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IVF Australia was seeking to develop a unified look across their 4 regional sites in which each have their own strengths and identity. Mitochondrial genes are inherited from our mothers’ eggs and passed on through her daughters to subsequent generations. The UK government has announced its intention to draft proposals allowing carriers of mitochondrial disease to have babies using a controversial IVF treatment that’s currently prohibited. The draft proposals will detail the regulation of the procedure and need to be endorsed by public consultation and parliament before being put into practice. Mitochondrial DNA diseases offer distinct challenges to scientists and clinicians because we inherit our mitochondrial DNA in a different manner to our chromosomal genes. Mitochondrial genes are located in very small bodies called mitochondria and not with the chromosomes in the nucleus of the cell, which determine characteristics such as hair and eye colour. If one of these genes is mutated, the individual may suffer from very debilitating diseases that affect, for example, muscle and nerve function. The dilemma for a woman who carries mitochondrial DNA disease is that she doesn’t know how much damaged mitochondrial DNA is present in each of her eggs; each of these eggs is likely to have a different amount of mutation. So, if she and her partner choose to have a family, they will have no idea of the outcome – for them, it’s simply a matter of chance. Scientists are now developing two approaches to try and prevent children from inheriting these diseases.
The first of these techniques will transfer the mother’s chromosomes from one of her eggs into an egg from a donor. Then, as with normal IVF treatment, the eggs are fertilised with her partner’s sperm and the resultant embryo can develop for a few days in the lab before being transferred to the chromosomal mother to implant into her womb. The second technique is similar but would first allow the partner’s sperm to fertilise the egg and then transfer the mother’s and father’s chromosomes to a healthy (empty apart from mitochondria) donor egg. Some groups argue that scientists are entering the brave new world of designer babies and that these techniques are similar to cloning. Others argue that the technologies offer significant benefits, such as the potential to eradicate mitochondrial diseases. In many respects, UK scientists are at the forefront of convincing government to legalise these procedures under the control of the country’s fertility regulator, the Human Fertilisation and Embryology Authority. In the last two years, there have been two significant reports supporting these procedures but they contained important reservations. If further research shows these techniques to be sufficiently safe and effective, we think it would be ethical for families to use them if they wished to, provided they receive an appropriate level of information and support. The Human Fertilisation and Embryology Authority sought public views on behalf of the secretary of state for health and reported in late March, 2013. These reservations are important because they are directed to two key aspects of the procedures. This is very important as even a small amount of mutant mitochondrial DNA in the egg can become the dominant population in the baby and lead to mitochondrial disease.
The second is whether these techniques would lead to the baby suffering from any harmful side effects. While I fully embrace these new approaches to fight mitochondrial disease, we still need to make significant advances in determining their safety and effectiveness, and they require a considerable amount of validation. If they pass these tests, these technologies offer ways to prevent mitochondrial genetic disease from being passed from a female to her descendants through one round of assisted reproduction. Scientists found that malaria parasites resistant to antimalarial Atovaquone cannot survive inside their mosquito host.
Should the government pay to bring new babies into the world who otherwise wouldn’t have existed?
Ideas for Australia: Rethinking funding and priorities in IVF – should the state pay for people to have babies?

