Clinical Embryology in 21st Century

Scientific Lectures and Reviews

Lopata Alex

Abstract.
The author analyses the achievements of modern embryology such as the use of time-lapse technology in the assessment of oocyte developmental potential. Timelapse technology that consists of a compact inverted videomicroscope placed inside an incubator makes it possible to obtain images of embryos every 5-10 minutes and monitor developing embryos without removing them from the incubator. The obtained morphokinetic data on the division rate and symmetry, the availability of fragmentations make it possible to assess embryo quality, its ability to form a blastocyst and implant into endometrium.
The perspective scientific direction in prevention and management of a range of rare childhood diseases as well as common disorders of aging such as heart diseases, diabetes, Parkinson disease and dementia, the author thinks, is the use of donor’s enucleated oocytes in the presence of abnormalities of mitochondrial DNA (mtDNA ). In cases of abnormalities of mtDNA that are inherited from the mother it is possible to prevent the disease by removing a germinal vesicle (from oocyte) that contains abnormal mitochondria and injecting it into the donor’s healthy enucleated oocyte.
The article contains the data of two meta-analyses dated 2013 on the risks for oncopathology and some neurological disorders in children born by ART. The increased risks for childhood cancers (haematological cancers, central nervous system/neural cancers and others) in children born by ART have been described. A possible mechanism of cancer predisposition in these children may be aberrant imprinting during gametogenesis and embryogenesis. Although the statistical risks are real, it is still unclear whether it is the ART treatment or factors related to the subfertility that are associated with the increased risks. There was no increase of neurological disorders such as autistic disorder and mental retardation in children born following IVF. However an increased risk for neurological disorders was observed when ICSI was used.

Key words:
time-lapse technology, mitochondrial diseases, health of children born following IVF, epigenetic disorders.

Author:
Lopata Alex
e-mail: alex.lopata15@gmail.com
Department of Obstetrics and Gynaecology University of Melbourne, Royal Women’s
Hospital; MB BS PhD
132 Grattan St. Melbourne, Australia