Category Archives: Embryology

Englands first not-for profit IVF clinic will open next year to combat fertility inequality – The Sun

ENGLANDS first not-for-profit IVF clinic will open next year with the aim of combating fertility inequality.

The new service will debut in London before being rolled out across England, and will allow people to access treatments at cost value - with no additional charges or add ons.

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The British Pregnancy Advisory Service (BPAS) will undercut the cost of private clinics and charge the true cost of treatment - which can be between 3,000 and 3,500 for three cycles of IVF.

The charity, which has been helping women with pregnancy advice for more than 50 years will get rid of add ons such as embryo glue and assisted hatching, which have not been proven to work, but which many patients say they have been pressured into purchasing as well as the IVF itself.

Guidelines from the National Institute for Clinical Excellence (Nice) state that drugs and treatment should be available on the NHS in England and Wales.

But as funding budgets are cut in many areas, IVF provisions have been pushed back - with many offering no paid options, with some offering just two cycles.

Often patients can also face discrimination when attending appointments, with some experts refusing to treat women over the age of 35.

WHAT IS IVF?

ONE OF the techniques used to help couples with fertility problems who are struggling to have a baby is in vitro fertilisation (IVF).

IVF refers to the process involves removing an egg from a womans ovaries and fertilising them using sperm in a laboratory.

The fertilised egg, also known as an embryo, is transferred back into a womans womb to grow.

The process can use eggs and sperm from the couple themselves, or these can be sourced from a donor.

How does IVF work?

There aresixmain stages of IVF:

Others have also been refused if they are not in a stable relationship, or couples where one partner already has a child from a previous relationship.

BPAS wants to make sure that IVF is inclusive to all and the first clinic will open in London in September 2021.

Egg collection and embryo transfers will be available and scans and other appointments will take place at satellite clinics in BPAS centres outside the capital in Peterborough and Swindon, before later being rolled out across England.

The clinics will use different entrances for patients seeking IVF and patients seeking abortions.

This, BPAS says is so that a woman wishing to terminate a pregnancy aren't placed in a waiting room with a woman who is struggling to conceive.

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BPAS was founded in 1968 and has drawn comparisons with IVF in 2020 to abortion in the 1960s.

The charity states that in the 1960s women had been unable to access NHS funded abortion care and had to go to private providers who charged extortionate prices.

Katherine OBrien, associate director of communications and campaigns at BPAS said while the IVF situation is not as severe, some IVF providers are encouraging women to undergo clinically unproven treatments at a huge personal and financial cost.

Marta Jansa Perez, director of embryology at the charity said the clinics should be as inclusive as possible in terms of ethnic diversity, sexual orientation and gender identities.

She added: Were not going to say bluntly say no to anyone but we are planning to follow all professional guidelines and provide patients with the full picture in terms of chances and risks to them and the baby that they will potentially have.

While she said people wont be turned away from being too old, experts will have very honest conversions with people about their chance of conceiving.

Jansa Perez said it is still the case that many people are being given false hope.

She had fertility treatment to conceive her two children and said she is passionate about giving other people the opportunity.

BPAS will aim to carry out 200 egg collections in the first year.

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It hopes it will eventually become a registered IVF provider for the NHS - which means patients could choose to have their NHS-funded IVF cycles at the BPAS clinics.

The clinic will be regulated by the Human Embryology and Fertility Authority.

Jansa Perez added: A lot of patients feel that when they have a negative pregnancy test, theyre either rushed on to having another treatment cycle and there is not discussion of maybe not having any further treatment, looking at the whole picture and seeing what their chances are, and whether thats something that they want to do, emotionally and financially.

Were not selling them the baby, were selling them a chance to possibly have one.

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Englands first not-for profit IVF clinic will open next year to combat fertility inequality - The Sun

Can editing the DNA of human embryos protect us from future pandemics? – Scroll.in

Hollywood blockbusters such as X-men, Gattaca and Jurassic World have explored the intriguing concept of germline genome editing a biomolecular technique that can alter the DNA of sperm, eggs or embryos. If you remove a gene that causes a certain disease in an embryo, not only will the baby be free of the disease when born so will its descendants.

The technique is, however, controversial we can not be sure how a child with an altered genome will develop over a lifetime. But with the Covid-19 pandemic showing just how vulnerable human beings are to disease, is it time to consider moving ahead with it more quickly?

There is now good evidence that the technique works, with research normally carried out on unviable embryos that will never result in a living baby. But in 2018, Chinese scientist He Jiankui claimed that the first gene-edited babies had indeed been born to the universal shock, criticism and intrigue of the scientific community.

This human germline genome editing was performed using the Nobel-prize winning CRISPR system, a type of molecular scissors that can cut and alter the genome at a precise location. Researchers and policymakers in the fertility and embryology space agree that it is a matter of when and not if human germline genome editing technologies will become available to the general public.

In 2016, the United Kingdom became the first country in the world to formally permit three-parent babies using a genetic technique called mitochondrial replacement therapy replacing unhealthy mitochondria (a part of the cell that provides energy) with healthy ones from a donor.

Scientists are now discussing genome editing in the light of the Covid-19 pandemic. For example, one could use CRISPR to disable coronaviruses by scrambling their genetic code. But we could also edit peoples genes to make them more resistant to infection for example by targeting T cells, which are central in the bodys immune response. There are already CRISPR clinical trials underway that look to genome edit T cells in cancer patients to improve anti-tumour immunity (T cells attacking the tumour).

This type of gene editing differs to germline editing as it occurs in non-reproductive cells, meaning genetic changes are not heritable. In the long term, however, it may be more effective to improve T-cell responses using germline editing.

It is easy to see the allure. The pandemic has uncovered the brutal reality that the majority of countries across the world are completely ill-equipped to deal with sudden shocks to their, often, already overstretched healthcare systems. Significantly, the healthcare impacts are not only felt on Covid patients. Many cancer patients, for instance, have struggled to access treatments or diagnosis appointments in a timely manner during the pandemic.

This also raises the possibility of using human germline genome editing techniques to tackle serious diseases such as cancer to protect healthcare systems against future pandemics. We already have a wealth of information that suggests certain gene mutations, such as those in the BRCA2 gene in women, increase the probability of cancer development. These disease genetic hotspots provide potential targets for human germline genome editing therapy.

Furthermore, healthcare costs for diseases such as cancer will continue to rise as drug therapies continue to become more personalised and targeted. At this point, would gene editing not be simpler and cheaper?

As we approach the mezzo point of the 21st century, it is fair to say that Covid-19 could prove to be just the start of a string of international health crises that we encounter. A recent report by the UN Intergovernmental Science-Policy Platform on Biodiversity and Ecosystem Services emphasised the clear connection between global pandemics and the loss of biodiversity and climate change. Importantly, the report delivers the grim future prediction of more frequent pandemics, which may well be deadlier and more devastating than Covid-19.

It is not just more viral pandemics that we might have to face in the future. As our global climate changes, so will the transmission rates of other diseases such as malaria. If malaria begins presenting itself in locations with unprepared healthcare systems, the impacts on healthcare provision could be overwhelming.

