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Issue 912 (07 August 2017)


Welcome to BioNews by email, published by the Progress Educational Trust, providing you with news, comment and reviews on genetics, assisted conception, embryo/stem cell research and related areas.

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News Digest




Men, delayed childbearing and age-related fertility decline

07 August 2017

By Caroline Law

Page URL: Appeared in BioNews 912

While media reports regularly remind us of women's biological clocks and warn of the dangers of women leaving it 'too late' to have children, until recently little attention has been paid to the role of men in timing when to have children, and the effect of age on male fertility. However, July 2017 saw a surge of interest in this in mainstream media, following evidence from the Beth Israel Deaconess Medical Center and Harvard Medical School presented at the European Society for Human Reproduction and Embryology's (ESHRE) annual conference. Findings from a study of 18,802 IVF cycles suggest that amongst couples undergoing the procedure, for men over 35 increasing age was associated with lower cumulative incidence of live birth. Outlets including The Guardian, the BBC (including BBC Radio 4) and BioNews picked up on these findings, bringing this discussion into the public domain. The Guardian and the BBC also reported findings from a systematic review, from the Hebrew University of Jerusalem, of recent trends in sperm counts, which reported a decline in sperm concentration and count between 1971 and 2011.

Thus the accepted wisdom that men can continue to have children into later life, easily and without consequence, has been called into question. In some articles, authors blame men's lack of awareness of age-related fertility decline, and lazy or glib attitudes towards having children, either explicitly or implicitly. Alongside this, coverage of recent research (Inhorn, Baldwin, Gurten) on egg freezing suggests that women freeze their eggs because they are not able to find a suitable male partner; there is a 'dearth of eligible men' wherein the number of qualified, professional women is not matched by an equivalent number of qualified, professional men. These accounts have added weight to the idea that men's roles in relationships, in starting a family, and in when to start a family are of crucial importance.

Prior to this, to a large extent media attention had mirrored social science research on the topic: the minimal focus on men being greatly outweighed by a focus on women. This is also reflected in our national data collection: while the Office for National Statistics (ONS) gathers data on women's ages at the birth of their first child, this is not the case for men; for men, a distinction between first and subsequent children is not made, as it is for women. Consequently, while we can track changes in the age at which women are becoming mothers, we cannot track trends in when men are becoming fathers.

Nonetheless, ONS data does suggest that the average age of men at the birth of any children has risen from 31.1 in 1993 to 33.2 in 2015. Research suggests that the majority of men want children, and being an 'older' father isn't something most desire. Men identify certain pre-conditions as necessary before embarking on parenthood, including being in a good relationship with the right partner and someone whom they feel would make a good parent; having financial and material security; and feeling emotionally and psychologically ready. Men's aspirations to be both the breadwinner, as well as a nurturing and involved father, also create added pressures.

However, scientific evidence about the impact of age on men's fertility, while still contested, appears to be a growing. A 2015 systematic review of 90 studies identified age-associated declines in semen volume, percentage motility, progressive motility, normal morphology and unfragmented cells. Elsewhere, evidence suggests that advanced paternal age is also linked with increased risk of infertility, miscarriage and various pathological conditions in offspring. In addition, the 2013 NICE fertility guidelines reported that there was now evidence of declining male fertility with increasing age, for the first time.

All these developments point towards the need to take greater consideration of the role of men in reproductive timings (and in whether, when and why women opt to freeze their eggs) and related research – both social and medical. If age does indeed play a role in men's fertility health, this needs to be taken into account in research, policy and practice.

Finally, we need to question why women's behaviours and reproductive 'choices' are routinely held to account in delayed childbearing, not men's; a greater focus on men will go some way to redress the balance. In 2013 Reproductive Biomedicine Online published a special issue on age-related fertility decline, beginning with the piece 'Cassandra's prophecy: why we need to tell the women of the future about age-related fertility decline and 'delayed' childbearing'. In the lively debate that followed, authors considered whether 'telling' women is sufficient, and grappled with how this complex issue can be addressed. Perhaps the recent media interest in men, age and fertility is a sign that the time for a full and frank debate about talking to men about age-related fertility decline – both women's and men's - will soon be upon us.  



