Embryo Project Encyclopedia Articles

Human pluripotent stem cells are valued for their potential to form numerous specialized cells and for their longevity. In the US, where a portion of the population is opposed to destruction of human embryos to obtain stem cells, what avenues are open to scientists for obtaining pluripotent cells that do not offend the moral sensibilities of a significant number of citizens? It is this question that the official position paper, or white paper, "Alternative Sources of Human Pluripotent Stem Cells," published in May 2005 by the President's Council on Bioethics under the chairmanship of Leon Kass, seeks to answer. Three experts external to the council, Andrew Fire from the Stanford University School of Medicine, Markus Grompe of the Oregon Health and Science University, and Janet Rossant from the Samuel Lunenfeld Research Institute in Toronto, also reviewed the white paper prior to publication.

Orchiopexy, also known as orchidopexy, is a surgical technique that can correct cryptorchidism and was successfully performed for one of the first times in 1877 in Scotland. Cryptorchidism, a condition where one or both of the testicles fail to descend before birth, is one of the most common male genital birth defects, affecting approximately 2 to 8 percent of full-term male infants, and around 33 percent of premature infants. Typically in the womb, male testes form within the abdomen, then descend into the scrotal area between twenty-five to thirty-five weeks’ gestation. If one or both testicles fail to descend before birth, physicians use orchiopexy to surgically relocate the undescended testes to their normal position in the scrotum. According to many researchers, most cases of cryptorchidism do not resolve on their own, and therefore, orchiopexy surgery is often necessary. Orchiopexy, when performed before puberty, can decrease the risk of testicular cancer and infertility associated with cryptorchidism.

First manufactured in 1988 by Serono laboratories, recombinant gonadotropins are synthetic hormones that can stimulate egg production in women for use in fertility treatments. Recombinant gonadotropins are artificially created using recombinant DNA technology, a technology that joins together DNA from different organisms. In vertebrates, naturally-occurring gonadotropins regulate the growth and function of the gonads, known as testes in males and ovaries in females. Medical professionals can derive female gonadotropins from the urine of pregnant and post-menopausal women, often using it to facilitate in vitro fertilization, or IVF. With the rapid development of assisted reproductive technologies like IVF, demand for human-derived gonadotropins rose to a global yearly demand of 120 million liters of urine by the beginning of the twenty-first century, which resulted in a demand that could not be met by traditional technologies at that time. Therefore, researchers created recombinant gonadotropins to establish a safer and more consistent method of human gonadotropin collection that met the high demand for its use in fertility treatments.

In 2007, Ishola Agbaje, Deirdre Rogers, Carmel McVicar, Neil McClure, Albert Atkinson, Con Mallidis, and Sheena Lewis published “Insulin Dependent Diabetes Mellitus: Implications for Male Reproductive Function,” hereby “Diabetes Mellitus: Implications,” in the journal Human Reproduction. In their article, the authors explore the effects of elevated blood sugar in the form of diabetes mellitus on the quality of male sperm. When investigating possible fertility issues, fertility specialists often study semen, the male reproductive fluid that contains sperm cells to detect changes in sperm count, movement, and structure. In “Diabetes Mellitus: Implications,” the authors use both conventional semen analysis and technical molecular methods to assess the quality of sperm from diabetic and non-diabetic men. The authors found that men with diabetes had higher levels of DNA damage within their sperm and highlighted a need for additional research on the link between diabetes and male reproductive health.

In the twentieth century, researchers developed the oral glucose tolerance test, or OGTT, as a method to diagnose different types of diabetes, a medical condition that causes blood sugar levels to become abnormally high. During the test, a healthcare provider measures a person’s blood sugar levels before and after the person consumes a predetermined amount of glucose solution. While not exclusively used for pregnant women, an OGTT may test for gestational diabetes which, according to the International Diabetes Federation, affected one in six pregnancies worldwide in 2019. Generally, the results from an OGTT can inform a patient and her physician how her body is responding to glucose during pregnancy, and high levels may increase her risk of developing adverse pregnancy outcomes such as heavy bleeding during delivery and a high blood pressure condition known as preeclampsia. An OGTT can help to accurately diagnose, treat, and monitor gestational diabetes in pregnant women, which can reduce health and pregnancy complications for the woman and the fetus.