Interestingly, there is a way to protect people from malaria introducing a single faulty gene for the sickle cell anaemia. One copy of this faulty gene gives you a level of protection against malaria. But if two people with a single faulty gene have a baby, the child could develop sickle cell anaemia. This shows just how complicated gene editing can be you can edit genes to protect a population against one disease, but potentially causing trouble in other ways.

Despite the first human germline genome editing humans already having been born, the reality is that the technique will not be entering our mainstream lives any time soon. The UK Royal Society recently stated that heritable genome editing is not ready to be tried in humans safely, although it has urged that if countries do approve human germline genome editing treatment practices, it should focus on specific diseases that are caused by single specific genes, such as sickle cell anaemia and cystic fibrosis. But, as we have seen, it may not make sense to edit out the former in countries with high rates of malaria.

Other major challenges for researchers is unintended genetic modifications at specific sites of the genome which could lead to a host of further complications to the genome network. The equitable access to treatment provides another sticking point. How would human germline genome editing be regulated and paid for?

The world is not currently ready for human germline genome editing technologies and any progress in this field is likely to occur at a very incremental pace. That being said, this technology will eventually come to feature in humanity for disease prevention. The big question is simply when?. Perhaps the answer depends on the severity and frequency of future health crises.

Yusef Paolo Rabiah is a PhD Candidate at UCL Science, Technology, Engineering and Public Policy at the University College London.

This article first appeared on The Conversation.

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Can editing the DNA of human embryos protect us from future pandemics? - Scroll.in

Im a super sperm donor with 150 kids & Im leaving my tier 4 area to impregnate women, its an essential ser – The Sun

SUPER sperm donor, 49-year-old Joe Donor* - who came over to the UK to offer his services in September - admitted he was continuing to impregnate women while living in tier four Essex/London borders - saying it was an 'essential service'.

Earlier this year Joe, from the USA, spoke to Fabulous and told how he travelled the world impregnating people.

Read our coronavirus live blog for the latest news & updates

He arrived in the UK in September and for a while travelled up and down the country from Hull to Wales to Birmingham and Kent.

But tier four hit and he is still continuing to offer his services, claiming it is an 'essential service', although he says he is no longer travelling as far.

His residence is in Essex, a tier four area, but he was yesterday helping a woman in Dover, Kent. This appears to go against travel restrictions.

When approached by Fabulous, who did not pay him to speak, he said: "I believe this is one of the exceptions to lockdown because I believe that I am helping people who who due to advance maternal age if they can't get pregnant now they will forever miss that opportunity.

"I am not having any raves or attending large gatherings but I am meeting people women who need to get pregnant now," he told Fabulous.

"I don't believe I am breaching lockdown because I think this falls as an exception."

For those affected, Tier 4 is essentially a return to the full lockdown which ended in England on December 2.

It began on December 20 and was set to be reviewed on December 30, however, it was revealed that more of England will be plunged into the strictest tier as soon as Boxing Day.

The PM's key message for those in these regions was to stay at home unless it's for essential reasons.

I believe this is one of the exceptions to lockdown because I believe that I am helping people who who, due to advance maternal age, if they can't get pregnant now will forever miss that opportunity.

There have been real concerns about the new strain, which is blamed for a sudden surgein hospitalisations.

Joe, staying in west London, told the Mail he had attempted to impregnate 15 women and three were due to have children. "Helping women create the gift of life is the best present of all," he said. "I'm always ready to climb down that chimney and give women the dream baby they've always wanted.

"'I'd say about three of those women I have met I've had sex with, and two of those are pregnant. But not everyone reports back and lets me know if they're expecting.

"Since my time in the UK I have travelled to Wales, Hull, Birmingham, Portsmouth and Kent. I'm the luckiest man in the world."

Previously Joe told Fabulous how, after every encounter, he leaves with his trademark comment: Good luck and I hope you have good news in two weeks.

He doesn't just use a turkey baster or syringe though - actually having sex with the women.

It was PI, he told Fabulous.

By that he means partial intercourse - sex without kissing or cuddling.

He also has NI, natural intercourse, and AI, artificial intercourse.

Natural intercourse is really full sex, like you might have on a first date, Joe said. So no bedroom gymnastics, but kissing and cuddling. Artificial intercourse is when you use a turkey baster.

Helping women create the gift of life is the best present of all.

He added a lot of people wanted to be inseminated the old-fashioned way - but he only has STI checks once a year (although more frequently if asked).

And he admitted he doesnt do background checks on the people he is potentially impregnating, adding: I think having a baby makes people more mature. I dont do any checks on them though.

He says he has had sex with a lot of people, but won't say the exact number.

Its fewer than 200, he laughed. Im not a rockstar and Im very respectful.

Single Joe, who uses a pseudonym, revealed he had 150 kids worldwide - although with more coming.

Its more than the average person but there are people who have more. Theres some sultans out there who have more, he said.

His name is on a few, not many birth certificates and he wouldnt mind if the children called him daddy but he doesnt really see many of them often. They have my DNA, of course, he said. But I leave it up to the mothers. If they want to send me pictures, great. If they block me as soon as Ive done the deed, thats okay too.

Joe, who anonymously donates his sperm by concealing his real name, said he wasnt paid for his actions but did it to help.

He set up his business 12 years ago after realising he wanted to benefit people - but shockingly his parents dont know although are aware I have a few kids.

He denied it was about ego, explaining: "I have about 150 kids worldwide but there's currently five women pregnant with my children and one already born.

I enjoy seeing more of my children running around.

I dont think there is an inordinate amount of ego associated with it.

Some of them call me daddy, some dont.

Ive met about 50 of them, Ive seen some of them when they were born, but not since.

He wasnt slowed down by the pandemic, despite being stuck in Argentina - instead opting to sow his seed there.

"I feel busier than ever, he said. "I love seeing photos of the babies when they're born as a lot of them do look like me.

"I don't financially gain from providing my sperm to women, I just enjoy helping people.

"Luckily I run a few online businesses so I'm always available and can provide sperm whenever they're ovulating."

Unfortunately, the nature of his work has meant he hasnt managed to maintain his own long-term relationship with his last ending in November last year.

That was with a woman in her 20s when I was living in Australia, he explained. We were going out for about six months but its ended. When we were in the relationship I didnt have sex with other women, but it was difficult.

He admitted sometimes his impregnation sessions could lead into longer relationships, but they almost always ended when people wanted something more stable.

I dont have a girlfriend in the typical sense, he said. But I do develop friendships and sometimes romantic relationships with the women I impregnate, he added.

However, it is not all plain-sailing with some women lying to their men about meeting Joe, he said.

Hes been caught out trying to impregnate women behind their partners back.,

He denies any wrongdoing in relation to this.

I dont pry into peoples personal matters, he said. Im not the one cheating or lying in the relationship. Its them."

He told of one incident where he went to impregnate a woman only to learn her husband didnt want one.