09 October 2017 - by Shaoni Bhattacharya 
Researchers hope that a study detailing the four stages of human sperm stem cell development may shed light on infertility and certain cancers...
14 August 2017 - by Professor Allan Pacey 
Twenty-five years ago, I recall sitting in a journal club in which the collective minds tore apart the then recently published (and still much quoted) meta-analysis by Elizabeth Carlsen, 'Evidence for decreasing quality of semen during past 50 years'. This BMJ paper made the headlines in 1992...

31 July 2017 - by Dr Katie Howe 
Sperm counts of men in developed nations have fallen by 52 percent in the last 40 years...
03 July 2017 - by Shaoni Bhattacharya 
The success of IVF in women under the age of 40 may be affected by the age of their male partners, suggests a US study...
30 May 2017 - by Shaoni Bhattacharya 
A giant scanner has been successfully used to sort 'good' sperm from 'bad'...


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Australian nurse jailed for illegal Cambodian surrogacy

07 August 2017

By Jennifer Willows

Page URL: Appeared in BioNews 912

An Australian nurse has been given a prison sentence after being found guilty of running an illegal surrogacy service in Cambodia.

Tammy Davis-Charles and two Cambodian colleagues were arrested a fortnight after authorities banned commercial surrogacy in November 2016. (see BioNews 879). All three have now been found guilty of recruiting foreign couples and Cambodian surrogates from a clinic in Cambodia's capital, Phnom Penh, and also of faking documents to procure birth certificates for the newborns. They have each been sentenced to 18 months in jail, and fined.

During her trial, Ms Davis-Charles told the court: 'I asked three different lawyers about the law in Cambodia. I was told that there was no law about surrogacy in Cambodia and it was allowed.'

The nurse claimed said that her role was only to provide medical care to the surrogate mothers, but the court was not convinced. 'Tammy Davis-Charles was an intermediary between intended parents and Cambodian surrogate mothers,' said Judge Sor Lina in the ruling.

Ms Davis-Charles, who is originally from Melbourne, ran a surrogacy clinic in Thailand before authorities outlawed the practice in 2015 (see BioNews 791) after which she relocated to Cambodia. She is the mother of five-year old twin boys born via a Thai surrogate, whom she says she has not seen since her arrest.

During the trial, several women who acted as surrogates for Ms Davis-Charles testified that they were not coerced and were paid around US $10,000. It is believed that Australian couples were paying around US $50,000 for surrogacy in Cambodia, approximately one-third of what it would cost in Australia or the US.

When the Cambodian authorities outlawed international surrogacy, they reasoned that it is a form of people-trafficking.  Concerns about exploitation, and scandals such as the 'Baby Gammy' case in Thailand in 2014 (see BioNews 765) have motivated governments across south-east Asia to criminalise commercial and international surrogacy. As well as Thailand, India (see BioNews 866) and Nepal (see BioNews 817) have banned the practice in recent years.

Such is demand that the trade has already moved on to Laos, which currently has no regulations around surrogacy.


29 August 2017 - by Taqdeer Sidhu 
Commercial surrogacy will be permanently banned in Cambodia if a new law drafted by Women's Affairs Ministry is approved...
14 August 2017 - by Julianna Photopoulos 
A number of liberal reforms to the Surrogacy Regulation Bill 2016 have been proposed by India's parliamentary Standing Committee on Health and Family Welfare...

19 June 2017 - by Ryan Ross 
The trial of a nurse accused of running an illegal overseas surrogacy service began in Cambodia last week...
28 November 2016 - by Ryan Ross 
A fertility nurse in Cambodia has been arrested for her involvement in the commercial surrogacy industry, following a recent crackdown by authorities...
07 November 2016 - by Lucas Taylor 
The Cambodian Health Minster Mam Bunheng has published a directive appearing to ban all forms of surrogacy in the country...
13 June 2016 - by Stephen Page 
A parliamentary inquiry into surrogacy laws in Australia has just reported its recommendations, but they don't go far enough and the country is likely to remain the world's largest exporters of intended parents...


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NgAgo is a no-go

07 August 2017

By Rachel Siden

Page URL: Appeared in BioNews 912

The original paper promoting a new genome editing technology known as Natronobacterium gregoryi Argonaute (NgAgo) has been retracted.

The retraction follows repeated failures to repeat the results described. Published in Nature Biotechnology in May 2016, the paper created a media sensation in China when it was suggested that NgAgo could supersede the CRISPR/Cas9 genome editing system.

