January 2023 - Repro Reader
Jan 27, 2023
Author: ASRM
Origin: Repro Reader: An ASRM Community Newsletter
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WELCOME TO REPRO READER–AN ASRM COMMUNITY NEWSLETTER.
WE'RE HAPPY YOU'RE HERE. REPRO READER BREAKS DOWN THE SCIENCE BEHIND REPRODUCTIVE MEDICINE AND MAKES IT ACCESSIBLE FOR EVERYONE. JOIN US QUARTERLY FOR PATIENT RESOURCES, ADVOCACY AND POLICY UPDATES, MENTAL HEALTH TIPS, AND SO MUCH MORE. LET'S GET INTO IT!
COULD YOU EXPLAIN THAT?
Could You Explain That? breaks down complex subjects into easily digestible information
PCOS: Polycystic Ovary Syndrome
According to an international consensus of physicians, sponsored by ASRM and the European Society for Human Reproduction, individuals with PCOS have at least two of the following three characteristics:- Higher than typical levels of testosterone. This can manifest as acne or excessive hair growth, especially around the face (hirsutism).
- Irregular or absent ovulation (release of egg from an ovary). This can manifest as fewer or missing menstrual cycles.
- Polycystic ovaries. This can be seen on ultrasound as a more than usual developing follicles in both ovaries.
Symptoms of PCOS may include irregular menstrual periods, obesity with difficulty losing weight, excessive growth of central body hair (a condition called hirsutism), and infertility caused by absent or decreased frequency of ovulation.
If you are experiencing any of the symptoms listed above, you should consult with your healthcare specialist to discuss treatment options.
Learn more about symptoms, treatment options, options for those actively trying to conceive and more here.
Want to keep the learning going? Check out these two podcast episodes where fertility and OB/gyn experts breakdown PCOS and more:
SART Fertility Experts: PCOS
ASRM Today: PCOS with Dr. Kathleen Hoeger
NEW & NOTABLE
New and Notable is an ASRM member provided content section related to research and innovation in the field of reproductive medicine, Q&A style.
For our inaugural edition of Repro Reader we spoke with Paula A mato, MD, MCR, about her work on mtDNA. Dr. Amato is a Professor in the Department of Obstetrics & Gynecology and a Director of the Division of Reproductive Endocrinology & Infertility at Oregon Health & Science University. She is also our current ASRM President-Elect.
For our inaugural edition of Repro Reader we spoke with Paula A mato, MD, MCR, about her work on mtDNA. Dr. Amato is a Professor in the Department of Obstetrics & Gynecology and a Director of the Division of Reproductive Endocrinology & Infertility at Oregon Health & Science University. She is also our current ASRM President-Elect.
Q - What do you do at Oregon Health & Science University?
A - I am a Professor of Obstetrics & Gynecology and Director of the Division of Reproductive Endocrinology & Infertility. I also currently serve as president-elect of ASRM 😊
Q - What is mtDNA?
A - mtDNA is the DNA found within mitochondria. The mitochondria are the energy powerhouses of the cell. There are many thousands of copies of mtDNA within each cell. Unlike nuclear DNA, which encodes for most things we consider traits and we inherit from both parents, the mtDNA is inherited exclusively from our mothers. Mutations in the mtDNA can lead to serious mitochondrial diseases.
Q - What are the current research projects you are working on surrounding mtDNA?
A - Our laboratory, led by Dr. Shoukhrat Mitalipov, developed a technique called mitochondrial replacement therapy (MRT) which involves transferring the nuclear DNA from one egg (leaving the mutated mtDNA behind) into a donor egg (with healthy mtDNA) that's had its nuclear DNA removed. The reconstituted egg is then fertilized with sperm to form an embryo and then eventually a baby. The embryo would contain DNA from three different individuals. This technique could prevent the transmission of mitochondrial diseases from mothers to their children.
Q - How will this research advance reproductive healthcare?
A - More recently we have been investigating whether MRT (or more correctly cytoplasmic transfer ie replacing the entire cytoplasm of an egg) may be an efficient treatment for age-related female infertility. We know that IVF pregnancy success rates decrease with advanced maternal age due to decreases in egg number but also egg quality. The idea is that this nuclear transfer technology (also called enucleated oocyte donation) would hopefully improve reproductive outcomes while maintaining a genetic relationship between the embryo and both intended parents.
Although there have been several babies born throughout the world via MRT and it appears safe, it is very important that randomized clinical trials be conducted to determine efficacy before this "add-on" becomes widely practiced in the field. Unfortunately, due to NIH funding restrictions and FDA regulatory barriers, we are unable to conduct these much-needed clinical trials in the United States.
A - I am a Professor of Obstetrics & Gynecology and Director of the Division of Reproductive Endocrinology & Infertility. I also currently serve as president-elect of ASRM 😊
Q - What is mtDNA?
A - mtDNA is the DNA found within mitochondria. The mitochondria are the energy powerhouses of the cell. There are many thousands of copies of mtDNA within each cell. Unlike nuclear DNA, which encodes for most things we consider traits and we inherit from both parents, the mtDNA is inherited exclusively from our mothers. Mutations in the mtDNA can lead to serious mitochondrial diseases.
Q - What are the current research projects you are working on surrounding mtDNA?
