IMPLICATIONS OF THE FINDINGS
Though embryo donation is an established form of third-party reproduction, it is significantly less robustly studied compared to other forms of gamete donation (oocyte or sperm donation). This study provides a larger data set with a more expanded age range of children compared to the limited number of previously published studies. Furthermore, these findings indicate a high parental disclosure rate with respect to the use of embryo donation which contrasts previous findings.

STUDY FUNDING/COMPETING INTEREST(S)
No external funding source was utilized for the completion of this study. No conflicts are disclosed.

#29

Research / Semen microbiome linked to spe...

Last post by mensfe_admin - 2024-01-23 15:40

by Dr Semyon Bodian

Semen microbiome composition has been associated with sperm abnormalities, in a study of men in the United States.

Scientists from the University of California, Los Angeles (UCLA) were able to correlate the levels of different bacteria in semen with both sperm motility and concentration. Little research has investigated the links between the semen microbiome and resulting sperm abnormalities and, thus, potential effects on male fertility. Meanwhile there has been focus on the vaginal microbiome and its impact on reproductive and neonatal outcomes.

'There is much more to explore regarding the microbiome and its connection to male infertility. However, these findings provide valuable insights that can lead us in the right direction for a deeper understanding of this correlation' said Dr Vadim Osadchiy, study lead author and resident in the Department of Urology at UCLA, California.

Two genera of bacteria whose levels correlated to sperm abnormalities were identified. Semen with higher levels of Lactobacillus iners were linked with abnormally lower levels of sperm motility. Three species from the Pseudomonas genus, P. flourescens, P. stutzeri and P. putida, were linked to sperm concentration. Semen with higher levels of P. fluorescens and P. stutzeri were associated with abnormally lower sperm concentration. However, such concentrations were also associated with lower quantities of P. putida.

A potential link between L. iners and lower sperm motility may result from the bacteria's production of the L-lactic acid isomer, which is associated with increased inflammation of the local environment. The study's authors were keen to underline that these findings do not indicate causation of infertility or sperm abnormalities and are purely observations which could aid in the understanding of the mechanisms of infertility and sperm abnormalities.

The study, published in Scientific Reports, examined the semen from 73 men who were receiving consultation for either fertility treatment or vasectomies, with the latter having proven biological paternity. The subjects' semen was analysed using both a calibrated automated semen analyser and a high-powered microscopy. DNA was extracted from the semen, amplified and then sequenced to study the sperms' ribosomal RNA.

Results were adjusted for age, BMI, circumcision status, smoking, and alcohol intake history, but the study was limited by the limited range of socioeconomic status of the study participants, sourced from the same geographical location. In addition, antibiotic use or treatment for genitourinary infections was not accounted for, as was neither information regarding the participant's sexual behaviour nor the use or mode of contraception. A man's semen microbiome could be affected through different sexual activities and interactions with other bodily microbiomes, such as the urethra.

'Our research aligns with evidence from smaller studies and will pave the way for future, more comprehensive investigations to unravel the complex relationship between the semen microbiome and fertility,' said Dr Osadchiy.

Reviews

#30

General Discussion / Sperm abnormalities - a study ...

Last post by mensfe_admin - 2024-01-23 15:38

Semen microbiome composition has been associated with sperm abnormalities, in a study of men in the United States.

Scientists from the University of California, Los Angeles (UCLA) were able to correlate the levels of different bacteria in semen with both sperm motility and concentration. Little research has investigated the links between the semen microbiome and resulting sperm abnormalities and, thus, potential effects on male fertility. Meanwhile there has been focus on the vaginal microbiome and its impact on reproductive and neonatal outcomes.

'There is much more to explore regarding the microbiome and its connection to male infertility. However, these findings provide valuable insights that can lead us in the right direction for a deeper understanding of this correlation' said Dr Vadim Osadchiy, study lead author and resident in the Department of Urology at UCLA, California.

Two genera of bacteria whose levels correlated to sperm abnormalities were identified. Semen with higher levels of Lactobacillus iners were linked with abnormally lower levels of sperm motility. Three species from the Pseudomonas genus, P. flourescens, P. stutzeri and P. putida, were linked to sperm concentration. Semen with higher levels of P. fluorescens and P. stutzeri were associated with abnormally lower sperm concentration. However, such concentrations were also associated with lower quantities of P. putida.

A potential link between L. iners and lower sperm motility may result from the bacteria's production of the L-lactic acid isomer, which is associated with increased inflammation of the local environment. The study's authors were keen to underline that these findings do not indicate causation of infertility or sperm abnormalities and are purely observations which could aid in the understanding of the mechanisms of infertility and sperm abnormalities.

The study, published in Scientific Reports, examined the semen from 73 men who were receiving consultation for either fertility treatment or vasectomies, with the latter having proven biological paternity. The subjects' semen was analysed using both a calibrated automated semen analyser and a high-powered microscopy. DNA was extracted from the semen, amplified and then sequenced to study the sperms' ribosomal RNA.

Results were adjusted for age, BMI, circumcision status, smoking, and alcohol intake history, but the study was limited by the limited range of socioeconomic status of the study participants, sourced from the same geographical location. In addition, antibiotic use or treatment for genitourinary infections was not accounted for, as was neither information regarding the participant's sexual behaviour nor the use or mode of contraception. A man's semen microbiome could be affected through different sexual activities and interactions with other bodily microbiomes, such as the urethra.

'Our research aligns with evidence from smaller studies and will pave the way for future, more comprehensive investigations to unravel the complex relationship between the semen microbiome and fertility,' said Dr Osadchiy.

Reviews