However, the paper quickly drew widespread criticism as scientists began reporting an inability to reproduce the results.

'Despite the efforts of many laboratories, an independent replication of [our] results has not been reported,' the scientists, led by Dr Chunyu Han of Hebei University of Science and Technology, stated in their retraction notice. 'We are therefore retracting our initial report at this time to maintain the integrity of the scientific record.'

NgAgo appeared to show advantages over the CRISPR/Cas9 system - greater guide stability, reduced off-target editing, and the use of reagents that are easier to synthesise and handle.

But scientists who could not reproduce the results using the described protocols soon began citing their concerns over social media, in blogs, and in published papers. In November 2016, Nature Biotechnology published an expression of concern alongside the paper, presenting a collection of data that challenged the original findings.

Dr Han's team and other independent groups responded by coming to the journal with new data supporting the reproducibility of NgAgo genome editing, but could not sufficiently refute the growing amount of research that continued to challenge the original findings.

'Some of us have even sent visiting researchers to [Dr] Han's laboratory but they were not allowed to perform genome editing experiments involving mammalian cells when they were there,' a team of Chinese and US scientists led by Dr Shawn Burgess of the National Human Genome Research Institute reported in November 2016 to the journal Protein & Cell. 'Consequently, none of them returned with any information confirming Han's data.'

An editorial by Nature Biotechnology concluded: 'We are now convinced that the decision of Han and colleagues to retract the paper is the best course of action to support the integrity of the published record.... When it comes to biology, answers are often not definitive. And when it comes to replication studies, the one thing we know is that it takes time. In the case of NgAgo, the time has come and the data have spoken.'

Though the NgAgo controversy has led to the original paper's retraction, Dr Han and his team have not given up on NgAgo, stating in the retraction notice: 'We nevertheless continue to investigate the reasons for this lack of reproducibility with the aim of providing optimised protocol.'

Retraction Watch | 02 August 2017
Nature News | 03 August 2017
Nature Biotechnology | 02 August 2017
GenomeWeb | 03 August 2017
The Scientist | 21 November 2016
Nature Biotechnology | 02 August 2017


15 February 2016 - by Kirsty Oswald 
The world-renowned Karolinska Institute is at the centre of a scandal surrounding the conduct of stem-cell surgeon Paulo Macchiarini...
07 July 2014 - by Antony Blackburn-Starza 
Nature has retracted two papers published in January on the creation of so-called 'STAP' cells, after all co-authors agreed to the retractions....
25 July 2011 - by Dr Lux Fatimathas 
The journal Science has retracted a controversial paper on the genetics of extreme longevity by scientists at Boston University. The paper, released online last year, was retracted before publication in print following a formal ‘expression of concern’ regarding fundamental technical flaws....
27 September 2010 - by Dr Jay Stone 
Questions continue to be asked after Dr Savio Woo, a gene therapist at the Mount Sinai School of Medicine in New York, was forced to retract two more of his papers last week. Dr Woo has retracted six papers this year after two of his post-docs, Li Chen and Zhiyu Li, were accused of scientific misconduct....


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Israel court postpones judgment on 'discriminatory' surrogacy law

07 August 2017

By Antony Blackburn-Starza

Page URL: Appeared in BioNews 912

An Israeli Supreme Court justice has criticised the country's laws on surrogacy as 'apparently discriminatory', while postponing a long-awaited ruling on a surrogacy petition pending draft legislation.

The case was brought two years ago to allow same-sex couples and single parents to undergo surrogacy in the country. Currently only heterosexual couples can undergo surrogacy in Israel and same-sex couples must enter surrogacy arrangements abroad, which can often involve significant financial costs.

But in his last ruling before his retirement, Supreme Court Justice Salim Joubran said that there was 'no justification to prefer heterosexual parentage to same-sex parents'.

'I find it difficult to accept a situation in which single parents and same-sex couples are prevented from exercising their right to become parents by surrogacy contracts, while their heterosexual counterparts are given that right,' he said.

However, Justice Joubran added that 'the time had not yet come to decide a final decision on the petition,' given that draft legislation was currently making its way through Israel's parliament, the Knesset. 

The court chose to defer its final ruling for six months to give the Knesset time to consider the bill, which intends to give single women access to surrogacy using their own eggs if they are unable to carry a pregnancy for medical reasons.