Repromed has the most active and successful research and development programs in South Australia. Development of metabolomic testing (BeSST embryo selection) of embryos to assist our laboratory team in selecting the highest quality embryos for transfer. Development of embryo glue culture media, giving you a higher chance of a successful pregnancy outcome.
Development of the Egg Timer Ovarian  Reserve Test (AMH) in 2004, which is now widely used by many IVF clinics in Australia.
Repromed are thrilled to launch our new cutting edge embryo genetic screening technology Embryo Screen.
Screening for aneuploidy before an embryo transfer increases the likelihood of selecting the embryo(s) with the best chance of implanting while also reducing the rate of miscarriage or chances of a pregnancy of a baby with a genetic condition. Cryopreservation is an integral part of an IVF program and allows patients to store oocytes or surplus embryos for subsequent treatment. The embryo(s) chosen for transfer is routinely selected by an IVF scientist based on the embryos’ development and morphology.
The TUNEL test determines the health of the sperm by measuring the level of damage to the DNA. A woman is born with approximately 1 million eggs and during her reproductive life, this number will decline as they are lost through natural attrition and ovulation. The genomics research project will focus on cumulus cell viability markers of oocyte quality to predict the likelihood of pregnancy success and in turn to increase the numbers of single embryo transfers and successful pregnancies (live birth rates) while decreasing multiple births.
I refreshed the online identity of IVF Australia with the following principles: Fresh, modern, honest and truthful. John receives funding from NHMRC, which looks at mitochondrial mutations and previously held a grant from the UK MRC, which looked at cloned embryos and mitochondrial inheritance. We use a Creative Commons Attribution NoDerivatives licence, so you can republish our articles for free, online or in print.
The procedure is controversial because the babies will inherit DNA from three genetic parents. Our mitochondrial genes are passed down from our mothers’ eggs and on through her daughters to subsequent generations. Our cells use this form of energy for their everyday functions; mitochondrial genes are essential to this process. There are an increasing number of diseases that are associated with these mutations including diseases we hear about everyday, such as diabetes and Alzheimer’s disease. Also, there’s no simple genetic test that can be used to tell the carrier whether her child would be affected.
The donor egg would have had its chromosomes removed but retains its healthy mitochondrial DNA.
These are the chromosomes that the mother and father contribute, as is normal following fertilisation. The first is whether any of the mutant mitochondrial DNA accompanies the chromosomes as they are transferred into the donor egg.
It allows IVF scientists to confirm the correct genetic material (number of chromosomes) is present in an embryo being transferred. At Repromed embryos are frozen using a specialised method of rapid freezing known as vitrification which is different to the traditional method of slow freezing.
At Repromed, selection of an embryo for transfer may now include assessment of the metabolic health of your embryos.
Recently several advanced sperm selection techniques including High Magnification Sperm Selection have been developed. Smoking, alcohol, heat, some chemicals and other factors such as paternal BMI and age, can damage the DNA in sperm cells.

The rate of loss varies between women and it is estimated that 10% of women will have accelerated loss. It contains a combination of antioxidants that are thought to promote male fertility and therefore increase pregnancy chances. The project will use cumulus cell gene expression to select a single embryo for transfer based on the genetic information of the cumulus cells which surrounded the oocyte the embryo was derived from. Data analysis from the last two years from our laboratory has shown that pregnancy rates from a fresh embryo transfer in young women do not improve when more than four eggs are collected.  An increase in the number of eggs does not translate into increased fresh pregnancy rates, but does increase the risk of complications such as Ovarian Hyper-Stimulation Syndrome (OHSS) and may interfere with egg and endometrial quality. This is beneficial as it allows the Scientists to further monitor your embryos and choose the most advanced one for transfer. The introduction of day 4 and day 5 vitrification has led to improved survival and pregnancy rates compared to the previous blastocyst slow freezing. To do this, the media solution used to culture your embryo is assessed to determine the quantity of specific nutrients consumed by the embryo which have been shown to relate to embryo viability. High Magnification Sperm Selection requires the sperm to be assessed under a much higher magnification to examine features that are thought to be predictive to sperm health.
This increase in DNA damage may influence a couple’s ability to fall pregnant as TUNEL is correlated with pregnancy success.
The ovarian reserve or number of eggs remaining can be estimated by a single blood test which measures a woman’s Anti-Mullerian hormone (AMH).
Menevit is the only male preconception supplement clinically shown to help with pregnancy rates and was designed in conjunction with one of Repromed’s Specialists, Associate Professor Dr Kelton Tremellon.
This test will be particularly important for those patients who are to receive a single embryo at transfer but have multiple embryos with similar developmental rates and morphological appearance available on the day of transfer.
This extended culture and transfer technique that Repromed uses has been proven by Level 1 Medical Evidence to result in higher pregnancy rates.
This cryopreservation program also provides a viable option for cancer patients needing to preserve their fertility. Therefore a TUNEL test is performed in conjunction with a routine semen analysis and provides additional information as to the quality of the sperm. This gives an indication of the likely fertility status of a woman to give an estimate of the Ovarian Reserve.
The test is completely non-invasive to the oocyte as it utilises the cumulus cells collected prior to insemination when they are routinely removed. BeSST enables us to more accurately pick the best embryo for transfer based on its metabolic health and has significantly increased pregnancy success rates.
As Repromed is interested in the DNA of live (motile) sperm, the semen is washed to isolate the motile sperm from a preparation. The initial design and validation of the AMH test for ovarian reserve was performed in conjunction with Repromed staff and Repromed is the only IVF clinic in South Australia to perform this testing on-site. The cumulus cells then undergo genetic testing of candidate genes already associated with the primary outcomes of the project: pregnancy success resulting in live birth and health outcomes of the babies born. This selection method is used in conjunction with embryo development and morphology in patients with multiple good quality embryos available for transfer. Each oocyte and embryo is tracked individually throughout culture and the gene expression profile of the cumulus mass from each oocyte can then be used to predict the likelihood of a successful, healthy pregnancy resulting in a live birth.

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