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I3 Revisited: The Curious Case of Lactate, a Blastocyst and an Endometrium

Professor David Gardner 19 July 2023

Lactate is typically considered a “waste-product” of glucose metabolism, produced through glycolysis, when there is insufficient oxygen available.

But why does the blastocyst produce significant quantities of lactate even when there is an abundance of oxygen?

The answer to this question will make you rethink completely the significance of metabolic functions, and you will discover that this quirky metabolic trait is a prerequisite for a tissue that needs to invade, establish a blood supply and avoid immuno rejection. Spoiler alert – cancers use the same trick as our beautiful blastocysts to invade surrounding tissues!

PROFESSOR DAVID K. GARDNER, FAA

PROFESSOR DAVID K. GARDNER, FAA

David is the Scientific Director of Melbourne IVF and a Distinguished Professor in the School of BioSciences, University of Melbourne. 

He completed his PhD (1987) at the University of York. In 1988 he moved to Harvard Medical School, after which he moved to Monash, Australia, in 1989. In 1997 became the Scientific Director of the Colorado Centre for Reproductive Medicine in Denver, where his work on human embryo culture conditions revolutionised how human IVF is performed today with the introduction of blastocyst transfer. 

In 2007 he was appointed Professor at the University of Melbourne and promoted to the level of Distinguished Professor in 2018. He has published over 285 papers and chapters and has edited 15 books, and is one of the mostly highly cited scientists in Reproductive Medicine, with over 25,000 citations and an H Factor of 91. 

In 2017 in recognition of his many significant contributions to reproductive sciences he was elected as a Fellow into the Australian Academy of Science (FAA) and further was the recipient of the Distinguished Researcher Award from the American Society of Reproductive Medicine.


This video is one of many educational resources produced by the International IVF Initiative (I3). As a worldwide movement, I3 focuses on improving education and refining methods in assisted reproductive technologies. To explore a wider range of educational content, we invite you to visit https://ivfmeeting.com.


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News: New Findings Link Higher Live Birth Rates in IVF to Summer Egg Collection

IVF.net Newsdesk 19 July 2023

The time of year when eggs are collected from women’s ovaries during fertility treatment influences live birth rates, according to recent research published in Human Reproduction, one of the world’s leading reproductive medicine journals.

The Australia-based research team found that transferring embryos, initially frozen then thawed, which were retrieved from eggs collected in the summer, resulted in a 30% higher likelihood of live births than those collected in the autumn.

Dr Sebastian Leathersich, who led the study, stated, "If eggs were collected in autumn, the live birth rate was 26 births per 100 people, but if collected in summer there were 31 births per 100 people. This improvement was seen regardless of when the embryos were finally transferred to the women’s wombs."

The study also observed a 28% increase in the chances of a live birth among women who had eggs collected on days with the most sunshine compared to those with the least sunshine.

New Insights into Seasonal Variations

Previous studies have presented conflicting findings about the influence of seasons on pregnancies and live birth rates after egg collection and embryo freezing. Dr Leathersich elaborated, "Most studies have looked at fresh embryo transfers, where the embryo is returned within a week of the egg being collected. We realised that many embryos are now 'frozen' and transferred later, allowing us to explore the impact of environment on egg development and early pregnancy separately."

The study analysed outcomes from all frozen embryo transfers carried out at a single clinic in Perth over a period of eight years. The researchers took into account factors such as the season, temperature, and actual number of hours of bright sunshine.

The results showed that the likelihood of a live birth was higher when the egg was collected on a day with more sunshine, irrespective of the season and conditions during the embryo transfer.

However, the study found that temperature on the day of egg collection did not influence live birth chances. Interestingly, live birth rates decreased by 18% when embryos were transferred on the hottest days, accompanied by a small rise in miscarriage rates.

Implications of the Findings

"Our study suggests that the best conditions for live births appear to be associated with summer and increased sunshine hours on the day of egg retrieval," said Dr Leathersich.

Factors that may contribute to increased live birth rates after summer egg collection and during more sunshine hours include melatonin, as its levels are typically higher in winter and spring. Lifestyle differences between winter and summer months may also play a part.