The bill has passed its first reading but if made into law, it would not assist the petitioners since in its current form the bill does not extend to same-sex couples or single men.

The comments by Justice Joubran in support of widening access to surrogacy could result in further amendments to the bill, however, and the court is yet to issue its ruling.

'On the question of defining eligible parents, I am sure that the lawmakers will heed the continuing suffering of the petitioners and will act with due efficacy to complete the legislative process,' Justice Joubran said.

A previous attempt to introduce legislation to extend surrogacy to same-sex couples in 2014 failed to pass before the Knesset was dissolved (see BioNews 757).

Jerusalem Post | 03 August 2017
Business Standard | 04 August 2017
Haaretz | 04 August 2017
Israel National News | 03 August 2017
Supreme Court: Everyone has a right to a surrogate


09 June 2014 - by Patricia Cassidy 
A bill permitting same-sex couples and single men and women to use surrogacy in Israel has been approved by the Israeli Cabinet. The bill now needs to be passed by Israel's parliament, the Knesset, before it can become law...
03 February 2014 - by Rebecca Carr 
Israel has issued its first passport to a baby born to a Thai surrogate, after the intended parents protested against the Government's refusal to grant the child Israeli citizenship...
16 December 2013 - by María Victoria Rivas Llanos 
The Israeli Health Minister, Yael German, has announced the introduction of a new measure to allow unmarried and homosexual men and women access to surrogacy services in the country...
27 August 2013 - by Ayesha Ahmad 
A court in Israel has rejected a lesbian couple's request to undergo a surrogacy procedure in the country....


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Disease-causing mutation edited out of human embryos

07 August 2017

By Charlotte Spicer

Page URL: Appeared in BioNews 912

Scientists have published their study confirming they are the first to correct a disease-causing mutation in human embryos using genome editing.

The team used CRISPR to successfully correct a mutation causing the often-fatal heart condition, hypertrophic cardiomyopathy (HCM), with significantly improved efficiency and accuracy than previous efforts.

'Every generation on would carry this repair because we've removed the disease-causing gene variant from that family's lineage,' said senior author Professor Shoukhrat Mitalipov of the Oregon Health and Science University, Portland. 'By using this technique, it's possible to reduce the burden of this heritable disease on the family and eventually the human population.'

The scientists used sperm donated by a man carrying a mutation in the MYBPC3 gene, one of the most common causes of HCM. They mixed the sperm with the CRISPR reagents and injected it into eggs from 12 healthy females via intracytoplasmic sperm injection.

The researchers found that just over 70 percent of the 42 CRISPR-injected embryos were successfully edited and contained two normal copies of the MYBPC3 gene. Under normal circumstances, roughly half of the embryos would have the mutation. The gene-corrected embryos developed in a similar manner to control embryos, although they were never intended for implantation.

Interestingly, despite the team introducing a copy of the healthy version of the gene alongside the CRISPR components, they found that the embryos used the maternal copy of the gene as a template for repair instead.

'Our technology successfully repairs the disease-causing gene mutation by taking advantage of a DNA repair response unique to early embryos,' said co-author Dr Jun Wu, at the Salk Institute, California.

Importantly, the scientists used a short-lived version of CRISPR which prevented any further, unwanted editing – known as 'off-target' effects – in the embryos. Injecting CRISPR at the same time as the sperm, instead of shortly after the point of fertilisation when cells are beginning to divide, also meant they avoided previous problems of mosaicism in all but one embryo.

'There is still much to be done to establish the safety of the methods, therefore they should not be adopted clinically,' commented Professor Robin Lovell-Badge of the Francis Crick Institute, who was not involved in the study. He also pointed out that the technique would probably not be able to correct maternal mutations, or even to insert 'more sophisticated genetic alterations.'

'The possibility of producing designer babies, which is unjustified in any case, is now even further away,' he said.

The implantation of edited human embryos is currently illegal in the UK. The HFEA said that high quality public discussion about the ethics of new treatments, expert scientific advice and a robust regulatory system would be crucial if genome editing were to be considered as a new treatment. '[Genome editing] would need to offer new options to couples at risk of having a child with a genetic disease, beyond current treatments like embryo testing,' they said.

Co-author Professor Juan Carlos Izpisua Belmonte of the Salk Institute agreed that scientists will need to proceed with caution as genome editing is still in its infancy.

