Microdissection testicular sperm extraction is a procedure used to extract sperm from patients with irreversible non-obstructive azoospermia. Sperm extracted are then used for in vitro fertilization (IVF). While this technique has improved the sperm retrieval rate compared to other biopsy techniques, sperm are still often not retrieved. The purpose of our research was to develop a technique for identifying small foci of sperm for retrieval for use in IVF.
After injecting the seminiferous tubules of fertile mice testes with a mouse antibody specific for the human acrosome, we could identify sperm in the majority of animals using confocal microscopy on excised testes. Performance of the same procedure on sterile mice did not reveal any fluorescent signal.
Though pleased with the results of our research, there are several limiting factors that must be addressed prior to practical clinical use. First, injection of human seminiferous tubules and achieving adequate antibody distribution might prove more difficult as the seminiferous tubules are longer, and it will likely require increased hydrostatic pressure to disperse the antibody. This pressure may prove problematic and lead to rupture of the tubules.
Second, while the antibody did bind to the sperm, it was not as selective as anticipated. There was binding of the antibody to both the head and tail of spermatozoa, not just the acrosome. This could have been due to the fact that a mouse-derived antibody was used in a mouse model, which could possibly be associated with the occurrence of a significant amount of non-specific binding of the sperm. There was also background staining within the tubules, making identification of the sperm more difficult. Also, it is still unknown the extent to which the antibody will prove to be detrimental to the sperm, rendering it unusable for IVF.
Lastly, in our animal model the testes were excised from the mice prior to microscopic analysis since the specimen being observed under the confocal microscope required water submersion. Obviously, a different method of analyzing human testicular tissue in situ is required. Intraoperative performance of the confocal microscopy could address this problem, but providing the necessary equipment for this procedure in the operating room may prove challenging.
Despite the obstacles facing practical use of immunofluorescence in microdissection testicular sperm extraction, we are encouraged by the results of our study. More research is certainly needed to evaluate the feasibility of this technique in humans.
Written by Jason R. Greenhalgh, MD, Thomas S. Griffith, PhD, and Moshe Wald, MD as part of Beyond the Abstract on UroToday.com.
Tuesday, August 11, 2009
Monday, August 10, 2009
Human egg-trafficking business exposed in Romania
Two Israeli doctors and one Romanian are being detained by a special Romanian investigative police unit after raids on a Romanian IVF clinic suspected to be involved in international human egg and stem-cell trafficking. The Romanian department for fighting organized crime (DIICOT) announced in a statement that 'the group was focusing on identifying foreign couples eager to resort to assisted reproduction techniques and on grabbing Romanian (women) aged 18-30 to donate ova for 800 to 1,000 lei' (around £165 to £205).
The Sabyc Clinic in Bucharest, run by Israeli gynaecologist Harry Mironescu, has performed more than 1,200 IVF cycles over the last ten years. However at no point has it been licensed to provide such procedures and DIICOT stated that all were thus carried out illegally. The recipients of the majority of these cycles were Israeli, British and Italian women.
At the time of the raid around thirty people were arrested at the clinic (with the majority of them reported to have been Israelis). Of these, two Israelis – Professor Nathan Levitt and Dr. Genya Ziskind – and three Romanians have been put under house arrest on charges of human egg-trafficking, involvement in a criminal group, and practicing medicine without a permit. The two Israelis have been warned not to attempt to leave the country. The owners of the fertility and cosmetic surgery clinic, father-son pair Harry and Yair Miron, are also being held by the Romanian authorities.
In Israel legislation that would have relaxed rules on egg donation to allow those not undergoing IVF to donate eggs, though not in exchange for payment, has been put on hold. Israel has strict rules on egg donation and though IVF cycles are provided without additional charge as part of the national health benefits (helping Israel have the highest availability of IVF in the world), the eggs used in these procedures must be purchased individually.
Last month a study into cross-border fertility treatment in Europe showed that every year, thousands of women from Britain are travelling abroad to access treatment which is unavailable to them at home. The study, presented at the annual conference of the European Society for Human Reproduction and Embryology (ESHRE), estimated that 20,000 to 25,000 cross-border treatment cycles take place per year.
The Sabyc Clinic in Bucharest, run by Israeli gynaecologist Harry Mironescu, has performed more than 1,200 IVF cycles over the last ten years. However at no point has it been licensed to provide such procedures and DIICOT stated that all were thus carried out illegally. The recipients of the majority of these cycles were Israeli, British and Italian women.