So basically she had arranged an orgy because she didnt want him to know the truth - that it was just her and me and she was planning to get pregnant, he said.

But when the husband found out the truth he started waving a gun about - and Joe only just managed to escape.

Joe has travelled across America, Argentina, Italy, Singapore, The Philippines and the UK donating his sperm.

He added: "I have babies all over the world and although people always worry over incestual issues but that has never happened.

"I started donating sperm in 2008 and have fathered on average 10 children per year.

"I have always said I wouldn't father more than 2500 but that would technically be impossible unless I live until the age of 250.

"I aim to donate my sperm for as long as it works which could be until I'm in my 90s."

Talking about safe sex, Joe opts to have yearly medical checks.

He adds: "I have a health check at least annually but if a woman requests more frequent testing, I will have another check on demand.

"There's always a risk as what I'm doing isn't regulated but women have checks during pregnancy too so they'd soon find out if they'd contracted a sexually transmitted disease, which has never happened."

Joe, who says he doesn't charge for his services, is hoping to head back to his hometown of America after his UK trip but says he's happy to travel anywhere in the world to donate his sperm.

He added: "I'm contacted by women all over the world via Facebook or email.

"I don't mind travelling as I can work wherever I need to in the world.

"I'm hoping that as lockdown eases in some parts of the world again that it'll be easier to travel more frequently."

I have a health check at least annually but if a woman requests more frequent testing, I will have another check on demand.

In the UK, donation in exchange for payment is prohibited by law.

If you donate your sperm through a fertility clinic or a sperm bank, you wont have any responsibilities or rights towards a child conceived using your semen.

However, as of April 2005, children conceived through sperm donation do have the right to ask for certain information about their donor once they reach the age of 16.

You can find the clinic that is best for you through theHuman Fertilisation and Embryology Authority (HFEA) licensed clinic.

Every year, around 2,000 children are conceived with the help of a donor.

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Meanwhile, meet the 57-year-old sperm donor who believes he could have HUNDREDS of children.

And an entrepreneur opened up about how a DNA test revealed her dad wasnt her father and how she discovered her new family.

We also shared how a woman turned to a White Van sperm donor to have her daughter.

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Im a super sperm donor with 150 kids & Im leaving my tier 4 area to impregnate women, its an essential ser - The Sun

The sperm race: How an Irish firm is finding the strongest swimmers – The Irish Times

Every year roughly a million fertility treatment cycles are carried out in the EU and the US, and two-thirds of them fail. Fertility problems affect one in six couples and treatment costs about 5,000 for a single cycle in Europe and twice that or more in the US.

It takes an average of three cycles for a couple to conceive. When the treatments fail, those involved pay a heavy emotional and financial price.

Infertility is often wrongly seen as predominantly a female problem. But in up to 50 per cent of cases, issues with the sperm are a major contributing factor, says reproductive specialist Dr Sean Fair, who is also the driving force behind a new technology that dramatically improves sperm selection and increases the chances of a successful pregnancy.

Sperm is produced in the hundreds of millions, which suggests that a reasonable proportion will successfully make it up the female reproductive tract. This is not the case. Even in men considered to have robust fertility levels, only 4-8 per cent of their sperm have what is considered the normal shape required to go the full distance and fertilise an egg.

In a fertility clinic setting, most eggs are fertilised by an intra cytoplasmic sperm injection. This involves the embryologist selecting a sperm and injecting it directly into the egg, Fair says.

An experienced embryologist will select the best sperm available with a normal shape but they have no information about its DNA integrity which can fragment as the only test available to check it would destroy the sperm. We know that high sperm DNA fragmentation leads to lower fertilisation rates and doubles the risk of miscarriage, so the selection of sperm with the best DNA integrity is crucial.

Fairs background is in animal science, and he has been researching for the past 15 years how sperm interact with the female reproductive tract. Although much of his professional life has been spent on animal reproduction, he says there are close parallels with humans and it was a small step to transfer what he knew in one context to another.

Im guessing that not a lot of people know that Ireland has been at the leading edge of animal reproductive science for probably 40 years now, and there is a huge reservoir of knowledge here on the subject, says Fair. I felt there was significant potential to apply what we already knew about animals to humans given the mammalian similarities and I spoke to numerous fertility specialists who immediately identified with the science and saw it as a significant step forward in helping couples to overcome their infertility problems.

In August his research took a giant step towards commercialisation with the formation of NeoMimix, which will take the technology to market. The companys co-founder is embryologist Declan Keane (also founder of the ReproMed fertility group), and NeoMimix will be spun out from the University of Limerick, where Fair is based at the Bernal Institute. Market launch has been set for 2023.

We knew from looking at how sperm progress up the female reproductive tract in farm animals that they swim up small grooves along the edges of the cervix against outward-moving mucus. I discussed replicating this process in the lab with my engineering and product design teams and this led to our first basic prototype, which allowed us to see the sperm swimming against a fluid flow, says Fair.

Whats developed from there is NeoMimixs proprietary technology, which works by naturally stimulating the sperm to swim in microchannels against an active fluid flow. In other words, its exactly how sperm naturally orientate and swim up the female reproductive tract against an outward flow of mucus produced under the influence of oestrogen around the time of ovulation.

We can complete the selection process in about half the time it takes with current methods, and environmentally what were doing is also a step forward, as our technology requires the use of a single disc, not multiple test tubes that have to be discarded after use.

NeoMimixs microfluidics-based technology comprises a small reusable control unit and a disposable plastic disc with multiple tiny channels that act like the grooves of the cervix. The sperm sample is placed on the disc and the system then mimics the way the female body naturally conducts its selection process. In short, its all about survival of the fittest, and whats left at the end of the process is an elite group of super swimmers.

The embryologist then works with this elite cohort alone to fertilise the egg, thereby enhancing the potential for pregnancy and reducing the number of IVF cycles a couple has to go through.

Shaun Rogers is an embryology clinical scientist at the Gennet City fertility clinic in London, which is part of Europes third-largest provider of IVF. He has spent almost three decades in the field and is encouraged by what he has seen and heard so far about the NeoMimix technology.

There have been big advances in fertility treatment in the last 10 years but a lot of it has been focused on the embryo and improving the implant potential, says Rogers. The preparation of sperm samples has received less attention so there have been fewer big developments, which is why what NeoMimix is doing is particularly relevant. There are significant advantages to a sperm sorting system that will give us a better functional population to work with.

In my experience the ideas with the best potential usually come from the field rather than from a research company working in isolation, says Rogers. In the case of NeoMimix you have an approach that combines the best of both worlds: the experience of a reproductive biologist who has worked in the field for over 30 years and the rigorous approach of an academic researcher at the leading edge. Putting the two together gives the best chance of producing something thats different and ground-breaking.

Fair says the advantages of NeoMimixs system will become obvious to the infertility community once the company breaks cover and begins actively demonstrating its technology. Currently, our competition and the industry norm is a method called density gradient centrifugation.

