How should we assess the safety of IVF technologies?

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Presentation transcript:

How should we assess the safety of IVF technologies? Daniel R. Brison, Stephen A. Roberts, Susan J. Kimber Reproductive BioMedicine Online Volume 27, Issue 6, Pages 710-721 (December 2013) DOI: 10.1016/j.rbmo.2013.09.006 Copyright © 2013 Reproductive Healthcare Ltd. Terms and Conditions

Figure 1 The hospital building and operating theatre in which Louise Brown was born on 25 July 1978 is still standing and was operational as of late 2012. Lower right hand photograph courtesy of Dr Zul Anjum. Reproductive BioMedicine Online 2013 27, 710-721DOI: (10.1016/j.rbmo.2013.09.006) Copyright © 2013 Reproductive Healthcare Ltd. Terms and Conditions

Figure 2 Human Fertilisation and Embryology Authority (HFEA) Chair’s letter CH(11)06, September 2011, containing guidance on the requirements for assessing novel technologies in assisted reproduction. Note that clinics who wish to use a novel process are obliged to provide evidence that it is safe and effective. Reproductive BioMedicine Online 2013 27, 710-721DOI: (10.1016/j.rbmo.2013.09.006) Copyright © 2013 Reproductive Healthcare Ltd. Terms and Conditions

Figure 3 The pathway for assessing new technologies in assisted reproduction, from preclinical research on animal and human gametes and embryos through to assessment of clinical and cost-effectiveness. Modified from Harper et al. (2012). Reproductive BioMedicine Online 2013 27, 710-721DOI: (10.1016/j.rbmo.2013.09.006) Copyright © 2013 Reproductive Healthcare Ltd. Terms and Conditions

Figure 4 Embryos and omics: the different levels of omics technologies which can be used for the assessment of single human embryos, with closeness to phenotype increasing from left to right. CGH=comparative genomic hybridization; HPLC=high-performance liquid chromatography; IR=infrared; MS=mass spectrometry; MW=molecular weight; NMR=nuclear magnetic resonance; RT=reverse transcription; SNP=single-nucleotide polymorphism. OMICs technologies are part of a Systems biology approach to understanding the function of the entire cell (embryo), rather than the traditional reductionist approach of considering only aspects of function. Reproductive BioMedicine Online 2013 27, 710-721DOI: (10.1016/j.rbmo.2013.09.006) Copyright © 2013 Reproductive Healthcare Ltd. Terms and Conditions

Figure 5 Immunofluorescence assessment of pluripotency markers Oct4 (A–D) and Sox2 (E–H) in blastocysts derived from oocytes following chemical activation (C, D, G, H; Sneddon et al., 2011) compared with conventional IVF (A, B, E, F). Green indicates proteins; blue indicates nuclei (DAPI). Bar=100μm. Reproductive BioMedicine Online 2013 27, 710-721DOI: (10.1016/j.rbmo.2013.09.006) Copyright © 2013 Reproductive Healthcare Ltd. Terms and Conditions

Figure 6 Principle component analysis of transcript levels in individual oocytes (purple), 4-cell embryos (orange) and blastocysts (green). A and B present the same 3D plot rotated on the horizontal plane. Courtesy of Dr Helen Smith. Reproductive BioMedicine Online 2013 27, 710-721DOI: (10.1016/j.rbmo.2013.09.006) Copyright © 2013 Reproductive Healthcare Ltd. Terms and Conditions