Moreover, the study findings that miscarriage rates were highest when embryo transfer occurred on the hottest days echo epidemiological studies showing higher rates of miscarriage during summer months.

Despite these promising findings, the study's retrospective nature means it can only demonstrate an association between conditions at the time of egg collection and the difference in live birth rates, rather than causation.

Looking forward, Dr Leathersich believes the findings should be confirmed through replication in different settings, with varying conditions and treatment protocols. He also expressed an interest in analysing the impact of seasonal and environmental factors on sperm parameters.

Given the surge in "social egg freezing" for fertility preservation, Dr Leathersich stated, "It would be very interesting to see if these observations hold true with frozen eggs that are thawed and fertilised years later."

While this study offers significant implications for fertility treatments, it also highlights the intricate balance between environmental factors and biological processes, and the ever-evolving understanding of reproductive medicine.

Sources & References

ESHRE - More IVF babies born after egg collection in summer rather than in autumn


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Announcement: REPRODUCTIVE MEDICINE FELLOWSHIP

Dr Yogitha Rao 12 July 2023
REPRODUCTIVE MEDICINE FELLOWSHIP

Duration of the course; 18 months

Number of seats; 2 seats every 6 months

Eligibility criteria;

  • Has to be a Citizen of India,
  • MBBS Degree from a University recognised by the MCI
  • M.D. / M.S. (or its equivalent recognised degree) in Obstetrics & Gynecology from a University recognised by the MCI
  • or DGO with 3 years experience.
  • Courses start in January and July of every year.
  • Selection by:
    Written Exam followed by Interviews in June & December
    Contact:
    SANTASA IVF & ENDOSURGERY INSTITUTE
    HASSAN-573201
    call on : 9845688608 / 8904253475
  • Mail: training@santasaivf.com 
    visit : www.santasaivf.com

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News: ART & Embryology training program

Chennai Fertility Center and Research Institute 04 July 2023
ART & Embryology training program

 

August 2023 Training Batch Schedule - 07th August - 21st August 2023.

The International School of Embryology was established to offer training for clinicians in advanced reproductive technologies. Our skill and precision to all aspirants help them to know in-depth knowledge and experience. The members of our teaching faculty aim to bring doctors and embryologists to the highest level of knowledge about reproductive techniques and practical capability in the field.

Our courses cover basics in Andrology, embryology, ICSI, and cryosciences (Hands-on).

Limited Seats. For admission Contact  9003111598 / 8428278218 (Whats app) 


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News: New Study Finds One in Five Women Can Conceive Naturally After IVF

IVF.net Newsdesk 26 June 2023

In a study published in Human Reproduction, scientists have unveiled data challenging the traditional view on natural conception in women who have previously given birth via assisted reproductive technology (ART), such as in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI).

Led by Dr. Annette Thwaites, the study systematically reviewed and analyzed data from various sources to assess the proportion of women experiencing natural conception after an ART-aided live birth. The research suggests that natural conception may occur in at least one in five women after having a baby via ART, a number significantly higher than widely anticipated.

This study is groundbreaking as it disputes the common narrative that such natural pregnancies are “miracle” pregnancies, and instead, emphasizes that they are not as rare as previously thought.

The researchers conducted a systematic review with meta-analysis, scrutinizing studies published from 1980 to September 24, 2021. The team searched Ovid Medline, Embase, and PsycINFO databases for studies in English, involving human subjects. The main criterion for inclusion was studies that measured the proportion of women experiencing natural conception following an ART live birth.

The team assessed the quality of the included studies using the Critical Appraisal Skills Programme cohort study checklist or the AXIS Appraisal tool for cross-sectional studies. Random-effects meta-analyses were utilized to estimate the pooled effect of the proportion of natural conception pregnancies after ART live births.

Out of 1108 distinct studies initially identified, 11 studies involving 5180 women were selected for the review. The maximum follow-up period in these studies ranged from 2 to 15 years. The pooled estimate for the proportion of women experiencing natural conception pregnancies after ART live birth stood at 20% (95% CI, 17-22%).

The study acknowledges several limitations, including variability in methodology, population, subfertility cause, type and outcome of fertility treatment, and follow-up duration among the studies considered. These variations might lead to potential biases related to confounding, selection bias, and missing data.