This is where sperm are spun in a centrifuge at high speed and forced through silica nanoparticles. More dense sperm are pushed to the bottom, Fair says. This technique is rudimentary and not very selective. In addition, the centrifugation process stresses the sperm (our technology does not) and silica nanoparticles can get stuck to it and then need to be washed off by further centrifugations, which is far from ideal.

Component parts for NeoMimixs technology will be made in Sligo and Shannon, and its potential customers are fertility clinics worldwide. Its addressable market is estimated at 280 million, and Fair says the company intends to develop its microfluidics platform into a total embryo culture system that will open up a potential market of 23 billion.

Between now and the product launch in roughly two years time, the device has to go through US and EU regulatory processes and the company is about to embark on a 2 million fundraising round to build out its team and proceed to market. Investment in the technology to date is about 700,000, which has come from Enterprise Ireland, UL and the EUs EIT Health innovation network.

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The sperm race: How an Irish firm is finding the strongest swimmers - The Irish Times

Eating Nuts Makes Sperm More Robust, Study Says (So Thats Why Mr. Peanut Is So Cocky) – Mandatory

Nuts are a crunchy, tasty, often salty snack. They pair well with beer (if were being bad) or salad (if were being good) or trail mix (if we think were being good but actually being bad). We know theyre beneficial for our heart and brain health. But a new study suggests that men have yet another reason to chow down on the popular snack: superior sperm.

Research funded by the International Nut and Dried Fruit Council found that eating nuts can improve the DNA quality of sperm. This is the latest in a trio of studies that confirm that popping nuts on the regular can help your little swimmers go the distance.

A 2018 study from the European Society of Human Reproduction and Embryology studied 119 men and found that those who consumed 60 grams per day of almonds, hazelnuts or walnuts experienced boosts in sperm count, vitality, motility and morphology. In laymans terms, they were more virile.

And yet another study by the American Society of Andrology and the European Academy of Andrology of 72 men found that those who added nuts to their diet experienced DNA alterations in their sperm that might make them more likely to fertilize an egg.

So now you know why Mr. Peanut is so cocky though he shouldnt be, because peanuts are at the bottom of the nut hierarchy when it comes to health benefits. (Technically, theyre a legume.)

And you have to take these studies with a grain of salt (which is how we happen to like our nuts anyway sprinkled in sea salt to be exact) because they were all funded by Big Nut, which obviously has a vested interest in finding out good things about nuts.

Cynicism aside, how many nuts do you need to, um, nut more effectively? About 40 almonds, 40 hazelnuts or 20 walnuts a day which is a pretty hefty serving. If you do add that many nuts to your daily diet, make sure you reduce your caloric intake elsewhere or youll not only have beefier sperm but a beer belly as well and that will definitely not help you get laid.

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Eating Nuts Makes Sperm More Robust, Study Says (So Thats Why Mr. Peanut Is So Cocky) - Mandatory

The Impact of COVID-19 on the Fertility Sector – BioNews

21 December 2020

'What a year it's been!' With this statement, Sarah Norcross, director of the Progress Educational Trust (PET) opened the charity's annual conference 'Fertility, Genomics and COVID-19' on 9 December which, for the first time in its history, was online via Zoom.

She spoke about how the COVID-19 pandemic has 'affected the lives of all of us', and this was inevitably the unexpected theme of this year's conference. The plus side of holding a virtual conference was that half of this year's speakers were able to attend from overseas, said Norcross, speaking from her kitchen. She added that this year she did not have to worry about the conference catering, or queues for the loos, but rather whether delegates would hear the sound of her husband putting the kettle on.

Norcross also announced the appointment of Professor Dame Lesley Regan as a new patron of PET (which publishes BioNews).

The first session 'The Impact of COVID-19 on the Fertility Sector', chaired by Norcross, heard from three heavyweights and chairs of different organisations.

First to speak was Sally Cheshire, chair of the UK's Human Fertilisation and Embryology Authority (HFEA) and interim chair of the Children and Family Court Advisory and Support Service (CAFCASS).

The UK regulator will reach its 30-year anniversary in 2021, and she examined the role of the HFEA and how it has and will regulate fertility services through the pandemic and beyond. Cheshire said that fertility clinics in the UK shut their doors for the first time in 30 years on 15 April this year, in response to the Government's directive. 'It was the most challenging decision we had to make in 30 years,' she said.

Patient safety was paramount. And with this in mind, clinics stopped new treatments from 23 March, though fertility preservation treatments (eg for patients undergoing chemotherapy) have continued throughout the pandemic. Other issues that the HFEA had to consider with the upheaval caused by COVID-19 and lockdown included the 10-year storage limits for gametes, and patients who were approaching the cut-off age of fertility treatment on the NHS.

At the height of the pandemic in the spring, NHS fertility staff including anaesthetists and nurses, as well as laboratory testing equipment were turned over to help tackle COVID-19. In the private fertility sector, many staff were furloughed and the industry lost millions of pounds. She said there are normally about 6000 IVF cycles worth 30 million in one month alone.

'The worries about whether these businesses would survive were real ones,' Cheshire told delegates. Additionally, staff 'were undergoing what everybody else' was, with sickness and the loss of colleagues and loved-ones to COVID-19.

For patients there were many questions about treatment and waiting lists. Cheshire said that the technical NHS term 'non-emergency' applied to fertility treatments provoked some anger among patients on social media. Patients' worries about the 10-year storage limit for gametes were addressed by the UK government with a two-year extension given to those affected by the pandemic (see BioNews 1040).

The fertility sector was the earliest sector to reopen on 11 May, said Cheshire. Many adjustments have been made, including in the HFEA's own processes such as the video assessments of clinics.

On a different note, she said the HFEA has extended its own strategy to 2024, and are in discussions on changes to the Human Fertilisation and Embryology (HFE) Act. But Cheshire cautioned: 'Warnock two might be a long way off.'

Following on from this, Dr Jane Stewart gave her clinician's perspective on the pandemic. Chair of the British Fertility Society, Dr Stewart made it clear that she was speaking from her experiences as head of the Newcastle Fertility Centre.

She said her Trust already had a pandemic policy in place. So when the Government directive came to close all centres: 'There was no time for panic, we had to start planning.' All elective and non-emergency work was stopped, staff redeployed, and many worked from home.

'Patient communication was an enormous part of it,' she said. 'We didn't always get that right but certainly it was a priority for us.'

Once their clinic reopened, they re-established appointments via phone calls or video-link, and would bring patients in separately for their physical assessments. 'We scrutinised all treatment protocols to reduce the number of visits,' said Dr Stewart.

She welcomed the vaccine news on COVID-19, as 'things beginning to turn a corner'. However, she also noted that a 'big dilemma' would be coming up for fertility patients as there is no data on use of the vaccine in pregnant women, so it is currently not advised in this group.

'Hopefully, there will be some discussion around this,' she said.

Dilemmas were the focus of the next speaker, Julian Savulescu, professor of practical ethics at the University of Oxford and director of the Oxford Uehiro Centre for Practical Ethics. 'IVF, in general, is a playground of ethical issues with many questionable policies and regulatory issues,' he said.

