I recently ran across an article by Fiona Macrae written on October 29, 2009 from Mail Online entitled “No men OR women needed: Scientists create sperm and eggs from stem cells”. I proceeded to read this article before I read the actual scientific manuscript that it was based on; the article itself makes several very big claims: 1) the research could change the face of parenthood, 2) the research could be the cure for infertility and 3) it may soon be possible for children to be born through entirely artificial means. For the last few years, there have been several outrageous media outlets that make a practice of taking an interesting scientific manuscript and sensationalizing it as a cure for infertility, etc.

Egg and Sperm Image: Alison Kim

I continued on and read the original scientific paper they were describing in the column, “Human DAZL, DAZ and BOULE genes modulate primordial germ-cell and haploid gamete formation;” an article published in this month’s issue of Nature. It truly is a super paper describing the role the DAZL, DAZ, and BOULE genes play in the progression of embryonic stem cells to primordial germ cells (PGCs) and the subsequent development into a haploid gamete. Interestingly, this group isolated fluorescently-tagged PGCs that were developed from embryonic stem cells in culture (previously shown), but for the first time demonstrated that DAZL, DAZ, and BOULE are upregulated in order to induce these PGCs to begin meiosis and then arrest at early prophase of meiosis I.

What the scientific paper did not describe, or even hint at, was that this science would be a cure for infertility.  What this paper does, however, is attempt to clarify another step in the process of early germ cell formation that may be used as a tool for elucidating critical steps in male and female infertility. There is not one simple solution to infertility. I urge all scientists and non-scientists to be objective about outrageous claims that are made about cures and answers and to read the actual scientific papers and find the true messages behind the science.

Every summer, Teresa Woodruff sends out a summer reading list to the people in her lab. Because there isn’t much of a global perspective on Oncofertility yet, this year’s theme is “Global Perspectives on Reproduction” to prepare, hopefully, to create partnerships with the World Health Organization and other global health organizations.

The reading list will provide a foundation and an entry-point into the existing literature and includes some of the recent papers from the Oncofertility Consortium and, of course, the Oncofertility book by Teresa Woodruff (recently reviewed in the journal Fertility and Sterility — see blog entry dated June 4th).

Here is a copy of Teresa’s list:

1. Woodruff, Teresa K. and Snyder, Karrie Ann Sr.  Oncofertility: Fertility Preservation for Cancer Survivors.  Springer, 2007.

2. Inhorn, Monica C and Van Balen, Frank.  Infertility Around the Globe: New Thinking on Childlessness, Gender, and Reproductive Technologies.   University of California Press, 2002.

3. Ginsburb, Faye D and Rapp, Ranya.  Conceiving the New World Order: The Global Politics of Reproduction.  University of California Press, 1995.

4. Edwards, Jeanette; Franklin, Sarah; Hirsch, Eric; Price, Francis; and Strathern, Marilyn.  Technologies of Procreation: Kinship in the Age of Assisted Conception.  Routledge, 1999.

5. Ellison, Peter T.  On Fertile Ground: A Natural History of Human Reproduction.  Harvard University Press, 2001.

6. Runowicz, Carolyn D., Petrek, Jeanne A. and Gansler, Ted S.  Women in Cancer: A Thorough and Compassionate Resource for Patients and Their Families.

7. Heiney, Sue P., Hermann, Joan F., Bruss, Katherine V., and Fincannon, Joy L..  Cancer in the Family: Helping Children Cope with a Parent’s Illness.  2001.

8. Eyre, Harmon J., Lange, Diane Partie, and Morris, Lois B.  Informed Decision: The Complete Book of Cancer Diagnosis, Treatment, and Recovery.   Viking, 1997.

9. Shenfield, Francoise and Sureau, Claude.  Contemporary Ethical Dilemmas in Assisted Reproduction.  Informahealthcare, 2006.

The American Society for Reproductive Medicine published a review of “Oncofertility: Fertility Preservation for Cancer Survivors” in the May 2009 volume of its journal Fertility and Sterility.

Cover of the Oncofertility book reviewed by Dr. Jared Robins in the journal Fertility and Sterility

Some exerpts from the review by Dr. Jared Robins, Brown University:

• “Oncofertility is a term recently coined by this book’s editor, Teresa K. Woodruff.”
• “In the first chapter of this book, the authors estimate that there are currently over 630,000 young cancer survivors and more than 12,400 are diagnosed each year.”
• “Overall, this book is a comprehensive review of all aspects of the new field of oncofertility. The book is divided into five sections, each devoted to educating the reader about an important aspect of this emerging field.”
• “The concluding chapter is a compilation of stories about real patients’ experiences with fertility and cancer. I commend the editors for including this section because it ties each of the disciplines together with important patient experience.”

To read the entire review, you will need access to Fertility and Sterility through your personal, work, school or library membership: Oncofertility: Fertility Preservation for Cancer Survivors.

Jacqueline S. Jeruss, MD, Ph.D, a breast surgical oncologist and one of the founding oncology members in the Oncofertility Consortium™, and Dr. Teresa K. Woodruff (Thomas J. Watkins Professor of Obstetrics and Gynecology and Director of The Oncofertility Consortium™) have co-authored a paper in the New England Journal of Medicine titled “Preservation of Fertility in Patients with Cancer.” (NEJM 2009; 360:902-911).

The Oncofertility Consortium™ is a nationwide, interdisciplinary and interprofessional group led by Northwestern University researchers, dedicated to the advancement of technologies that will provide improved fertility preserving options to cancer patients whose lifesaving treatments can threaten their fertility. Its goal is to address the scientific, clinical and psychosocial challenges that must be solved to expand the menu of options available and to raise consciousness among scientists, physicians and families about this critical quality of life issue.

Cancer treatments are increasingly successful in improving long term survival. However, these same life saving treatments can impact fertility: fertility preservation has become an important quality of life issue for cancer survivors. Fertility preservation interventions are very effective but must be utilized before cancer treatment can begin. Oncologists, and those who care for young cancer patients, must have the information and resources available to discuss these options with their patients.

This New England Journal of Medicine paper provides a review of the effects of cancer treatment on fertility, the current and future methods of fertility preservation, algorithms for their use in clinical practice and the importance of fertility preservation for in clinical decision-making. Breast cancer treatment is used as template for integration of care. The Oncofertility Consortium is a nationwide network of fertility preservation provider

In a webinar , scheduled for Tuesday, March 3 at 2PM CST, Dr. Jeruss and Dr. Woodruff will discuss the implications of the concepts presented in this paper and the new discipline of oncofertility with moderator Marla Paul.

The Webinar is scheduled for Tuesday, March 3 at 2 PM CST and will be available at http://oncofertility.northwestern.edu/events/webinars.