A - Our laboratory, led by Dr. Shoukhrat Mitalipov, developed a technique called mitochondrial replacement therapy (MRT) which involves transferring the nuclear DNA from one egg (leaving the mutated mtDNA behind) into a donor egg (with healthy mtDNA) that's had its nuclear DNA removed. The reconstituted egg is then fertilized with sperm to form an embryo and then eventually a baby. The embryo would contain DNA from three different individuals. This technique could prevent the transmission of mitochondrial diseases from mothers to their children.
Q - How will this research advance reproductive healthcare?
A - More recently we have been investigating whether MRT (or more correctly cytoplasmic transfer ie replacing the entire cytoplasm of an egg) may be an efficient treatment for age-related female infertility. We know that IVF pregnancy success rates decrease with advanced maternal age due to decreases in egg number but also egg quality. The idea is that this nuclear transfer technology (also called enucleated oocyte donation) would hopefully improve reproductive outcomes while maintaining a genetic relationship between the embryo and both intended parents.
Although there have been several babies born throughout the world via MRT and it appears safe, it is very important that randomized clinical trials be conducted to determine efficacy before this "add-on" becomes widely practiced in the field. Unfortunately, due to NIH funding restrictions and FDA regulatory barriers, we are unable to conduct these much-needed clinical trials in the United States.
REPRODUCTIVE HEALTH POLICY
- 2023 welcomes in a new congressional leadership. An update on where ASRM stands regarding reproductive health policy here.
- On December 20th, Senator Tammy Duckworth (D-IL) asked unanimous consent for the Senate to consider and pass the Right to Build Families Act.
- Watch this space for updates on reproductive health policy from ASRM.
THE BIG QUESTIONS
Big Questions will tackle ethical or legal dilemmas involving reproductive medicine.
Here's how it works:
For example: Send us a DM with your question on this quarter's topic, "What are the ethical implications of genetic testing?" And that's it! Our Ethics Committee will respond in our next edition.
Head over to our Instagram and submit your thoughts via DM!
Here's how it works:
- We will provide a topic in each newsletter.
- You will submit your thoughts, questions, and reactions to our Instagram.
- Our ethics committee will respond to them in our next edition of Repro Reader.
For example: Send us a DM with your question on this quarter's topic, "What are the ethical implications of genetic testing?" And that's it! Our Ethics Committee will respond in our next edition.
Head over to our Instagram and submit your thoughts via DM!
TEST YOUR KNOWLEDGETHE BIG QUESTIONS
COMPLETE THE PCOS CROSSWORD!
ACROSS
2. Can help lower the risk of developing diabetes or metabolic syndrome
3. Can lower androgens and control the menstrual cycle
5. The predominant sex hormone in men and cause “male” sex characteristics
7.Caused by high levels of androgens and lack of ovulation
8. Medication that induces ovulation
2. Can help lower the risk of developing diabetes or metabolic syndrome
3. Can lower androgens and control the menstrual cycle
5. The predominant sex hormone in men and cause “male” sex characteristics
7.Caused by high levels of androgens and lack of ovulation
8. Medication that induces ovulation
DOWN
1. Excessive hair growth, especially around the face
4. Release of egg from an ovary
6. A symptom of PCOS
1. Excessive hair growth, especially around the face
4. Release of egg from an ovary
6. A symptom of PCOS
You can also complete the crossword puzzle online by clicking here.
Scroll to the end of the newsletter for answers.
ALL ABOUT THE FEELS
Preparing for the Journey: 5 Steps You Can Take to Mentally Prepare for IVF
- Plan for the best but prepare for the worst. Listen to your doctor and set expectations for success based on those conversations. Remember: IVF can be a distance run, not a sprint.
- Form your support circle before you start. Think about who is going to be in your circle and how much you want to share with them depending on what your IVF outcome could be, whether positive or negative.
- If you are starting IVF with a partner, strategize your communication beforehand. Make sure you are both setting aside time to talk together. Our mental health professionals recommend the 15-Minute Rule – set aside 15 minutes to talk about how IVF is affecting you and then move on to different topics once time is up so you don’t dwell on the challenging aspects of IVF longer than you need to.
- Fatigue is one of the biggest complaint our doctors see from patients undergoing IVF. Set yourself up at work and home to make sure you aren’t under added stress during your IVF cycle. That can include not scheduling work projects during your cycle and/or meal prepping food to have ready in your freezer.
- Identify things that make you feel cared for so you will have things to look forward to while you are in your IVF cycle. That can be a new show/book you’ve been wanting to dive into, a manicure/massage, or a dinner at your favorite restaurant.
PATIENT SUPPORT
These organizations help to empower, educate, provide financial assistance, and advocate patients struggling with infertility. - The Broken Brown Egg - The Broken Brown Egg exists to empower, inform, and advocate for those questioning or experiencing the impact of infertility, with an emphasis on the Black experience of it.
- Men Having Babies - Men Having Babies, Inc. is a nonprofit organization that offers guidance, advocacy and financial assistance for current and future gay surrogacy parents.
Crossword Answers: 1. Hirsutism 2. Metformin 3. Birthcontrol 4. Ovulation 5.Androgens 6. Acne 7. Cyst 8. Letrozole
We'd love to hear your feedback on the Repro Reader!