He shared some of his work on ethics and COVID-19, reflecting on how this might be applied to dilemmas in fertility treatment.

'It seems to me that the challenges facing people with infertility are the challenges facing all of us during the pandemic,' said Professor Savulescu.

These include the trade-offs between liberty and wellbeing, in particular, that of the infertile versus the health of the elderly; policies of selective restriction of freedom; and in the allocation of limited resources, how we balance equality versus utility. The comparisons were particularly pertinent in how limited resources such as ventilators, vaccines or IVF are allocated.

The principle of equality or egalitarianism is 'equal treatment for equal need' (one of the NHS's basic principles), which means that factors such as potential length of life gained and the probability and quality of survival would be ignored in allocating resources.

Healthcare decisions based on utility or utilitarianism allocate according to what will bring the greatest benefit. This approach would take into account for example, the quality and predicted length of survival when allocating a ventilator to a COVID-19 patient.

Many governments use QALYs (cost per quality-adjusted life year) which estimate how much benefit is gained for the cost, to make healthcare utilitarian decisions. Professor Savulescu noted that for the UK's pandemic lockdown response, the QALYs were 'enormous'. He said that the prioritisation of IVF inside and outside the pandemic is a massive value assumption depending on how you value the life of a subsequent child (IVF calculations do not typically include QALYs for the child).

While the UK did not use utilitarian decision-making in pandemic allocations, for example NICE and the Intensive Care Society used frailty rather than QALYs to allocate ventilators, such principles guide some IVF allocations. For example, an IVF age-cut off that 'may well' also breach the UK's Equality Act 2010. Likewise, in Australia, BMI limits are placed on IVF.

Professor Savulescu noted contestable ethical issues arising from the pandemic itself. Early on in the pandemic it became apparent that the disease primarily kills the elderly, he said.

Modelling by the US Centres for Disease Control and Prevention in November suggested the chance of someone aged 20-49 dying from COVID-19 lay somewhere between 7 in 100,000 and 2 in 10,000. He said the chances of a person in this age group the IVF patient age group, dying in a car accident are 1 in 10,000.

With such a low risk, the primary reason for stopping IVF during the pandemic is to prevent transmission. 'Then the issue is can we use PPE to prevent transmission?' asked Professor Savulescu.

He wrapped up by saying that patients with infertility have been a low priority whose 'liberty has probably been excessively restricted' and raised questions about them being given greater priority now.

As usual with PET events, the second half of the session was given over to audience questions. Cheshire was asked about the potential to reopen the HFE Act to bring it up to date. She agreed that it would be beneficial to review some areas, but acknowledged that Parliamentary time is likely to be taken up with COVID and Brexit. One of the areas she and Dr Stewart spoke about was the extra level of confidentiality surrounding fertility treatment, meaning that it does not appear on a patient's medical records, and how these restrictions put patients' lives at risks due to hiding information about patient care outside the hospital patient management systems.

PET would like to thank the sponsors of its conference - the Anne McLaren Memorial Trust Fund, the Edwards and Steptoe Research Trust Fund, ESHRE, Wellcome, the European Sperm Bank, Ferring Pharmaceuticals, the London Women's Clinic, Merck, Theramex, Vitrolife and the Institute of Medical Ethics.

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The Impact of COVID-19 on the Fertility Sector - BioNews

‘Survivor’s’ Candice Woodcock, John Cody Respond to Twitter Haters – Heavy.com

TwitterJohn Cody and Candice Woodcock Cody of 'Survivor: Blood vs Water'

Last week, Survivor couple Candice Woodcock Cody and John Cody revealed that they are 35 weeks along with their third child. They are due in mid-January and are waiting to be surprised as to the sex of the baby.

But what drew Twitter users ire is the fact that Woodcock Cody posted a photo of herself receiving the COVID-19 vaccine. While most followers simply offered congratulations, some expressed concern about a pregnant woman getting vaccinated and others became downright abusive about it. Heres what you need to know.

Many responses were positive, including one Twitter user who wrote, I have my appt tomorrow for a vaccine Im 23 weeks pregnant and a Registered Nurse ! Thank you for your post it makes me feel better about my decision to get vaccinated.

Another wrote, Youre incredibly brave. Not just for working in your job for months already, but for being among the first to try a new vaccine, and for being willing to show it on this platform. #staystrong #itsyourdecision.

But many people blasted the couple for either endangering their unborn child or being bribed to act like there is a vaccine when there isnt one, perpetuating conspiracy theories about the vaccine being fake. The reason they thought the photo was faked was because of the angle of the safety needle cap however, the cap was in the right place. When a shot is being administered, it is supposed to be off to the side at a right angle.

They are pieces of Filth!!! The needle is not in her arm! Just look closely! This is Propaganda & should be held LIABLE! Criminal & Civil. Its just unbelievable! Data is for ALL who can read. MD = Drug Dealer NOT a healer! They never cured even the common cold/Flu. Makes me [angry emoji], wrote one user.

Another wrote that she prays this is fake, and a third wrote, The cap is still on. Just like all the others. They are clearly telling you there isnt gonna be a vaccine. Wake up for f*** sake.

For the record, according to the Center for Disease Control, there are two approved and recommended vaccines, one from Pfizer-BioNTech and one from Moderna. There are two others that are in their clinical trial phase, one from AstraZeneca and one from Janssen.

Woodcock Cody is an anesthesiologist, which one commenter thought meant she wasnt a medical doctor, but she is that is a specialty and she practices at the Virginia Health Center in McLean, Virginia. Cody is former Army physician and current orthopedic surgeon at the Walter Reed Army Medical Center in Bethesda, Maryland. Cody responded with a Twitter thread explaining how both the American Society for Reproductive Medicine and the American College of Obstetricians and Gynecologists feel that even though there havent been studies done on pregnant women, the benefits of the vaccine outweigh potential risks and are unlikely to negatively affect pregnant women.

In a joint statement made with several other pregnancy and fertility organizations, the ASRM and ACOG wrote, It is especially important that certain eligible patient populations, including pregnant women, consult with their trusted physician when considering whether to take the vaccine.

Basically, it is up to the patient and their doctor about choosing whether to vaccinate. The CDC says that the patient and healthcare provider should consider the likelihood of the patients exposure and risks the virus would pose to their fetus. While the FDA cannot officially recommend the vaccine to pregnant women because there is a lack of data, the CDC believes that because the vaccine contains no active virus, it is unlikely to pose a risk to pregnant women.

For the Codys, they feel that based on Woodcock Codys level of risk as a healthcare worker, it was necessary that she be vaccinated.

Cody wrote, Recently, ACOG and the @ReprodMed recommended that the COVID vaccine be offered to pregnant and lactating women, based on their individual level of risk The Pfizer and Moderna vaccines contain NO active virus, and they did not rely on any aborted fetal tissue for viral culture or reproduction like some have inaccurately suggested. No, we are not paid actors. Yes this is real. No it is not propaganda. We are both physicians that make $0 from pharma. As a full time anesthesiologist, @CandiceCodyMD must take risks with her health when she cares for COVID patients. It is a very high risk specialty. At 35 weeks, the baby is nearly full term with only growth and fat production, and some lung maturation left to occur. Some of you Twitter scientists need to review your embryology a little bit before you spit fire at people that deeply understand this process.