The study’s findings have wide-reaching implications, primarily in dispelling misconceptions surrounding natural conception post-ART. This knowledge is vital for healthcare professionals and couples who have undergone or are considering ART.

Recognizing the frequency of natural conception following ART, it becomes crucial to provide tailored counseling to couples contemplating further ART procedures.

Dr. Thwaites and her team advocate for national, data-linked studies to ascertain more accurate estimates and analyze factors associated with natural conception after ART. Such data would empower women and couples to make informed choices regarding family planning and further fertility treatments.

This research, supported by the National Institute for Health Research (NIHR) as part of an academic clinical fellowship awarded to Dr. Thwaites, is poised to transform perceptions and practices in the realm of reproductive science.

Sources and References

Human Reproduction - How common is natural conception in women who have had a livebirth via assisted reproductive technology? Systematic review and meta-analysis

BBC News - One in five chance of natural pregnancy after IVF baby

UCL News - One in five women become pregnant naturally after having a baby conceived with IVF

 


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News: WORLDWIDE SURVEY OF CLINICAL EMBRYOLOGY

Lifeinvitro Academy 24 June 2023
WORLDWIDE SURVEY OF CLINICAL EMBRYOLOGY

World Embryologist' Day is fast approaching..Thank you everyone who have already taken the global embryologists survey..This survey will be closed in few weeks. We still haven't received enough responses from some geographical regions like UK, Eastern European countries, Russia, East Asia, Middle East and North Africa..Please share the following link with your colleagues: 

You are invited to support a unique opportunity for clinical embryologists/IVF laboratory professionals. A collaboration between the Reproductive Biology Laboratory (Department of Obstretrics & Gynaecology at the university of Pretoria-south-Africe), Life In Vitro Academy (UK), and the Middle East Fertility Society Embryology Specialty Interest Group seeks to take the pulse of the world’s embryologists’ workforce.

Any professional working in a fertility laboratory is kindly requested to participate.

You are invited to share your opinions and perceptions about clinical embryology by taking the following survey. Through your participation, this survey will provide a portrait of embryologists’ morale levels, practice patterns and perspectives across the globe. The questionnaire can be accessed using the link below.


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News: Creation of Synthetic Human Embryos using Stem Cells

IVF.net Newsdesk 19 June 2023

A remarkable scientific breakthrough has been achieved as researchers successfully produced synthetic human embryos using stem cells. This milestone allows scientists to bypass the conventional requirement for eggs or sperm, potentially paving the way for significant medical advances.

These lab-cultivated embryo models closely mirror those in the earliest stages of human development. Consequently, they offer scientists an invaluable opportunity to delve deeper into the impact of genetic disorders and better understand the biological triggers of recurrent miscarriage.

Yet, this scientific accomplishment isn't without its complications. It raises several ethical and legal questions because these laboratory-engineered entities exist outside the bounds of current legislation in the United Kingdom and most other countries worldwide.

Unlike natural embryos, these lab-grown structures don't possess a beating heart or preliminary brain development. Nevertheless, they contain cells that usually form essential elements of the embryo, such as the placenta and yolk sac.

While the creation of these human embryo-like models marks a significant scientific stride, their practical, clinical use is currently out of reach. Legal restrictions forbid their implantation into a patient's womb, and their potential to mature beyond the initial developmental stages is yet to be confirmed.

The main impetus behind this research is to illuminate the mysterious "black box" period of development. Scientists, due to legal constraints, can only cultivate embryos in labs for up to 14 days, hence this period's name. Subsequent developmental tracking occurs much later, relying on pregnancy scans and research-donated embryos.

This new approach provides an unprecedented opportunity to gain in-depth knowledge about embryonic development and potential complications, all without the necessity of using early-stage embryos for research.

This breakthrough follows previous successes from teams that demonstrated mouse stem cells' ability to self-assemble into early embryo-like structures. This catalyzed efforts to apply these findings to human models, with several teams now having replicated the earliest stages of development successfully.

These novel findings are yet to be published in detail in a peer-reviewed journal. However, it has been reported that the embryos were cultivated to a stage slightly beyond what corresponds to 14 days of development in a natural embryo.

