Tag: ovaries

Bioethics News

What I Learned From Home DNA Testing

July 25, 2017

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There may come a time in everyone’s life when they find themselves sitting at the kitchen table on an otherwise unexceptional weekday morning, drooling saliva into a test tube in the spirit of scientific inquiry.

The spit is for one of the home genetic-testing kits I’m sampling. A growing number of these kits (brands such as 23andMe, DNAFit, Thriva, MyHeritage DNA, and Orig3n) promise to unlock the mystery of your genomes, variously explaining everything from ancestry, residual Neanderthal variants, “bioinformatics” for fitness, weight loss and skincare, to more random genetic predispositions, denoting, say, the dimensions of your earlobes or the consistency of your earwax.

More controversially, some of these kits profess to tell you your biological (as opposed to actual age) by measuring the length of your telomeres (in basic terms, the caps at the end of each strand of DNA that protect chromosomes, like plastic tips at the end of shoelaces). Other tests, such as 23andMe, predict higher risks of developing serious conditions, such as multiple sclerosis, Alzheimer’s and Parkinson’s, including the test for BRCA1/BRCA2 (breast and ovarian cancer) that Angelina Jolie famously underwent, going on to have a preventative double mastectomy and surgery to remove her ovaries.

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The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

The Ethics of In Vitro Gametogenesis

Françoise Baylis comments on the ethics of using gametes derived from human induced pluripotent stem cells for future human reproduction.

__________________________________________

A recent New York Times article, provocatively titled “Babies from Skin Cells? Prospect is Unsettling to Some Experts,” has once again drawn attention to controversial research by scientists at Kyushu University in Japan who succeeded in making fertile mouse pups using eggs created through in vitro gametogenesis (IVG). This is a reproductive technology that involves creating functional gametes (sperm and eggs) from induced pluripotent stem cells. Induced pluripotent stem cells are cells derived from adult body cells (such as skin cells) that have the ability to become other body cells including reproductive cells (sperm and eggs).

Supporters of this reproductive technology eagerly anticipate similar research in humans. Indeed, enthusiasts are quick to trumpet the potential benefits of in vitro gametogenesis. These benefits fall into three general categories.

First, we are told that research to derive human gametes from induced pluripotent stem cells is important for basic science. It will advance our understanding of gamete formation, human development, and genetic disease. In turn, this increased understanding will create new options for regenerative medicine.

Second, we are told that this research will allow clinicians to improve fertility services. For example, with in vitro fertilization (IVF), women typically have to undergo hormonal stimulation and egg retrieval. This can be onerous in terms of the time required for interviews, counseling, and medical procedures. It can also be harmful. Potential psychological harms include significant stress and its sequelae.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Dueling BRCA Databases: What About the Patient?

The news release Monday morning grabbed my attention:

“Study finds wide gap in quality of BRCA1/2 variant
classification between Myriad Genetics and a common public database.”

Myriad Genetics had been exclusively providing tests, for
$3000+ a pop for full BRCA gene sequencing, for 17 years before the Supreme
Court invalidated key gene patents back in 2013. Since the ruling a dozen or so
competitors have been offering tests for much lower prices. Meanwhile, Myriad
has amassed a far deeper database than anyone else, having been in the business
so much longer. And it’s proprietary.

CLASSIFYING GENE VARIANTS

(NHGRI)

Public databases of variants of health-related genes have
been around for years too. The best known, ClinVar, collects and curates data
from the biomedical literature, expert panels, reports at meetings, testing
laboratories, and individual researchers, without access to Myriad’s database.
ClinVar uses several standard technical criteria to classify variants as
“pathogenic,” “benign,” or “of uncertain significance.” (“Likely pathogenic”
and “likely benign” were used more in the past.)

ClinVar lists 5400 variants just for BRCA1. The criteria
come from population statistics, how a particular mutation alters the encoded
protein, effects on the phenotype (symptoms), and other information.
Bioinformatics meets biochemistry to predict susceptibility. The BRCA1 protein
acts as a hub of sorts where many other proteins that control DNA repair
gather. DNA Science discussed the genes behind breast and ovarian cancers here.