'Thanks to advances in stem cell technologies and genome editing, we are finally starting to address disease-causing mutations that impact potentially millions of people,' he concluded.

The study was published in the journal Nature.


30 October 2017 - by Dr Rachel Huddart 
A new molecular tool to change individual letters in an RNA sequence may open up new possibilities for gene therapy...
02 October 2017 - by Dr Rachel Brown 
A genome editing technique called 'base editing' has been used to correct the mutation causing the inherited blood disorder beta-thalassemia in human embryos...
25 September 2017 - by Paul Waldron 
UK scientists have successfully edited the genome of human embryos to study the role of a gene key to the earliest stages of development...
04 September 2017 - by Annabel Slater 
A group of scientists have challenged the landmark study which reported the first successful editing of human embryos for a genetic disease...
04 September 2017 - by Eleanor Taylor 
As a scientist working in a fertility clinic, my normal everyday work routine is occasionally punctuated by the ripple effect that occurs when reports of a new groundbreaking reproductive technology enters the public consciousness. I am soon inundated with questions...

31 July 2017 - by Charlotte Spicer 
Scientists in the US may have successfully used genome editing in human embryos to correct disease mutations, according to a report by MIT Technology Review...
13 March 2017 - by Dr Katie Howe 
Chinese scientists have successfully used genome editing to correct mutations in viable human embryos for the first time...
14 November 2016 - by Sarah Gregory 
Researchers have had further success using the CRISPR/Cas9 genome-editing technique to repair the mutation that causes sickle-cell anaemia...
26 September 2016 - by Anneesa Amjad 
A scientist in Sweden has become the first to edit genes in healthy human embryos...
11 April 2016 - by Ayala Ochert 
A second team in China report that they have created genetically modified human embryos, in an attempt to make them resistant to HIV, using the genome-editing technique CRISPR/Cas9...


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International genetics groups advocate germline CRISPR research

07 August 2017

By Dr Greg Ball

Page URL: Appeared in BioNews 912

Research into human germline genome editing should continue, recommends an international group of 11 human genetics organisations.

However, such research should not culminate in human pregnancy until important scientific and ethical questions have been answered.

The joint policy statement comes a day after a report in Nature of the successful correction of a disease-causing gene using the CRISPR/Cas9 genome editing technology in a human embryo, potentially bringing clinical germline editing in humans a step closer.

Although in support of research into editing human embryos or gametes, the statement warns that future clinical application should proceed only if there is a compelling medical need, and sufficient evidence to support its safe and effective use.

Several ethical questions are also highlighted, including potential unknown consequences for future generations, concerns regarding eugenics, so-called 'designer babies', and access to the technology.

'While germline genome editing could theoretically be used to prevent a child being born with a genetic disease, its potential use also raises a multitude of scientific, ethical, and policy questions - these questions cannot all be answered by scientists alone, but also need to be debated by society,' said Dr Derek Scholes, director of science policy for the American Society of Human Genetics.

The statement also supports public funding of in vitro germline genome editing research, which is currently not provided. Professor Kelly Ormond, one of the statement's lead authors, emphasised this point, saying, 'We felt it was really important to say that we support federal funding for this kind of research'.

The American Society of Human Genetics initiated the preparation of the statement, but was keen to include other organisations from around the world due to the global impact of the work, and the fact that research is carried out in many different countries, each with different regulatory frameworks. These included UK organisations the Association of Genetic Nurses and Counsellors and the British Society for Genetic Medicine.

Professor Frances Flinter, consultant in Clinical Genetics at Guy's and St Thomas' NHS Foundation Trust, said: 'The statement is timely and well balanced. There are so many uncertainties and potentially serious risks that it would be extremely irresponsible to embark on any form of germline genome editing that results in a human pregnancy at present. Further research, however, performed in a strictly regulated environment, as in the UK, may yield useful information about potential clinical applications.'


21 August 2017 - by Dr Rachel Huddart 
A new survey suggests that Americans are becoming more accepting of the use of genome editing in humans, and there is strong support for more public involvement in discussions on the technology...

