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- 2015 Course: Week 2 Lecture 1 Lecture 2 Lab 1 | Week 3 Lecture 3 Lecture 4 Lab 2 | Week 4 Lecture 5 Lecture 6 Lab 3 | Week 5 Lecture 7 Lecture 8 Lab 4 | Week 6 Lecture 9 Lecture 10 Lab 5 | Week 7 Lecture 11 Lecture 12 Lab 6 | Week 8 Lecture 13 Lecture 14 Lab 7 | Week 9 Lecture 15 Lecture 16 Lab 8 | Week 10 Lecture 17 Lecture 18 Lab 9 | Week 11 Lecture 19 Lecture 20 Lab 10 | Week 12 Lecture 21 Lecture 22 Lab 11 | Week 13 Lecture 23 Lecture 24 Lab 12 | 2015 Projects: Three Person Embryos | Ovarian Hyper-stimulation Syndrome | Polycystic Ovarian Syndrome | Male Infertility | Oncofertility | Preimplantation Genetic Diagnosis | Students | Student Designed Quiz Questions | Moodle page
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Week 1 Assessment
1) PMID 18603501
Increased Progesterone/Estradiol Ration on the Day of hCG Administration Adversely Affects Success of In Vitro Fertilisation-Embryo Transfer in Patients Stimulated with Gonadotropin-releasing Hormone Agonist and Recombinant Follicle-stimulating Hormone
This study examines the influence of premature luteinisation, with respect to ovarian response, during IVF. This was done using gonadotropin-releasing hormone agonist (GnRHa) and recombinant follicle-stimulating hormone (rFSH).The study defined premature luteinisation as a ratio between progesterone and estradiol of greater than one, the day hCG was administered. The experimental group of prematurely luteinised was then compared to the non-prematurely luteinised groups.
The study was performed on 311 infertile couples, in which a total of 339 cycles of ovarian hyperstimulation with GnRHa and rFSH. The females studied were aged from 20 to 40 years, and did not undergo cycles incorporating hMG, nor did they receive oocyte donations. The patients underwent ovarian stimulation, a long stimulation protocol of GnRHa therapy, rFSH administration as well as transvaginal oocyte retrieval, respectively. hCG was administered after adequate follicular maturation and oocytes were obtained 35-37 hours after hCG administration using transvaginal aspiration with ultrasound assistance. The follicular fluids and follicular washes were examined using a dissecting stereomicroscope that was incubated at 37 degrees with 5%CO2. Sperm insemination procedures were also performed, after which the oocytes were inseminated with spermatozoa. The oocytes were removed after 2 hour exposures to the spermatozoa and cultured in fresh IVF medium. The control group underwent ICSI procedures, while the experimental group underwent IVF procedures. The oocytes were then cultured and assessed for pronuclei presence 16-18 hours incubation in order to determine fertilisation (presence of 2 pronuclei). Embryos were then cultured and classified, as were the blastocysts.
The study found 137 out of the 339 cycles to have premature luteinisation. Poor ovarian response was more common in the experimental group. It was also found the the experimental group had a higher progesterone level and lower E2 level on the hCG administration day. However the mean luteinising hormone on day 6 of stimulation was similar in both control and study groups but higher in the control group on hCG administeration day. The experimental group demonstrated a lower number of oocytes obtained, and lower number of mature oocytes recovered. It should be noted that fertilisation rates were similar in both groups. Embryo number was lower for the experimental group compared to the control group. 130 gestational sacs were demonstrated after a transfer of 577 embryos in the control group while 76 gestational sacs were demonstrated out of 339 embryo transfers in the study group. The non-prematurely luteinised group and prematurely luteinised group had similar implantation rates. It was also found that 48.5% of the non-prematurely luteinised group achieved clinical pregnancies while 36.6% of the prematurely luteinised group achieved clinical pregnancies.
2) PMID 21793811
Impact of endometriosis on in vitro fertilization and embryo transfer cycles in young women; a stage-dependent interference
Due to the significantly higher prevalence of endometriosis in infertile women as compared to the general population, a causal relationship between endometriosis and infertility has been postulated. In vitro fertilisation and embryo transfer (IVF-ET) has been considered a suitable treatment for patients with a history of endometriosis. This study examines the effect of endometriosis on IVF-ET cycles on women younger than 35 years of age and who have had surgical treatment for endometriosis without clinical recurrence signs. The endometriosis group was compared to another group of patients also undergoing IVF-ET, but with tubal infertility without clinical signs of endometriosis. The results were analysed according to the different stages of endometriosis as classified by the American Society for Reproductive Medicine.
The experimental group consisted of 148 patients whereas the control group (tubal infertility patients) consisted of 72 patients. All groups consisted of patients that were less than 35 years of age and did not have clinical indication for any other cause of infertility. The experimental group underwent 164 IVF-ET cycles while the control group underwent 80 IVF-ET cycles. Patients received a long-acting down-regulation drug regime, a daily subcutaneous FSH dose, as well as gonadotropin doses which were decided individually according to age, basal FSH, ovarian volume and ovarian response. After two or more follicles reached maximal diameter of 17-18mm, hCG was administered and oocytes were obtained 36 hours later using vaginal ultrasonography, to then be fertilised on the same day. Embryo transfers were made two to three days after oocyte retrieval. Natural progesterone in oil was then administered. Plasma beta-hCG values were used to assess pregnancy. Clinical pregnancy was determined when at least one gestational sac was found with a fetal pole and heart activity through ultrasond.