As gene sequences accumulate in the databases and troops of
geneticists and genetic counselors annotate them, the proportion of pathogenic
and benign entries will increase as that of the unsettling “variants of
uncertain significance” — VUS — will decrease.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Dueling BRCA Databases: What About the Patient?

The news release Monday morning grabbed my attention:

“Study finds wide gap in quality of BRCA1/2 variant
classification between Myriad Genetics and a common public database.”

Myriad Genetics had been exclusively providing tests, for
$3000+ a pop for full BRCA gene sequencing, for 17 years before the Supreme
Court invalidated key gene patents back in 2013. Since the ruling a dozen or so
competitors have been offering tests for much lower prices. Meanwhile, Myriad
has amassed a far deeper database than anyone else, having been in the business
so much longer. And it’s proprietary.

CLASSIFYING GENE VARIANTS

(NHGRI)

Public databases of variants of health-related genes have
been around for years too. The best known, ClinVar, collects and curates data
from the biomedical literature, expert panels, reports at meetings, testing
laboratories, and individual researchers, without access to Myriad’s database.
ClinVar uses several standard technical criteria to classify variants as
“pathogenic,” “benign,” or “of uncertain significance.” (“Likely pathogenic”
and “likely benign” were used more in the past.)

ClinVar lists 5400 variants just for BRCA1. The criteria
come from population statistics, how a particular mutation alters the encoded
protein, effects on the phenotype (symptoms), and other information.
Bioinformatics meets biochemistry to predict susceptibility. The BRCA1 protein
acts as a hub of sorts where many other proteins that control DNA repair
gather. DNA Science discussed the genes behind breast and ovarian cancers here.

As gene sequences accumulate in the databases and troops of
geneticists and genetic counselors annotate them, the proportion of pathogenic
and benign entries will increase as that of the unsettling “variants of
uncertain significance” — VUS — will decrease.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics News

‘We Simply Don’t Know’: Egg Donors Face Uncertain Long-Term Risks

February 1, 2017

(STAT News) – When Catherine Fonseca volunteered as an egg donor, the intake form asked for her SAT scores. It did not ask if she understood the long-term health implications of stimulating her ovaries to produce a bumper crop of eggs to be extracted and turned over to an infertile couple. That wasn’t an oversight by the clinic. No one knows the long-term risks to egg donors — if, in fact, there are any. Anecdotally, some women — Fonseca among them — said they experienced an array of health problems after donations, including ovarian cysts and endometriosis, a painful inflammatory disease that can cause infertility.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics News

Hormone May Offer New Contraceptive That Protects Ovaries from Chemotherapy

January 31, 2017

(Eurekalert) – A naturally occurring hormone that plays an important role in fetal development may be the basis for a new type of reversible contraceptive that can protect ovaries from the damage caused by chemotherapy drugs. In their report receiving online publication in PNAS, a team from the Pediatric Surgical Research Laboratories in the Massachusetts General Hospital (MGH) Department of Surgery describes using Mullerian Inhibiting Substance (MIS) to halt, in a mouse model, the early development of the ovarian follicles in which oocytes mature, an accomplishment that protects these primordial follicles from chemotherapy-induced damage.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics News

Functional eggs obtained for the first time from mouse skin

Scientists in Japan have transformed mouse skin cells into eggs and have managed to obtain fertile offspring after their fertilisation (See Nature article HERE). This study represents the first production of eggs completely in vitro.

In 2012, mouse skin cells were reprogrammed into stem cells similar to embryonic stem cells and then induced into primordial germ cells (PGC). However, in order to get the PGC to derive into mature eggs, they had to be transferred to the ovaries of live mice (see HERE). The following breakthrough took place in July 2016, when a team of investigators from Tokyo reported the transformation of PGC extracted from mouse foetuses into eggs, without using a live animal (http://www.pnas.org/content/113/32/9021). Now, the cycle has been completed: from skin cells to functional eggs completely in vitro.

These findings come after investigators in China announced in February that they had produced rudimentary mouse sperm (spermatids) in vitro. Although spermatids are not fully mature cells, the investigators managed to obtain offspring.