At the time of the raid around thirty people were arrested at the clinic (with the majority of them reported to have been Israelis). Of these, two Israelis – Professor Nathan Levitt and Dr. Genya Ziskind – and three Romanians have been put under house arrest on charges of human egg-trafficking, involvement in a criminal group, and practicing medicine without a permit. The two Israelis have been warned not to attempt to leave the country. The owners of the fertility and cosmetic surgery clinic, father-son pair Harry and Yair Miron, are also being held by the Romanian authorities.
In Israel legislation that would have relaxed rules on egg donation to allow those not undergoing IVF to donate eggs, though not in exchange for payment, has been put on hold. Israel has strict rules on egg donation and though IVF cycles are provided without additional charge as part of the national health benefits (helping Israel have the highest availability of IVF in the world), the eggs used in these procedures must be purchased individually.
Last month a study into cross-border fertility treatment in Europe showed that every year, thousands of women from Britain are travelling abroad to access treatment which is unavailable to them at home. The study, presented at the annual conference of the European Society for Human Reproduction and Embryology (ESHRE), estimated that 20,000 to 25,000 cross-border treatment cycles take place per year.
Sunday, August 9, 2009
Not your child’s biological parent? You may still have an influence on their genes
I am not a scientist. My life-long field of interest has always been human development and relationships. But, as a parent of two donor-conceived young adults and Manager of the Donor Conception Network (DC Network), I also have more than a passing curiosity about the extent of the influence of genetic inheritance on an individual's way of being in the world. Having met adult half-siblings of one of the earliest sperm donors I have been shocked by the likeness of intelligence and speech patterns as well as facial features. Parents of donor-conceived children mostly do not spend a lot of time thinking about what their child might have inherited from their donor. Whilst not attempting to deny the role of genetics, DC Network members prefer to think about how much they can influence their child's life through the love and security they provide and the values that they will pass on. My own training and background convinces me that the provision of a loving and secure environment does have a profound effect, but what if the previously thought of ‘non-genetic' parent could have a genetic influence as well…an epigenetic one?
The term epigenetics first came to my attention about 18 months ago. Browsing a well known infertility web forum I came across a post which told of a branch of science that was proving that recipients of donated eggs could have an influence on how genes were ‘turned on' in the child they were carrying. It referred to an example from the equine world:
‘In horse breeding for example, it's not uncommon to implant a pony embryo into the womb of a horse. The foals that result are different from normal ponies. They're bigger. These animals' genotype – their genes – are the same as a pony's, but their phenotype – what their genes actually look like in the living animal – is different. The implication of epigenetics is that the child inherits characteristics from the woman who carries the child even if the original DNA comes from a donor egg. In other words the birth mother influences what the child is like at a genetic level - it IS her child.'
A flurry of postings followed which immediately latched on to the meaning that the posters desperately wanted it to have. This would not be a child that was not genetically connected to them at all… in fact, perhaps the donor could be air-brushed out of the picture because if genes were altered by the environment of the womb and the mothers were able to contribute to a baby's wellbeing through good diet etc, then maybe the donor didn't need to be acknowledged at all.
Whilst DC Network actively encourages would-be parents, those pregnant or already with donor-conceived children to own their status and authority as true parents, we are also clear that early honesty about beginnings is fundamental to healthy family relationships. Denial of the role of the donor is not helpful to child or parent, but, if epigenetics was able to show that a recipient of donated eggs exerts an influence on the way genes are expressed or silenced, what would this mean? At the very least it could be comforting information for women and their partners who discover that the only way they are likely to be able to have a child is with the help of an egg donor.
Sandy Starr of the Progress Educational Trust wrote to me when I first mentioned the way I had noticed emerging epigenetic information being used, saying that ‘the fallacy most commonly associated with classical genetics has been ‘genetic determinism', where more is ascribed to genes that they can truthfully account for. We may see a new fallacy of ‘epigenetic determinism', where epigenetics is used in the same way – for instance to overstate the influence of the recipient mother and impugn the contribution of the donor. Or conversely, we could see a fallacy of ‘epigenetic relativism' where the complexity of epigenetics is used as a pretext to dismiss all claims of genetic influence, which would allow people to dismiss the genetic contribution of the donor as effectively unknowable and therefore irrelevant'.
The challenge for Progress Educational Trust - and I am delighted that their autumn conference is focusing on this topic - is to come to a settled position about what the term ‘epigenetics' really means, and then to make sure that the implications for each area that this science applies to (cancer, mental health, reproductive medicine etc) are carefully unraveled and explained for non-scientists like me and disseminated in ways and in places that can genuinely inform and guide those for whom it may have great meaning.
If are interested in attending PET's annual conference Does Genetics Matter? Help, Hype and the New Horizon of Epigenetics, taking place in East London on Wednesday 18 November, contact Sandy Starr at sstarr@progress.org.uk or on +44 (0)20 7278 7870.