25 January 2016 - by Antony Blackburn-Starza 
We report from the fourth session of annual conference of the Progress Educational Trust, titled 'Germline in the Sand: The Ethics and Law of Engineering the Embryo', which discussed the ethics of human embryo genome editing...
30 November 2015 - by Dr Silvia Camporesi and Dr Lara Marks 
It is important to engage the public in the debate about genome editing as early as possible, and in a way that is as open as possible, to make sure that all possible voices are included...
12 October 2015 - by Dr Silvia Camporesi and Dr Lara Marks 
The UNESCO International Bioethics Committee has released a statement reaffirming an earlier moratorium called by a group of US scientists on the use of CRISPR/Cas9 in human embryos. We argue that the current framing of the debate in terms of dystopic or imagined futures is too narrow and constrains the boundaries of the debate to germline applications...
06 July 2015 - by Cait McDonagh 
The US Congress has released a bill that would prohibit the Food and Drug Administration from spending any money in relation to projects that involve editing the human genome...


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Gene therapy skin grafts for obesity and diabetes

07 August 2017

By Annabel Slater

Page URL: Appeared in BioNews 912

A proof-of-concept study in mice has demonstrated how skin grafts could deliver gene therapy for obesity and diabetes.

'We think this platform has the potential to lead to safe and durable gene therapy, in mice and we hope, someday, in humans, using selected and modified cells from skin,' said senior author Dr Xiaoyang Wu of the University of Chicago, Illinois.

The technique explores the potential of glucagon-like peptide 1 (GLP1), a hormone which could help to treat conditions like diabetes and obesity. GLP1 reduces appetite and stimulates the release of insulin to lower blood sugar, but does not last long in the blood and is challenging to deliver orally.

The researchers used CRISPR to edit skin stem cells taken from newborn mice. They inserted a modified version of the GLP1 gene, designed to increase the duration of the hormone, and a genetic 'switch' to turn the gene on in the presence of an antibiotic.

They grew the skin stem cells into a skin organoid, and grafted them onto mice. When the mice were fed small amounts of antibiotic, they successfully produced modified GLP1, which lasted for three months, and showed higher levels of insulin and lower levels of glucose. 

The researchers also tested feeding the mice a high-fat diet. Compared to controls, the mice with modified GLP1 skin grafts put on less weight.

Dr Wu said the skin graft method could be safer than using engineered viral vectors to edit genes in patient's own tissues, as viruses 'may cause a very strong immune reaction and inflammation in vivo.' He added that lab-grown skin grafts have been used clinically for some time to treat burns, and have been proven safe.

Being able to control the gene expression using a drug would also allow doctors to calibrate how much of the enzyme enters a patient’s bloodstream.

'We think this can provide a long-term safe option for the treatment of many diseases,' Dr Wu said. 'It could be used to deliver therapeutic proteins, replacing missing proteins for people with a genetic defect, such as haemophilia. Or it could function as a metabolic sink, removing various toxins.'

Dr Jeffrey Millman of Washington University, St Louis, who was not involved in the study, told The Scientist that more research would be needed to ensure that neither the genome editing nor the stem cell culturing method inadvertently introduce dangerous mutations.

Genetic Engineering and Biotechnology News | 02 August 2017
New Scientist | 03 August 2017
Cell Stem Cell | 03 August 2017
Science Daily | 03 August 2017
The Scientist | 04 August 2017


30 January 2017 - by Arit Udoh 
Insulin-producing cells from pancreases grown in rats can cure diabetes when transplanted into mice, according to a study...
26 September 2016 - by Hannah Somers 
People carrying a gene variant linked to weight gain can benefit from weight-loss programmes just as much as those without it, research from Newcastle University has shown...
18 April 2016 - by Paul Waldron 
Two new studies report the creation of functioning human beta cells, which can release insulin in response to changes in blood sugar, holding promise for the treatment of diabetes...
27 October 2014 - by Siobhan Chan 
A section of functioning human intestine has been transplanted into mice, giving scientists a new model with which to study intestinal diseases...


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IVF treatment may be restricted to 30-35s

07 August 2017

By Sarah Pritchard

Page URL: Appeared in BioNews 912

Clinical Commissioning Groups (CCGs) in the Bristol region are the first to propose restricting NHS-funded IVF treatment to women aged 30 to 35 years.

Bristol, North Somerset and South Gloucester CCGs are asking for public feedback on the proposal to change their current policy, which says that women up to the age of 40 years can receive fertility treatment on the NHS provided they meet all other eligibility criteria.

