Biological and Clinical Aspects of Human Reproduction, November 2006

Yorkshire Branch in association with SETPOINT South Yorkshire

Annual Symposium

Saturday 11 November 2006

Biological and Clinical Aspects of Human Reproduction

Forty-two delegates met at the Stoddart Building, Sheffield Hallam University for the annual symposium held in association with the SETPOINT South Yorkshire Centre for Science Education.

The Chair of the Yorkshire Branch, Professor David Coates, Dean of the School of Life Sciences, the University of Bradford introduced Dr Richard Walton, Reader in Education and Director of SETPOINT South Yorkshire.

Dr Walton welcomed delegates to the centre and set the scene for the day by providing an overview of the aims and objectives of SETPOIINT and the work of the South Yorkshire Centre currently contributing an impressive 28% of total National SETPOINT events as well as actively promoting Science, Technology, Engineering and Mathematics  (STEM) in South Yorkshire.

The objectives of the centre include ensuring that the general public are made aware as early as possible of the “next big thing” by “scanning the horizon” for future technical and scientific developments.  Providing early public awareness and improved perception will enable all citizens to make informed personal decisions on key issues. Routes to achieve this would be included in the afternoon session when delegates would have the opportunity to work with the Democs (Deliberative Meeting of Citizens) programme to explore aspects of Stem-cell research and its implications.

The symposium continued with Professor Ian Cooke, Emeritus Professor of Obstetrics and Gynaecology, Sheffield University and currently Director of Education, International Federation of Fertility Societies presenting “and in vitro fertilisation was only the beginning”.

Professor Cooke described how technological advances in IVF (In-vitro fertilisation) are helping solve 50% of all human fertility problems. Early pioneering work in the UK by Doctors Patrick Steptoe and Robert Edwards made the headlines in July 1978 with the first baby being born following in-vitro fertilisation.

There followed twelve years of public concern which resulted in the formation in 1990-1991 of the Human Fertilisation and Embryology Authority (HFEA), the recent enactment of the EU Tissue Directive will mean that it is likely that the HFEA will merge with the Human Tissue Authority (HTA).

Developments in Intracytoplasmic sperm injection (ICSI) and difficulties in obtaining sperm were reviewed, including commercial aspects of IVF, with Denmark currently having the greatest number of treatment centres.

Details of multiple embryo transfer, egg sharing and posthumous sperm donation, egg, sperm and embryo freezing and the associated therapeutic techniques and implications required to make the process work were reviewed. The traditional concept of mother and father has to be re-written due to IVF, considering the resultant number of possible donor and recipient combinations.

The future of IVF was reviewed including ongoing work to develop pre-implantation Clinical diagnostic techniques with the potential for elimination of certain diseases.  Through the Millennium Development initiative an expansion of IVF into developing countries with low-cost, simplified techniques may help solve some infertility including that due to disease.

The second session entitled “what came first, the chicken or the egg-completing the stem-cell cycle” was presented by Professor Harry Moore, Co-Director, Centre for Stem-cell Biology, Sheffield University. A fascinating in-depth review of the early pioneering work by researchers and the ground-breaking work currently being carried out by the Centre was described.

In summary, Stem-cells are found in most cells of the body and have a specific function. However, when stem-cells divide they have the ability to form any cell of the body or to remain as a stem-cell.

Human embryonic stem-cell biology has a great potential in the future to cure diseases through stem-cell research. Surplus IVF fertilised eggs are taken under fully informed consent at the early stages of development. The inner cell mass is taken out and put into culture with feeder cells. A colony of self-renewed cells is maintained with the potential to actively proliferate to make genetically normal copies of all cells of the body.

Sheffield University is at the forefront of having the first seven stem-cell culture lines available for clinical and research use. Although there has been much recent “hype”, the potential for treatment of illness such as diabetes, repair of nerve cell damage and heart cell repair is predicted to be at least 10-15 years into the future.

The question of stem-cells being able to produce primordial cells was reviewed. During the last 1-2 years multi-potent adult stem-cells have been found to behave in the same way as embryonic germ cells, one implication is that certain child-hood cancers may have their origin in the parent germ cell.

Research into artificial gametes provides an understanding of germ cell development and mechanisms involved, including spontaneous hormone production.   Ultimately leading to clinical applications to investigate the way in which it is suspected that some diseases caused by environmental pollutants can be passed on to the following generations though changes to the stem-cells.

Professor Moore concluded by considering the ethical debate and the need to show that it is safe to treat diseases by stem-cell therapy. Future developments could include transfer of nuclear material back into the sperm or egg to treat infertility prior to transplant into the body.

Dr Paul Bartlett, Yorkshire Branch Vice-Chair, introduced the afternoon sessions. The first event took the form of a Democs workshop led by Mr Mark Windale, Senior Lecturer, Centre for Science Education, Sheffield Hallam University. Delegates were able to take part in a conversation-card based role playing activity. This enabled people to find out about a current scientific or medical topic, form their own opinions, and discuss the topic with other delegates.

Ideally suited to be used in education or within the community the Democs programme is unbiased with each card having a different viewpoint. The results from the activity can be taken to a vote and recommendations forwarded to decision makers or Government.

Currently, discussion topics available include Stem-cell research, GM Food, Climate change, Use of animals in medical research, Vaccinations and Nanotechnology.

The final session entitled “Bone marrow stem-cells-killers or cure” presented by Dr Jennifer Treleaven, Consultant Haematologist, Royal Marsden Hospitals, London.

Dr Treleaven described with examples the pioneering work that is being carried out at the Royal Marsden Hospitals in the treatment of some cancers, leukaemia, lymphoma and bone marrow failure by transplantation of bone marrow derived stem-cells.

The killers referred to in the title are sometimes as a result of side effects including infection, the cure being treatment for haematological conditions.

A bone marrow stem-cell transplant allows a patient to have a much higher dose of chemotherapy and radiotherapy if required, to treat the condition. This is followed by replacement of bone-marrow stem-cells by the transplantation of donor bone marrow stem-cells contained in bone marrow or several blood based sources. Donors can be related, or from an eight-millions strong data-base of prospective donors from fifty-two registries based in thirty-seven countries.

A review of the history of the therapy was provided from the early observations and the increasing understanding from 1960 onwards including advances in tissue typing, and understanding of the Graft-versus-Host Disease (GVHD) during the late 1960s. GVHD is the reaction of the donor’s immune system which sometimes attacks the patient’s body.

The year 1977 saw real advances in transplants, however these could fail for several reasons including, rejection (GVHD), relapse or infection including pneumonia which remains as the most common post treatment infection.

Recent advances include development of new antibiotic, antifungal, diagnostic and medical techniques. Some patients are able to have a family.

Future advances could include improvements to donor/recipient matching, and stem-cell therapy for cardiac patients.

The Yorkshire Branch wishes to thank Sheffield Hallam University for supporting this year’s symposium.

John Dickinson

Branch Committee