There is no word yet on when Survivor will be back on the air. There is talk about the production team filming three seasons this spring so that they can air one in the summer of 2021, one in the fall and then one in the spring of 2022.

READ NEXT: A Survivor Legend Got Caught Smuggling Food During the Family Visit

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Surrogacy and HFEA Update: December 2020 (Part 2) – Family Law Week

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In the second part of his surrogacy and HFEA update, Andrew Powell of 4PB analyses recent important judgments from Scotland and Northern Ireland.

Andrew Powell barrister, 4PB

For Part 1 of this article, covering judgments in the jurisdiction of England and Wales, please click here.

SB v University of Aberdeen [2020] CSIH 62

A Scottish decision in which the Inner House of the Court of Session granted a widow's petition to allow her to use her late husband's sperm for IVF treatment. The primary question was whether or not his will, together with forms signed consenting to the use of his sperm in inter alia intra uterine insemination (IUI), constituted the requisite consent for use in IVF under HFEA 1990, Sch. 3.

The parties (JB and SB) met and married. When JB's serious illness recurred, they agreed to commence fertility treatment, and were referred to a consultant by their GP. On medical advice JB had stored his sperm at the onset of his disease ten years previously and prior to meeting SB. Unfortunately however, JB's health deteriorated before treatment could begin.

It was discovered the day before he died, by which time he was unconscious, that the forms he had previously completed provided his consent only to the use of his sperm in inter alia IUI, and not IVF (which involves creation and storage of embryos).

Nonetheless, JB had discussed his wishes with his father, and a clause had been inserted into his will headed "Human Fertilisation and Embryology" and which directed his executors to ensure that "my donation of sperm will be for as long as possible and for as long as she may wish, available to [SB]."

SB petitioned the court asking it to exercise its powers under the nobile officium, and grant certain orders to allow her to use her late husband's stored sperm in IVF treatment. The issue before the court therefore was whether or not the will, either alone or in combination with the forms JB had signed giving consent to IUI, constituted consent by JB for the use of his sperm in IVF, as required in HFEA 1990, Sch. 3. Further, SB sought the storage of JB's gametes to be extended beyond the normal statutory period of ten years. The court concluded as follows (20-23):

"20. We proceed on the basis that the requirements of an effective consent to use of the deceased's gametes for IVF treatment are that:

(a) It must be in writing;

(b) It must be signed by the deceased;

(c) It must specify the purpose of use, and be clear that it encompasses consent to the creation of any embryo in vitro ;

(d) The individual must have been given a suitable opportunity to receive proper counselling about the implications of taking the proposed steps, and have been provided with such relevant information as is proper; and of the consequences in respect of the possibility of variation or withdrawal of consent as specified in schedule 4, paragraph 4 ; and

(e) It must not have been withdrawn.

In our view, the terms of the deceased's will constitute sufficient consent to meet these requirements. It is in writing, it is signed and it has not been withdrawn. The remaining two conditions for effective consent relate to the opportunity for counselling and whether the terms of the clause are sufficiently clear to provide consent for the specific form of treatment that is involved in IVF.

21. As to the first of these, it is clear that the deceased was, at the time of his first visit to the clinic at the start of his illness, provided with suitable and appropriate opportunities for counselling in respect of the steps which he was then undertaking. What is "a suitable opportunity to receive proper counselling", or provision of "such relevant information as is proper" is, as is accepted by the HFEA, situation specific. The context in which the deceased and the petitioner consulted their GP and were referred to the consultant and thus to the fertility clinic, was one in which they were investigating the possibility of having a child in the face of JB's impending death. It seems clear to us, taking together the affidavits of the consultant and the petitioner, that the terms of paragraph 3 of schedule 6 were adequately met before the deceased signed his will about two months after being seen by the GP and consultant. In addition, during their consultation with the consultant, the couple completed and signed a fertility clinic "Welfare of the Child" consent form. Under the heading "we have considered the following issues", they ticked a box stating "Our possible need for and the availability of independent counselling". The form was signed by both of them. The referral letter from the consultant to the clinic stated "The couple seem to have considered the difficult road ahead". The Authority accepts that treatment by IVF appears to have been in the contemplation of JB, and the affidavit of SB makes this clear. We consider therefore that there was a discussion, albeit limited, about IVF which was in the circumstances sufficient to meet the statutory requirements.

22. The remaining issue relates to the construction of the clause in the will. It is axiomatic that we should start by examining the plain meaning of the words in the context in which they occur. We regard the following features as important. First, it is a testamentary document in which JB was not only making disposition of his estate but, by this clause, expressing his wish for the future use of his stored gametes. Second, he and his wife had sought and been referred for treatment to en able them to have a child. Third, although it is expressed as a direction to his executors, in reality it is an expression of his wishes. For present purposes, we are not concerned with whether the clause could be given testamentary effect. The only question is whether it can be construed as granting the necessary consent. In our view there is no doubt that it can. It is the sort of provision that would only sensibly be made by a man contemplating his death in the near future, and seeking to make his wishes clear. The heading refers not merely to fertility but to "embryology". The clause itself is expressed unconditionally and in the widest terms. It specifies that the material be "available" to SB, in other words available for her unqualified use, thus covering the prospect of her treatment, given the known context, and meeting the terms of paragraphs 6(2) and 2(1)(b) of the schedule. All these factors point unerringly toward JB having given consent to IVF treatment. Consent to use of the gametes for the purpose of IVF must impliedly include consent for the storage of any embryos thereby created, thus meeting also the terms of paragraph 8 of the schedule .

23. Where it is desired to store gametes for a period in excess of ten years for the provision of treatment services there must be written consent of the donor and a medical opinion to the effect that that person was, or may have been likely to become, prematurely infertile ( Human Fertilisation and Embryology (Statutory Storage Period for Embryos and Gametes) Regulations 2009, regulation 4(3)(a) and 4(3)(b) ; and In re Warren [2015] Fam. 1). The clause in the deceased's will, specifying that the material be available to the petitioner for "as long as possible", together with the opinion of the treating oncologist as to the deceased's state of fertility, clearly meet these requirements."

The orders sought by SB were granted therefore, with the precise wording by consent and agreement of the parties (see 24).

Ms A and Ms R & Ors [2020] NIFam 6 A same-sex couple applied for a declaration of parentage in order to ensure that both of their names appear on the child's birth certificate. The court found itself unable to make a declaration of parentage, concluding that both s.42 and s.43 HFEA 2008 did not apply in the instant case. The court held it was also unable to make a declaration of parentage on the basis of social and psychological parentage; could not read s.42 to include couples in an "enduring relationship"; and refused to make a declaration of incompatibility with the ECHR Articles 8 and 14.