In a statement for the CCGs, a spokesperson said that the proposals had been drafted on the basis that 'clinical evidence shows that treatment between the ages of 30-35 offers the highest possible chance of success.'

The CCGs also propose that the prospective father or female partner in the case of a same-sex couple should be younger than 52 years, and that neither partner should have any living children.

The changes are needed to save money to be able to 'live within [their] means', say the CCGs.

The current recommendation from the National Institute for Health and Care Excellence (NICE) is that women under 40 years should be offered up to three cycles of IVF, if they have been trying to conceive for two years.

Elsewhere in the country, CCGs are proposing to cut NHS funding for IVF treatment altogether.

Budget pressures in East and North Hertfordshire, Herts Valley and the West Essex CCG regions have led to proposals to reduce or cut IVF funding completely, and the Southend CCG region is also reviewing its current policy on IVF with a view to making potentially drastic cuts.

Dr Mike Macnamee, chief executive officer of Bourn Hall, a fertility clinic that provides NHS-funded IVF treatment in the Hertfordshire regions, said that there has been no discussion with any CCG so far about how IVF could be delivered more effectively.

'A more integrated approach that would involve GPs and fertility specialists working more closely together would streamline the system, create better outcomes and be more cost-effective for the CCGs,' he said, adding that infertility is a medical condition that 'deserves better diagnosis' at an 'earlier stage'.

The Bristol-area consultation will run until 15 September 2017.


11 September 2017 - by Dr Mary Yarwood 
Cambridgeshire and Peterborough Clinical Commissioning Group has removed funding for free IVF treatment, despite being the county where the procedure was first developed 40 years ago...
14 August 2017 - by Dr Kimberley Bryon-Dodd 
Funding cuts by the UK's National Health Service has meant that 13 areas in England have restricted or halted IVF treatment since the start of 2017, according to Fertility Network UK...

26 June 2017 - by Dr Kimberley Bryon-Dodd 
From November 2017, patients will no longer be able to receive IVF at the Bristol Centre for Reproductive Medicine, Southmead Hospital...
20 March 2017 - by Sarah Pritchard 
Croydon has become the first Clinical Commissioning Group in London to cut funding for all IVF treatment, other than in 'exceptional circumstances'...
27 February 2017 - by Georgia Everett 
Women over the age of 34 will no longer be entitled to receive IVF funded by the NHS in some areas of Nottinghamshire...
20 February 2017 - by Sarah Pritchard 
New proposals from Richmond Clinical Commissioning Group (CCG) could see NHS-funded IVF treatment available only in 'exceptional circumstances', such as for patients with HIV or cancer...


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Event Review: Anne McLaren - Science, Ethics and The Archive

07 August 2017

By Lea Goetz

Page URL: Appeared in BioNews 912

'We're here to have a conversation about the archive,' is how Professor Sarah Franklin from the University of Cambridge introduced the event, 'Anne McLaren: Science, Ethics and the Archive'. Featuring talks and a panel discussion, this evening at the British Library celebrated the life and work of Anne McLaren, one of the UK's leading developmental biologists, who sadly died ten years ago. Anne's early research paved the way for the development of IVF technologies, and she made key contributions to the ethical debates and subsequent regulatory policy surrounding IVF and stem cell research in the UK.

With ambient harp music, soft lights, leather seats – 'very civilized' as the gentleman next to me commented – the evening started with a keynote speech by Baroness Mary Warnock, who worked with Anne on the Warnock committee to decide the future use and regulation of IVF. The memories she shared were told well and spiced with witty comments, which made it fun to listen to as well as full of insight into Anne's personality, and her contributions to the committee. 'The effect that Anne had on the production of the [Warnock] report was incalculable,' said Baroness Warnock. She pointed out that since Anne had been the only embryologist on the Warnock committee, she had contributed most of the science underpinning of the report's recommendations. In addition to her scientific knowledge, Anne McLaren had the 'clearest head' and her ability to think through problems 'kept me [Baroness Warnock] in a healthy mind', during difficult times. Baroness Warnock ended her address by recollecting the six years between the publication of the report in 1984 and the legislation in 1990: during this time she saw herself and Anne as a 'powerful pair of persuaders', who talked to people, and explained the science and ethics.

