Fertility

One in 8 couples suffer from infertility and for many of these, IVF treatment is their best hope of becoming parents. Demand for treatment has expanded rapidly since the first test tube baby, Louise Brown, was born in Greater Manchester on 25 July 1978 at Oldham General Hospital, for which Robert Edwards was awarded the Nobel Prize in 2010.

Approximately 2% of all births in the UK are now from IVF, with a total of more than 5 million IVF babies born worldwide to date. Despite the increasing availability of treatment, IVF success rates remain relatively low, and there are emerging concerns over the introduction of new technologies and the long term health of children born from IVF.

Funding

The Department of Reproductive Medicine, established in St Marys Hospital in 1983, is considered to be one of the top academic Reproductive Medicine departments in the UK and has an international reputation for research in early embryology. We have been outstandingly successful in attracting external grant funding (>£5 million in the last few years) for infrastructure and scientific programme and project grants from:

  • The North West Development Agency
  • Medical Research Council
  • Technology Strategy Board
  • Department of Health
  • Cancer Research UK
  • EU FP7 Health programme.

Aims

Consequently we host a clinical and academic research programme with the overarching aim of improving the safety and efficacy of assisted conception (IVF) treatment.

Our specific aims are to:

  • Understand the biochemistry and molecular biology of early human embryo development and in particular, the impact of the in vitro environment and IVF technologies.

    We have developed non-invasive metabolomic analysis of embryo culture medium including amino acid profiling as a clinical predictor of developmental competence. We have also used transcriptomic analyses of individual embryos and cells in order to understand the regulation of cell fate (pluripotency, apoptosis, differentiation) by gene networks, transcription factors and signalling pathways including growth factors.

    A major current focus is to understand how cell pluripotency is regulated and gradually restricted during early human development.
  • Use IVF technologies as a model intervention (the only ethically acceptable one) in early human development, in order to understand early programming of child and adult health.

    We have analysed the impact of a number of IVF technologies including oocyte and embryo cryopreservation, parthenogenetic activation of oocytes and growth factor regulation, and are currently investigating the impact of other IVF technology variables such as culture. Our two major areas currently are:
    • pre-clinical assessment of technologies on human embryo development and transcriptome profile
    • the long-term health of IVF children via data linkage studies.
    We are currently conducting the first study of this type in the UK, using the HFEA database of all IVF babies born in the UK from 1991-2009 (>110,000) to follow up birthweight and neonatal and child health.
  • Derive embryonic stem cells from human embryos for use as:
    (a) a model system for the study of early human development
    (b) a source of cells for regenerative medicine therapies.

    Human embryonic stem cell (hESC) research was established in Manchester in 2003 with grants from the MRC and subsequently the North West Development Agency to derive embryonic stem cells suitable for clinical use in laboratories equipped and run at Good Manufacturing Practice (GMP) standards. The NW Embryonic Stem Cell Centre was established in 2005 as a collaboration between CMFT and the University of Manchester, and has to date produced 16 human embryonic stem cell lines, 6 at clinical grade suitable for clinical transplantation. Our major clinical target is the use of hESC-derived chondrocytes in cartilage repair.

The Research programme is directed by Daniel R Brison, the Scientific Director of Reproductive Medicine, an NHS Consultant Scientist, and an honorary Professor of Clinical Embryology and Stem Cell Biology.