Ethical assessment of artifical human eggs

If the protocol works with human cells, eggs could be obtained from the skin of a woman and also from a man, which could then be fertilised. For this reason it has been speculated that in the future, there is a possibility that same sex couples could have children with the genetic material of both fathers.

Among the ethical problems raised by this possibility are those inherent to in vitro fertilisation, the enormous number of human embryos that would be destroyed in researching and putting this technique into practice, the need to use a surrogate, using the woman as a mere incubator and the fact that the child produced in this manner would not be genetically linked to any woman, i.e.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Functional eggs obtained for the first time from mouse skin

Scientists in Japan have transformed mouse skin cells into eggs and have managed to obtain fertile offspring after their fertilisation (See Nature article HERE). This study represents the first production of eggs completely in vitro.

In 2012, mouse skin cells were reprogrammed into stem cells similar to embryonic stem cells and then induced into primordial germ cells (PGC). However, in order to get the PGC to derive into mature eggs, they had to be transferred to the ovaries of live mice (see HERE). The following breakthrough took place in July 2016, when a team of investigators from Tokyo reported the transformation of PGC extracted from mouse foetuses into eggs, without using a live animal (http://www.pnas.org/content/113/32/9021). Now, the cycle has been completed: from skin cells to functional eggs completely in vitro.

These findings come after investigators in China announced in February that they had produced rudimentary mouse sperm (spermatids) in vitro. Although spermatids are not fully mature cells, the investigators managed to obtain offspring.

Ethical assessment of artifical human eggs

If the protocol works with human cells, eggs could be obtained from the skin of a woman and also from a man, which could then be fertilised. For this reason it has been speculated that in the future, there is a possibility that same sex couples could have children with the genetic material of both fathers.

Among the ethical problems raised by this possibility are those inherent to in vitro fertilisation, the enormous number of human embryos that would be destroyed in researching and putting this technique into practice, the need to use a surrogate, using the woman as a mere incubator and the fact that the child produced in this manner would not be genetically linked to any woman, i.e.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics News

Sperm and eggs grown in a Petri dish could revolutionise reproduction

The imminent arrival of eggs and sperm grown from skin cells makes legislative change imperative, three Ivy League professors argue in the journal Science Translational Medicine.

IVF was a game-changing technology, write Glenn Cohen, of Harvard Law School, George Q. Daley, of Harvard Medical School, and Eli Y. Adashi, of Brown University, but IVG – in vitro gametogenesis – could revolutionise reproduction.

Although at the moment IVG has only been successful in mice, it may only be a matter of time before scientists are able to make an ordinary skin cell revert to a pluripotent cell which can be grown into germ cell. This will provide scientists and IVF clinics with an “inexhaustible supply” of eggs and sperm.

That day is not around the corner. “Copious preclinical evidence of safety” will be needed. At the moment, “Whether human iPSCs have a propensity for genetic and epigenetic aberrations is unresolved.” But scientists in several countries are working feverishly on this. Sooner or later, it will happen – perhaps in countries where medical researchers are very lightly regulated, like Cyprus, China or the Dominican Republic.

Obviously, until IVG is successful, this essay about its social impact is merely speculative. But the legal horizon is very hazy, because such possibilities have never existed before. “Before the inevitable, society will be well advised to strike and maintain a vigorous public conversation on the ethical challenges of IVG,” they argue.

Cohen, Daley and Adashi list several uses for the IVG which could probably be used to lobby legislators.

1. Scientists will be able to study germline disease at the cellular and molecular levels.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics News

Woman Is First to Have Baby with Ovaries Frozen as a Child

December 15, 2016

(CNN) – A 24-year-old Dubai native has become the first woman to give birth after having her fertility restored from ovarian tissue frozen during her childhood. Moaza al Matrooshi gave birth to a healthy son, Rashid, at the Portland Hospital in London on Tuesday. She is the first person in the world to have had a successful pregnancy using ovarian tissue that was harvested before the onset of puberty and the only person to have her ovaries transplanted back after 13 years in storage.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.