These lab-grown structures, each originating from a single embryonic stem cell, achieved the developmental milestone known as gastrulation. This process sees the embryo transition from a continuous cell sheet into distinct cell lines, setting the basic body's axes. While these models lack a heart, gut, or preliminary brain, they exhibit the presence of primordial cells - the precursors to egg and sperm cells.

This scientific advancement has accentuated the ever-widening gap between the pace of scientific progress and the development of associated legal frameworks. Current legislation fails to acknowledge that these models, due to their close resemblance to normal embryos, should potentially be subject to similar regulation. This discrepancy is causing growing concern among researchers and society at large.

Adding to the complex legal and ethical landscape is the unanswered question of whether these synthetic structures could, theoretically, develop into a living organism. Previous attempts to implant synthetic embryos, derived from mouse and monkey cells, into the wombs of female animals, have not resulted in the birth of live offspring. At this point, it remains unclear whether this hurdle is merely technical or indicative of a more profound biological issue.

The future of this innovative field is uncertain, but the demand for more comprehensive legislation is evident. The question of whether these synthetic embryos could potentially become living beings underscores the urgency of this issue. As this groundbreaking work continues, both the ethical discourse and regulatory landscape must evolve in parallel with scientific advancements.

 

Sources and References

The Guardian - Synthetic human embryos created in groundbreaking advance


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Webinar: Session 120: Crossover

International IVF Initiative 17 June 2023
Session 120: Crossover

Tuesday, 20th June (3 pm EDT / 8 pm UK / 9 pm CET)

This webinar is kindly sponsored by IVF2.0 Ltd.

 

VIEW HERE

 

Moderator:

Dr. Stephanie Kuku, Dr. Andrew Drakeley, Matt Pettit

Presenters:

Dr. Denny Sakkas "Modernizing embryo handling and culture"

Dr. Christine Allen "Vitrification-automation"

Dr. Santiago Munne “Robotic ICSI”

Karol Kujawa “The minority report in the
IVF lab”

Q and A


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I3 Revisited: The Embryo in Culture: Imprinting, Oxidative Stress and Epigenetic Homeostasis

International IVF Initiative 09 June 2023

A wonderful lecture given by Dr. Kay Elder presenting the work of Professor Yves Ménézo.

DR. KAY ELDER

Following an academic career that included degrees in biochemistry (BSc, University of St Andrews), molecular biology (PhD, University of Colorado Medical School) and medicine (MBBChir, Cambridge), Kay Elder joined the Bourn Hall team as Clinical Assistant to Patrick Steptoe in 1984, directing the Out-Patient Department from 1985-1987 before joining the IVF lab as Senior Embryologist. Prior to medical studies in Cambridge, she was a research scientist at Imperial Cancer Research Fund in London. In 1989 she initiated and directed a program of Continuing Education for IVF doctors, scientists and nurses for the next 16 years, during which time she helped to set up and run two Master’s degree programs in Clinical Embryology. Kay was appointed Deputy Editor to Bob Edwards for the journal RBMonline from 2005. She has published 8 textbooks for IVF students and continues to mentor and tutor postgraduate students. 
In her current role as Senior Research Scientist at Bourn Hall, she co-ordinates research collaborations with academic research establishments and provides information and counselling for patients who wish to donate gametes or embryos to research.


This video is one of many educational resources produced by the International IVF Initiative (I3). As a worldwide movement, I3 focuses on improving education and refining methods in assisted reproductive technologies. To explore a wider range of educational content, we invite you to visit https://ivfmeeting.com.


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News: ART & Embryology training program

Chennai Fertility Center and Research Institute 03 June 2023
ART & Embryology training program

July 2023 Training Batch Schedule - 03rd July - 17th July 2023.

The International School of Embryology was established to offer training for clinicians in advanced reproductive technologies. Our skill and precision to all aspirants help them to know in-depth knowledge and experience. The members of our teaching faculty aim to bring doctors and embryologists to the highest level of knowledge about reproductive techniques and practical capability in the field.

Our courses cover basics in Andrology, embryology, ICSI, and cryosciences (Hands-on).

Limited Seats. For admission Contact  9003111598 / 8428278218 (Whats app)


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