By Olivia Montuschi
Manager of the Donor Conception Network (DC Network)
The term epigenetics first came to my attention about 18 months ago. Browsing a well known infertility web forum I came across a post which told of a branch of science that was proving that recipients of donated eggs could have an influence on how genes were ‘turned on' in the child they were carrying. It referred to an example from the equine world:
‘In horse breeding for example, it's not uncommon to implant a pony embryo into the womb of a horse. The foals that result are different from normal ponies. They're bigger. These animals' genotype – their genes – are the same as a pony's, but their phenotype – what their genes actually look like in the living animal – is different. The implication of epigenetics is that the child inherits characteristics from the woman who carries the child even if the original DNA comes from a donor egg. In other words the birth mother influences what the child is like at a genetic level - it IS her child.'
A flurry of postings followed which immediately latched on to the meaning that the posters desperately wanted it to have. This would not be a child that was not genetically connected to them at all… in fact, perhaps the donor could be air-brushed out of the picture because if genes were altered by the environment of the womb and the mothers were able to contribute to a baby's wellbeing through good diet etc, then maybe the donor didn't need to be acknowledged at all.
Whilst DC Network actively encourages would-be parents, those pregnant or already with donor-conceived children to own their status and authority as true parents, we are also clear that early honesty about beginnings is fundamental to healthy family relationships. Denial of the role of the donor is not helpful to child or parent, but, if epigenetics was able to show that a recipient of donated eggs exerts an influence on the way genes are expressed or silenced, what would this mean? At the very least it could be comforting information for women and their partners who discover that the only way they are likely to be able to have a child is with the help of an egg donor.
Sandy Starr of the Progress Educational Trust wrote to me when I first mentioned the way I had noticed emerging epigenetic information being used, saying that ‘the fallacy most commonly associated with classical genetics has been ‘genetic determinism', where more is ascribed to genes that they can truthfully account for. We may see a new fallacy of ‘epigenetic determinism', where epigenetics is used in the same way – for instance to overstate the influence of the recipient mother and impugn the contribution of the donor. Or conversely, we could see a fallacy of ‘epigenetic relativism' where the complexity of epigenetics is used as a pretext to dismiss all claims of genetic influence, which would allow people to dismiss the genetic contribution of the donor as effectively unknowable and therefore irrelevant'.
The challenge for Progress Educational Trust - and I am delighted that their autumn conference is focusing on this topic - is to come to a settled position about what the term ‘epigenetics' really means, and then to make sure that the implications for each area that this science applies to (cancer, mental health, reproductive medicine etc) are carefully unraveled and explained for non-scientists like me and disseminated in ways and in places that can genuinely inform and guide those for whom it may have great meaning.
If are interested in attending PET's annual conference Does Genetics Matter? Help, Hype and the New Horizon of Epigenetics, taking place in East London on Wednesday 18 November, contact Sandy Starr at sstarr@progress.org.uk or on +44 (0)20 7278 7870.
By Olivia Montuschi
Manager of the Donor Conception Network (DC Network)
Saturday, August 8, 2009
If you want grandchildren, pay for IVF for your ageing daughters
Would-be grandparents funding IVF treatments? Sounds wonderful. It is in the best tradition of families caring for each of their members and I’m delighted to see that such coherent and selfless families still exist.
There is already plenty of evidence that they do, of course. Grandparents account for a third of all childcare, taking on the burden of noisy toddlers to free up their daughters or daughters-in-law to go to work.
Wealthier grandparents regularly pay for private school fees, perhaps even hoping the offspring will follow in their shoes . . . to Eton, Harrow, St Paul’s. Even at the local comprehensive, grandparents may fund the extras: piano lessons, football coaching and school trips. The time to be generous is while children are young. Why hoard your money until the need has passed, only to hand it over in death duties?
If daughters get to 35 before wanting children, they are more likely to need IVF. And the cost is soaring. By then, of course, would-be grandparents are holding their breath with hope and apprehension. The yearning to be a grandparent can be powerful, news of friends and relatives becoming grannies and grandads hard to bear.
But there is a caveat: IVF is stressful and often disappointing. Would-be grandparents must face the prospect of their money being lost. More importantly, their own end-of-life care is likely to be more costly than they imagine. Living longer will mean providing for more years without earnings: middle-aged people aren’t saving enough to provide for themselves, let alone their offspring.
As a consequence it’s only the really well-off who can afford to pay for their children’s IVF. And longing for a child pays no regard to money.
I feel sorry for those without the means.