Transvaginal ultrasound-guided oocyte retrieval, also known as egg retrieval, is a surgical technique used by medical professionals to extract mature eggs directly from the women’s ovaries under the guidance of ultrasound imaging. In 1982, physicians Suzan Lenz and Jorgen Lauritsen at the University of Copenhagen in Copenhagen, Denmark, proposed the technology to improve the egg collection aspect of in vitro fertilization, or IVF. During IVF, a healthcare practitioner must remove mature eggs from a woman’s ovaries to fertilize them with sperm outside of the body. Transvaginal ultrasound-guided egg retrieval is a surgery that can be completed in a medical office setting in twenty minutes. Transvaginal ultrasound-guided egg retrieval increased mature egg collection and rates of successful fertilization, becoming the new standard for egg collection in IVF.

Researchers Geoffrey Sher and Jeffrey Fisch gave Viagra, also known as sildenafil, to women undergoing fertility treatment to test whether the medication could improve fertility and pregnancy rates. The researchers proposed that Viagra, typically indicated to treat erectile dysfunction in men, would help women with a history of failed past fertility treatments by thickening their endometrial lining, which is the layer of tissue in the uterus where an embryo implants during pregnancy. Sher and Fisch gave the women Viagra during in vitro fertilization, or IVF, an assisted reproductive technology. They summarized their findings in the article “Effect of Vaginal Sildenafil on the Outcome of In Vitro Fertilization (IVF) After Multiple IVF Failures Attributed to Poor Endometrial Development,” published in Fertility and Sterility in 2002. Although they noted additional research was needed, Sher and Fisch concluded that the prescribed combination treatment of Viagra and IVF resulted in an increased thickening of the endometrium lining which enabled the embryo to implant and result in a pregnancy.

The Spemann-Mangold organizer, also known as the Spemann organizer, is a cluster of cells in the developing embryo of an amphibian that induces development of the central nervous system. Hilde Mangold was a PhD candidate who conducted the organizer experiment in 1921 under the direction of her graduate advisor, Hans Spemann, at the University of Freiburg in Freiburg, German. The discovery of the Spemann-Mangold organizer introduced the concept of induction in embryonic development. Now integral to the field of developmental biology, induction is the process by which the identity of certain cells influences the developmental fate of surrounding cells. Spemann received the Nobel Prize in Medicine in 1935 for his work in describing the process of induction in amphibians. The Spemann-Mangold organizer drew the attention of embryologists, and it spurred numerous experiments on the nature of induction in many types of developing embryos.

On 9 August 2001, US President George W. Bush gave an eleven-minute speech from his ranch in Crawford, Texas, on the ethics and fate of federal funding for stem cell research. Bush also announced the creation of a special council to oversee stem cell research. In the speech President Bush acknowledged the importance of issues surrounding stem cell research to many Americans, presented different arguments in favor of and opposing embryonic stem cell research, and explained his decision to limit but not completely eliminate potential federal funding for embryonic stem cell (ESC) research. The speech was important to embryology as a field because it determined the US government's policy on funding human ESC research for the eight years of George W. Bush's administration.

Induced pluripotent stem cells (iPSCs) are studied carefully by scientists not just because they are a potential source of stem cells that circumvents ethical controversy involved with experimentation on human embryos, but also because of their unique potential to advance the field of regenerative medicine. First generated in a lab by Kazutoshi Takahashi and Shinya Yamanaka in 2006, iPSCs have the ability to differentiate into cells of all types. If scientists discover how to induce differentiated cells to return to a pluripotent state using a method that leaves the iPSCs safe for transplantation, then patients could receive stem cell transplants with cells containing their own DNA. This would presumably remove the danger of transplant rejection that comes with foreign cell transplantation.