MedicalResearch.com Interview with:
Stephen A. Krawetz, Ph.D.
Associate Director C.S. Mott Center for Human Growth and Development,
Charlotte B. Failing Professor of Fetal Therapy and Diagnosis,
Department of Obstetrics and Gynecology,
Center for Molecular Medicine and Genetics,
Wayne State University School of Medicine,
Detroit, MI, 48201
Medical Research: What is the background for this study? What are the main findings?
Dr. Krawetz: The current study developed over approximately the past 20 years of work in my laboratory. In the mid 1990s, along with David Miller, we independently discovered that sperm contain RNA. This was followed by our joint publication in The Lancet that began to describe the RNAs in normal fertile males along with our paper in Nature that showed that RNA was delivered to the oocyte at fertilization. Following these studies we assessed the ability of RNAs to be used as markers of morphologically abnormal sperm (teratozoospermia). My laboratory then had the opportunity to explore the complexity of the population of sperm RNAs using
Next Generation Sequencing. We recently began the translation of this work from the bench to bedside which takes us to the current paper in Science Translational Medicine that was a multi-institutional collaborative effort. Members of the team include Dr. Meritxell Jodar, Edward Sendler, Robert Goodrich, from my laboratory, along with Dr. Clifford L. Librach, Dr. Sergey I. Moskovtsev, and Sonja Swanson - CReATe Fertility Center, University of Toronto; Dr. Russ Hauser -Harvard University and Dr. Michael P. Diamond, Georgia Regents University. Here we tackled the issue of idiopathic infertility, that is, unknown infertility, since the couple appears normal in all respects. We specifically framed our study as the contribution of the male and female as a couple towards the birth of a healthy child focusing on male idiopathic infertility within the setting of a Reproductive Clinic. Representative publications from my laboratory that outline this part of my research program appear below.
1) Jodar, M., Sendler, E., Moskovtsev, S. Librach, C., Goodrich, R., Swanson, S., Hauser, R., Diamond, M. and Krawetz, S.A. (2015) Absence of sperm RNA elements correlates with idiopathic male infertility. Science Translational Medicine, 7(295):295re6.
2) Sendler, E., Johnson, G.D., Mao, S., Goodrich, R.J., Diamond, M.P., Hauser, R., and Krawetz, S.A. (2013) Stability, Delivery and Functions of Human Sperm RNAs at Fertilization. Nucleic Acids Research 41:4104-4117. PMID: 23471003
3) Platts, A.E., Dix, D. J., Chemes, H.E., Thompson, K.E., Goodrich, R., Rockett, J. C., Rawe, V.Y., Quintana, S., Diamond, M.P., Strader, L.F. and Krawetz, S.A. (2007) Success and failure in human spermatogenesis as revealed by teratozoospermic RNAs. Human Molecular Genetics. 16:763-773. PMID: 17327269
4) Ostermeier, G.C., Miller, D., Huntriss, J.D., Diamond, M.P. and Krawetz, S.A. (2004) Delivering spermatozoan RNA to the oocyte. Nature 429:154. PMID: 15141202
5) Ostermeier, G.C., Dix, D.J., Miller, D., Khatri, P. and Krawetz, S.A. (2002) Spermatozoal RNA profiles of normal fertile men. The Lancet. 360:773-777. PMID: 12241836
Dr. David McLernon[/caption]
David McLernon PhD MPhil BSc
Research Fellow in Medical Statistics
Medical Statistics Team
Institute of Applied Health Sciences
University of Aberdeen
Foresterhill Aberdeen
MedicalResearch.com: What is the background for this study?
Response: Normally when a couple attend a fertility clinic to begin IVF treatment they are only informed about their chances of having a baby for the first attempt of IVF. In actual fact the first treatment is often unsuccessful and many couples will go on to have several complete cycles of the treatment– each involving the transfer of one or two fresh embryos potentially followed by one or more frozen embryo transfers. We felt that a prediction model that could calculate the chances of having a baby over the complete package of treatment would provide better information for couples.
Ghenet Besera[/caption]
MedicalResearch.com Interview with:
Ghenet Besera, MPH
National Center for Chronic Disease Prevention and Health Promotion
CDC
MedicalResearch.com: What is the background for this study?
Response: The Title X program, established in 1970, offers confidential family planning and related preventive services to both men and women. While most clients are women, Title X also promotes use of services by men through delivery of male-focused services. Men’s family planning needs include services not only related to contraception, but also related to preconception care, infertility, and STD/ HIV services, which affect their reproductive health and overall health.
Dr. E. Scott Sills[/caption]
Dr. Scott Sills MD, PhD
Medical Director at the Center for Advanced Genetics
an IVF program based in Carlsbad, California
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Sills: Often regarded as a miracle procedure by many infertile couples, in vitro fertilization (IVF) can be financially difficult for those without insurance coverage for the treatment. This prohibitive cost leads many would-be parents who pursue IVF to transfer multiple embryos at once, to increase their chances of getting a baby and minimize the need for additional attempts.
This new study now reports that the economic impact of IVF deserves a closer look. As corresponding author E. Scott Sills, MD PhD noted, rates of cesarean-section deliveries, premature births, and low birth weight of babies are all greater with two or more embryos transferred to the mother at once, compared to a lower risk, single-embryo pregnancy.
The data derived from a comprehensive analysis of all IVF cases in Vermont (UVM) and was recently published in the journal Applied Health Economics & Health Policy. It is believed to be the first effort to calculate the difference in infant hospital costs based on the number of embryos transferred. Sills and his team had access to UVM Medical Center records of patients who conceived through IVF and delivered at least 20 weeks into their pregnancies between 2007 and 2011.
Dr. Oktay[/caption]
MedicalResearch.com Interview with:
Kutluk Oktay, MD, PhD.
Professor of Obstetrics & Gynecology, Medicine, and Cell Biology & Anatomy
Director, Division of Reproductive Medicine & Institute for Fertility Preservation
Innovation Institute for Fertility and In Vitro Fertilization
New York Medical College, Valhalla, NY
Medical Research: What is the background for this study? What are the main findings?
Dr. Oktay: Cancer treatments cause infertility and early menopause in a growing number of young women around the world and US. One of the strategies to preserve fertility, which was developed by our team, is to cryopreserve ovarian tissue before chemotherapy and later transplant it back to the patient when they are cured of the cancer and ready to have children. However, success of ovarian transplantation has been limited due to limitation in blood flow to grafts. In this study we described a new approach which seems to improve graft function. The utility of an extracellular tissue matrix and robotic surgery seems to enhance graft function. With this approach both patients conceived with frozen embryos to spare and one has already delivered.