Joan Bakewell , Times Online, UK
There is already plenty of evidence that they do, of course. Grandparents account for a third of all childcare, taking on the burden of noisy toddlers to free up their daughters or daughters-in-law to go to work.
Wealthier grandparents regularly pay for private school fees, perhaps even hoping the offspring will follow in their shoes . . . to Eton, Harrow, St Paul’s. Even at the local comprehensive, grandparents may fund the extras: piano lessons, football coaching and school trips. The time to be generous is while children are young. Why hoard your money until the need has passed, only to hand it over in death duties?
If daughters get to 35 before wanting children, they are more likely to need IVF. And the cost is soaring. By then, of course, would-be grandparents are holding their breath with hope and apprehension. The yearning to be a grandparent can be powerful, news of friends and relatives becoming grannies and grandads hard to bear.
But there is a caveat: IVF is stressful and often disappointing. Would-be grandparents must face the prospect of their money being lost. More importantly, their own end-of-life care is likely to be more costly than they imagine. Living longer will mean providing for more years without earnings: middle-aged people aren’t saving enough to provide for themselves, let alone their offspring.
As a consequence it’s only the really well-off who can afford to pay for their children’s IVF. And longing for a child pays no regard to money.
I feel sorry for those without the means.
Joan Bakewell , Times Online, UK
Friday, August 7, 2009
What You Sell?
Two Australian businessmen in Brisbane were sitting down for a break in their new store. As yet, the store wasn't ready, with no stock and only a few shelves set up.
One said to the other, 'I bet any minute now some idiot tourist is going to walk by, put his face to the window, and ask what we're selling'.
No sooner were the words out of his mouth when, sure enough, a curious Japanese tourist walked to the window, had a peek, and in a thick Japanese accent asked
'What you sell?'
One of the men replied sarcastically, 'We're selling arse-holes.'
Without skipping a beat, the Japanese man said,
'You doing velly well, only two left'.
One said to the other, 'I bet any minute now some idiot tourist is going to walk by, put his face to the window, and ask what we're selling'.
No sooner were the words out of his mouth when, sure enough, a curious Japanese tourist walked to the window, had a peek, and in a thick Japanese accent asked
'What you sell?'
One of the men replied sarcastically, 'We're selling arse-holes.'
Without skipping a beat, the Japanese man said,
'You doing velly well, only two left'.
Thursday, August 6, 2009
Mallu Joke
A beautiful "Mallu" female (from the heart of Kerala) went for a job interview for the post of a SECRETARY and also said she is good at English. When the manager saw the Mallu's colorful attire, gold, well oiled uncombed jet black hair, his mind was screaming "NOT THIS WOMAN".
Nevertheless, he still had to entertain the Mallu. So he told her "If you could form a sentence using the words that I give you, then maybe I will give you a chance! The words are GREEN, PINK, YELLOW, BLUE, WHITE, PURPLE and BLACK".
The enthusiastic Mallu lady thought for a while and said :
"I hear the phone GREEN GREEN GREEN, then I go and PINK up the phone, I say YELLOW....BLUE'S that? WHITE did you say? Aiye, wrong number....Don't PURPLELY disturb people and don't call BLACK, ok? Thank You."
The Manager fainted.....
Nevertheless, he still had to entertain the Mallu. So he told her "If you could form a sentence using the words that I give you, then maybe I will give you a chance! The words are GREEN, PINK, YELLOW, BLUE, WHITE, PURPLE and BLACK".
The enthusiastic Mallu lady thought for a while and said :
"I hear the phone GREEN GREEN GREEN, then I go and PINK up the phone, I say YELLOW....BLUE'S that? WHITE did you say? Aiye, wrong number....Don't PURPLELY disturb people and don't call BLACK, ok? Thank You."
The Manager fainted.....
Wednesday, August 5, 2009
Panda cub born using frozen sperm IVF
You You, a panda at the Wolong Giant Panda Research Centre in southwestern Sichuan province, gave birth after IVF treatment in what is believed to be the first successful pregnancy among the species using the frozen sperm technique.
"We did try before but it failed," said Huang Yan, a deputy research technician with the China Panda Preservation Research Centre.
The technique has been tried in other countries but this was the first known instance of a live birth, he said.
The sperm from a male panda, Lolo, had been frozen for "a number of years", said Mr Huang.
Artificial insemination is commonly used for breeding pandas, which have a very low sex drive. In 2006, 34 pandas were born through artificial insemination in China and 30 survived - both record numbers for the endangered species. The technique has also been used at zoos in the United States.
However, using panda sperm that has been frozen earlier - instead of from an immediate donor - had not been successful before.
The technique, if it can be replicated, will be a positive boost for panda conservation efforts. Only about 1,600 pandas live in the wild.
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