The decision involved a lesbian couple, R and A. They wished to co-parent a child, and sought a donor, P, who provided sperm with which in 2014 R conceived the child in question (C), who was born in the same year. A and R were not married or in a civil partnership at the time. R was listed on C's birth certificate as C's mother and only parent. P's name was not on the birth certificate, and crucially nor was A's.

The court had two key applications before it:

1.P's application for contact with C. The court noted that the role P was to play in C's life had not been definitively agreed between the parties. P contended he was to play some sort of part in C's life, including having at least one visit soon after C was born. R and A objected to this which in turn led to P making an application for contact. The court noted that:

"3. Regrettably there was never a written or agreed formulation of what role Mr P would play in C's life e.g. when he would see C, how often he would see C, how he would be introduced to him, how his children would be introduced to him or how he would be known to him. It is appalling that the planning between the adults for something so important and long lasting was so inadequate. People put more care into arranging a holiday than these three adults did for C. To the extent that there were discussions the outcome was incomplete and incoherent."

R and A challenged P's right to seek contact on the basis that he is not C's father in any way which should be recognised by the court. (Note that despite seeking contact, P did not seek to have his name added to C's birth certificate.)

2.A's application for a declaration of parentage under Article 31B of the Matrimonial and Family Proceedings (NI) Order 1989 ("the 1989 Order") naming her as C's second parent, and enabling her to be added to C's birth certificate. R and A subsequently entered a civil partnership, and wished for A to be added to C's birth certificate as a second mother. They argued P was not the natural father of C, and they were C's only natural parents. A sought to argue that a refusal to add A's name to C's birth certificate would be incompatible with her rights, and those of C and R, to family life pursuant to Article 8, and Article 14 insofar as she would be a victim of discrimination based on her status of being other than married or civil partnered. A, supported by R, argued that C was born when they were in an "enduring relationship" which should be officially recognised and respected as being equivalent to a civil partnership or marriage.

Further, A argued that she was a parent to C in the social and psychological sense recognised by Lady Hale in Re G [2006] UKHL 43, and the court should in the alternative make a finding of its own accord that a declaration of parentage is appropriate.

A sought that s.42 of the HFEA 2008 was to be read so as to apply to A even if she was not married to R or in a civil partnership because she was in an "enduring relationship". Alternatively, A sought a finding that s.42 was incompatible with the ECHR Articles 8 and 14, and also a finding that s.43 was incompatible because it required A to have received treatment services through a licensed clinic.

A argued it was not sufficient for her to benefit from any of the orders which might be made under the Children (NI) Order 1995 ("the 1995 Order), such as an order for parental responsibility or a joint residence order with R. Whilst these orders are of some value, A argued that they do not carry the permanence of registration as a legal parent on the birth certificate and are vulnerable to challenge as circumstances change. Nor would it be sufficient for her to become an adoptive parent. A argued she could only have her position recognised adequately if she was declared to be a parent.

The Department of Finance, the UK Secretary of State for Health and the Attorney General resisted these submissions, as did P.

The Law The court considered the HFEA 2008 in detail, including the provisions in ss.42 and 43 (10-22), and the provisions of the 1989 Order (4-5).

It concluded that if A fell within either s.42 or s.43 of the HFEA 2008 and was therefore "treated as a parent of the child" she would be entitled to a declaration of parentage under Article 31B of the Matrimonial and Family Proceedings (NI) Order 1989 ("the 1989 Order"), and in turn able to be registered on C's birth certificate as his second parent.

Sections 42 and 43 of HFEA 2008As A was not R's civil partner until C was born, s.42 did not apply (24).

Further, s. 43 did not apply either because R did not receive treatment from a licenced services provider, and the specified female parenthood conditions in s.43 had not been complied with in any way. This included the fact that A and R had not signed consent forms with a declaration acknowledging that they had received information about different options available, had been offered counselling, understood the implications of their consent, and was aware that the consent could be changed or withdrawn up to a certain point. The court noted that all of this was absent in this case and that "[t]hese consents are not incidental matters, they are fundamental to the process" (24).

ConclusionsThe court noted that:

"29. The 2008 legislation recognises married couples, couples in civil partnerships and unmarried couples in Sections 42 and 43 subject to certain conditions. None of those conditions is one which Ms A could not have complied with. Had she and Ms R entered a civil partnership earlier they would have come within Section 42. Alternatively they could have gone through a licensed clinic and met the demands of section 43. They chose not to do so and now seek to avoid the consequences of their deliberate decisions."

The court declined to read s.42 to include people in an "enduring relationship" as to do so would "open the door wider [] only ends the certainty which the legislation has sought to achieve in this complex and difficult area." (31)

In respect of A's submission that the court should make a declaration of legal parentage for the purpose of Article 31B of the 1989 Order on the basis of social and psychological parentage, the court followed Jackson J in Re G (Unregulated Artificial Conception) [2014] EWFC 1, where the court had concluded the existence or non-existence of psychological parenthood was not an apt subject for a declaration parenthood. In short, the court considered A was "asking much too much":

"32. Providing social or psychological parenting for a child is of enormous importance and value to a child as Lady Hale recognised. However, in my judgment, it is really quite different from what Article 31B contemplates and requires. At different times in a child's life one adult may leave the scene and another one arrive on it. That new adult might become central to the child's well-being and positive development on a long term basis. Wonderful as that is for the child it is not a basis for adding his or her name to the birth certificate."

The court ultimately concluded very strongly that:

"33. Ms A is not and cannot be the natural parent of C. Had she and Ms R taken one of the routes open to them they could have become the recognised legal parents. By failing to do so they have lost that opportunity, at least so far as Ms A is concerned."

In respect of the arguments raised by A regarding compatibility with the ECHR, the court held that whilst Article 8 is engaged and to an extent has been interfered with, the interference is "extremely limited" and justified because:i.As noted above, A had the opportunity to become a legal parent through the routes provided for by s.42 and 43 of the HFEA 2008: "It is not the law which denies second parentage to Ms A. On the contrary it is her failure to take any of the steps open to her by law." (34)

ii.While the interference is necessary to introduce certainty into the complex area of parental relationships, it is limited by the variety and combination of alternative orders which would be able to cement A's place in C's life (i.e. orders for parental responsibility and shared residence which, in the circumstances of this case, are likely to be long lasting in their effect as P was not seeking anything more than some form of contact) (34).

Further, in respect to the submissions that she had been discriminated against contrary to Article 14, the court found against A as the provisions in ss.42 and 43 allowed for recognition of a second parent of a woman who is in a marriage or civil partnership (s.42), or outside of a marriage or civil partnership (s.43). No comparator was found.

A declaration of parentage pursuant to Article 31B of the 1989 Order was declined. No declaration of incompatibility with Articles 8 and 14 of the ECHR were made either.

16/12/20

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Surrogacy and HFEA Update: December 2020 (Part 2) - Family Law Week

Institute of Life-IASO, EuroMediterranean Institute for Quality and Safety in Health Services and Temos Hellas: Certification of clinical results and…

ATHENS, Dec. 9, 2020 /PRNewswire/ --The Institute of Life-IASO, staying committed to its vision for continuous improvement of its procedures and services, has certified its clinical results and success rates.This certification is the first to be issued in Greece.