'[Anne] was our teacher. And she was the best teacher. She somehow managed to inspire, with the most amazing enthusiasm for the subject she was talking about.' It seemed to me that this enthusiasm had sprung over to Baroness Warnock, and now to the audience. Her talk really brought Anne to life and I found myself thinking that this is how amazing people like Anne should be portrayed, with memories from those who knew her. Why just keep an uninspiring archive with childhood items, notebooks and other random stuff?

That the 'stuff' in the archive is worthwhile, however, became very clear through the second speaker. Professor Elizabeth Robertson, embryologist at the University of Oxford, delivered a brief, informative introduction to embryo development, and then took the audience through three experiments Anne performed during the summer of 1965, using one Anne's handwritten laboratory notebooks and photographs from the archive. One experiment was to find out how the embryo synchronizes with the uterine environment. Anne had removed embryos and then re-implanted them in a uterus of the same or different age. She had recorded the performed procedures in minute detail in her notebook through drawings of the embryos, descriptions and comments about the 'plum-puddingy cell mass'. What I liked about Professor Robertson's talk was how enthusiastically she shared the experience of doing benchwork science, so that even non-scientists seemed to enjoy it too. Everyone got to appreciate the beauty of how meticulously Anne had kept her notebook and could see how very interesting the experiments were – an experience which non-scientists could not have had by visiting the archive, as they would probably not have picked up a lab notebook.

The set of talks was finished by a lecture from Chris Hassan, portfolio developer at the Wellcome Trust. He called Anne McLaren an 'archiver's dream', because she recorded her life and work very thoroughly. He set out to list the collection, including notes from high school and university studies, letters, laboratory equipment and personal items from childhood. He pointed out how her tendency to draw images and diagrams, such as in her lab notebooks, became a key way in which she made the point of science and ethics, something which makes her archives very visual. Yet in stark contrast to Baroness Warnock and Professor Robertson, who had met Anne McLaren during their careers, he didn't have a personal connection with Anne. Nor did he seem to have engaged with the collection that he was praising, so the praise felt somewhat empty and boring. And I found myself wondering why they could not have found a different speaker, such as Anne's daughter or scientist colleagues, all of whom were sat among the audience?

Their presence was felt when the Q&A started, as more insight about her personality and her work were shared: Anne's daughter Susan told the audience about the 'charming and very funny' diaries which Anne had kept from a very young age; and a scientist in the audience explained some recent experiments which confirmed data from Anne's experiments that we had heard about earlier, saying 'Anne would have loved that result.'

The audience, about half of whom were aged 60 plus, with a few students and others in-between, also had many questions for Baroness Warnock about the specific recommendations of the Warnock report, such as the 14-day limit, and its reception. Unfortunately, not all the speakers engaged in the Q&A and as a result the questions did not stimulate a discussion, which I thought would only have been appropriate given the interest of the audience and how Anne's contributions to science and policy had stimulated public discussion on IVF at the time. Especially because the 14-day rule is now back up for questioning, it is worth looking back to see how it was decided in the first place, and to consider the scientific reasoning and communication contributed by Anne, which Professor Franklin described as 'I'm a scientist, this is what I think, see what you think'.

The event did well in communicating this approach of Anne McLaren - driven by curiosity and enthusiasm for the subject, with a duty to explain her work and the ethical consequences to the public. It portrayed Anne as a role model, not just for aspiring scientists like myself, and I felt the time spent attending this event had been worthwhile and uplifting. I would recommend anyone with an interest in the scientific process, IVF and the surrounding ethical and political debate to engage with the Anne McLaren archives and become inspired by the life and work of a scientist-citizen role model. Interested readers should also consider attending the second anniversary event, all-day on 12 December, looking at Anne's translational role both within and beyond science, which will be sponsored by the Wellcome Trust.



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Published by the Progress Educational Trust


Public Conference
8 December 2017

Speakers include

Professor Azim Surani

Professor Magdalena Zernicka-Goetz

Professor Robin Lovell-Badge

Sally Cheshire

Professor Guido Pennings

Katherine Littler

Professor Allan Pacey

Dr Sue Avery

Professor Richard Anderson

Dr Elizabeth Garner

Dr Andy Greenfield

Dr Anna Smajdor

Dr Henry Malter

Vivienne Parry

Dr Helen O'Neill

Dr César Palacios-González

Philippa Taylor

Fiona Fox

Sarah Norcross

Sandy Starr


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