The certified validation of the Institute's statistical measurements and clinical effectiveness indicators once again establishes Institute of Life- IASOas a point of reference to the international scientific community of Assisted Reproduction Centers.

The certification of results was undertaken by the independent body "EuroMediterranean Institute for Quality and Safety in Health Services" and by Temos Hellas, exclusive agent of Temos International Healthcare Accreditation, after a lengthy procedure to validate statistical indicators and success rates for the Unit. The review was conducted by an age group of women who underwent assisted reproduction and in relation to the method applied to achieve pregnancy.

A special standard was developed for the compliance review procedures in accordance with European Union guidelines on criteria to ensure qualitative and objective statistical reporting, international standards for data verification and the principles of the European Statistics Code of Practice and European Commission Regulation 2017/0048 (COD).

Ms Angeliki Katsapi, Executive Director of the EuroMediterranean Institute for Quality and Safety in Health Services and of Temos Hellas, said: "The verification of the Unit's clinical results focuses on the origin of data and the way they are used in publishing statistical reports and, specifically, to the evaluation of their accuracy, transparency, consistency and comparability. I believe that this innovative certification of clinical results should serve as the beginning of more broadly applied certifications in the sector so that every woman, every couple, are able to obtain full and objective knowledge of the services being offered by health providers."

Mr. Eros Nikitos, Director of the Embryology Lab at the Institute of Life-IASO, noted that: "The certified verification of statistical data of our embryology lab demonstrates in the most reliable manner that we remain true to our vision: To offer the greatest possible chance for a couple to realize its dream. Additionally, the qualitative analysis of data allows us to present to each woman, individually, the realistic possibility of achieving pregnancy based on the specific factors present in each unique case."

The sample reviewed by the Institute's expert scientists, and checked, for its compliance with procedures and data reliability specifications, was drawn from the period November 2018 through November 2019 and verification of data for 2020 is already at its final stages.

bout Institute of Life

Institute of Life, one of the most advanced Assisted Reproduction Centres in Europe, has been created within "Iaso", the largest Obstetrics & Gynecology clinic in Greece and in Southeastern Europe. It was founded by a group of fertility doctors who shared a common dream: to offer patients the best chance of fulfilling their dream of parenthood.

SOURCE Institute of Life-IASO

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Editing the DNA of human embryos could protect us from future pandemics – The Conversation UK

Hollywood blockbusters such as X-men, Gattaca and Jurassic World have explored the intriguing concept of germline genome editing a biomolecular technique that can alter the DNA of sperm, eggs or embryos. If you remove a gene that causes a certain disease in an embryo, not only will the baby be free of the disease when born so will its descendants.

The technique is, however, controversial we cant be sure how a child with an altered genome will develop over a lifetime. But with the COVID-19 pandemic showing just how vulnerable human beings are to disease, is it time to consider moving ahead with it more quickly?

Theres now good evidence that the technique works, with research normally carried out on unviable embryos that will never result in a living baby. But in 2018, Chinese scientist He Jiankui claimed that the first gene-edited babies had indeed been born to the universal shock, criticism and intrigue of the scientific community.

This human germline genome editing (hGGe) was performed using the Nobel-prize winning CRISPR system, a type of molecular scissors that can cut and alter the genome at a precise location. Researchers and policy makers in the fertility and embryology space agree that it is a matter of when and not if hGGe technologies will become available to the general public.

In 2016, the UK became the first country in the world to formally permit three-parent babies using a genetic technique called mitochondrial replacement therapy replacing unhealthy mitochondria (a part of the cell that provides energy) with healthy ones from a donor.

Scientists are now discussing genome editing in the light of the COVID-19 pandemic. For example, one could use CRISPR to disable coronaviruses by scrambling their genetic code. But we could also edit peoples genes to make them more resistant to infection for example by targeting T cells, which are central in the bodys immune response. There are already CRISPR clinical trials underway that look to genome edit T cells in cancer patients to improve anti-tumour immunity (T cells attacking the tumour).

This type of gene editing differs to germline editing as it occurs in non-reproductive cells, meaning genetic changes are not heritable. In the long term, however, it may be more effective to improve T-cell responses using germline editing.

Its easy to see the allure. The pandemic has uncovered the brutal reality that the majority of countries across the world are completely ill equipped to deal with sudden shocks to their, often, already overstretched healthcare systems. Significantly, the healthcare impacts are not only felt on COVID patients. Many cancer patients, for instance, have struggled to access treatments or diagnosis appointments in a timely manner during the pandemic.

This also raises the possibility of using hGGe techniques to tackle serious diseases such as cancer to protect healthcare systems against future pandemics. We already have a wealth of information that suggests certain gene mutations, such as those in the BRCA2 gene in women, increase the probability of cancer development. These disease genetic hotspots provide potential targets for hGGe therapy.

Furthermore, healthcare costs for diseases such as cancer will continue to rise as drug therapies continue to become more personalised and targeted. At this point, wouldnt gene editing be simpler and cheaper?

As we approach the mezzo point of the 21st century, it is fair to say that COVID-19 could prove to be just the start of a string of international health crises that we encounter. A recent report by the UN Intergovernmental Science-Policy Platform on Biodiversity and Ecosystem Services (IPBES) emphasised the clear connection between global pandemics and the loss of biodiversity and climate change. Importantly, the report delivers the grim future prediction of more frequent pandemics, which may well be deadlier and more devastating than COVID-19.

It isnt just more viral pandemics that we might have to face in the future. As our global climate changes, so will the transmission rates of other diseases such as malaria. If malaria begins presenting itself in locations with unprepared healthcare systems, the impacts on healthcare provision could be overwhelming.

Interestingly, there is a way to protect people from malaria introducing a single faulty gene for the sickle cell anaemia. One copy of this faulty gene gives you a level of protection against malaria. But if two people with a single faulty gene have a baby, the child could develop sickle cell anaemia. This shows just how complicated gene editing can be you can edit genes to protect a population against one disease, but potentially causing trouble in other ways.

Despite the first hGGe humans already having been born, the reality is that the technique wont be entering our mainstream lives any time soon. The UK Royal Society recently stated that heritable genome editing is not ready to be tried in humans safely, although it has urged that if countries do approve hGGe treatment practices, it should focus on specific diseases that are caused by single specific genes, such as sickle cell anaemia and cystic fibrosis. But, as we have seen, it may not make sense to edit out the former in countries with high rates of malaria.

Other major challenges for researchers is unintended genetic modifications at specific sites of the genome which this could lead to a host of further complications to the genome network. The equitable access of treatment provides another sticking point. How would hGGe be regulated and paid for?

The world is not currently ready for hGGe technologies and any progress in this field is likely to occur at a very incremental pace. That being said, this technology will eventually come to feature in humanity for disease prevention. The big question is simply when?. Perhaps the answer depends on the severity and frequency of future health crises.

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Editing the DNA of human embryos could protect us from future pandemics - The Conversation UK