It was found that the experimental group had significantly lower numbers of follicles on the hCG day, oocytes obtained and transferred when compared to the control group, despite receiving a higher FSH dose. However no significant differences were found regardingt cycle cancellation rate, peak E2 levels of the length of the stimulation phase. 11.6% of clinical pregnancies per started cucle were observed in the experimental group as compared to 22.5% in the control group. However, this value wa not significant when the clinical pregnancy rate was considered per oocyte retrieval or per embryo transfer. It was also found that patients at stage I-II of endomtriosis had a significantly lower rate of fertilisation when compared to the control group patients. Patients at stage III-IV of endometriosis had a large reduction in pregnancy rate than the control group, however the fertilisation rate was comparable. Patients at stage III-IV had lower peak E2 concentrations, less follicles on the hCG day, fewer oocytes at retrieval and lower implantation rates. Furthermore, poor ovarion responses in 15 out of 109 cycles resulted in discontinuation of the cycle in patients at stage III-IV of the endometriosis group, compared to 2 of 55 in the stage I-II group and 3 of 80 in the control group.
--Mark Hill (talk) 14:08, 16 September 2015 (AEST) These are good summaries of the se 2 articles. You should make an effort to clearly identify what you have written as opposed to quoting directly from the paper.(5/5)
Week 2 Assessment
Week 3 Assessment
PMID 26074966 <pubmed>26074966</pubmed>
PMID 20416867 <pubmed>20416867</pubmed>
PMID 23873146 <pubmed>23873146</pubmed>
The three key pathways by which the incidence of OHSS has been curtailed involve identifying risk factors to predict OHSS development, modifying treatment regimes on the basis of the identified risk factors and intervention to prevent progression to OHSS once the patient has undergone Controlled Ovarian Stimulation.
1) Risk factors
Primary: Preexisting factors likely to exacerbate the ovarian stimulation response. Include: young age, low body weight, history of elevated response to gonadotropins, Polycystic Ovary Syndrome (PCOS), isolated PCOS characteristic or a previous history of OHSS. Anti-Mullerian Hormone markers (AMH) are a newly developed predictive tool with a sensitivity of 90.5% and specificity of 81.3%. Ultrasonographic markers including antral follicle count PMID 26074966
Primary: a) Gonadotropins: reduce duration, reduce dose, avoid GnRH Agonists PMID 23873146
b) Use Metformin Therapy
c) Target Unifollicular Ovulation
d) Avoid hCG
e) In Vitro Maturation
Secondary: a) Reduce hCG dose
c) Cryopreservation of Embryos
d) Cancel Cycle
e) Use alternative Agents
Week 4 Assessment
--Mark Hill (talk) 14:20, 16 September 2015 (AEST) Three negative questions. Q1 An interesting range of options. I suggest that your question might be more instructive. The incorrect option (zona pellucida binding protein 1) is a bit of a give away as why would the oocyte make this protein? A student using simple logic (rather than knowledge) may get this right. Q2 A little simplistic, as we spent some time on ZP sperm binding. Q3 has too simple options and is not well structured. (7/10)
Week 5 Assessment
What is the difference between gastroschisis and omphalocele?
Gastroschisis and Omphalocele are both congenital abdominal wall defects. Omphalocele is a condition involving the umbilical ring whereby the internal organs, typically consisting of the small intestine, colon, liver and spleen, are disemboweled in a sac made of peritoneum, Wharton's jelly and amnion. Gastroschisis is an anterior abdominal wall defect often located to the right of the umbilical cord, where like Omphalocele, there is a protrusion of the bowel. However, in Gastroschisis there is no sac covering the herniation. As such, both conditions defer with respect to location and presence of a sac. Omphalocele is caused by an abnormality in the embryo before week 9 of gestation whereby the bowel loops are malrotated or non rotated and do not return to the abdominal cavity. There are several competing theories as to the cause of Gastroschisis. A leading hypothesis suggests that Gastroschisis results from the inability of the vitelline structures and yolk sac to be incorporated into the body stalk.
Gastroschisis and Omphalocele represent the two most common abdominal wall defects. Gastroschisis is more common of the two and occurs at a rate of one per 600 live births. Omphalocele occurs in about one in 3000 to 10000 live births. Whilst the incidence of Omphalocele is stable, the incidence of Gastroschisis appears to be increasing. It is suspected that this may be due to better technology and screening methods. The male to female ratio of Omphalocele is 1:1.5 while the male to female ratio of Gastroschisis is equivalent. The maternal age of mothers who give birth to a child suffering from Omphalocele is typically 30 years of age. A mother who gives birth to a child from Gastroschisis is typically 22 years of age.
A key difference between Gastroschisis and Omphalocele is that congenital Omphaloceles are frequently associated with other abnormalities while Gastroschisis is not. In Omphalocele, chromosomal defects are found in 30-40% of cases while multiple associated anomalies including chromosomal changes are observed in 67-80% of cases. It is rare for associated anomalies to occur with Gastroschisis. These include: intestinal atresia which is found in 10% of cases, as well as cardiac, renal, musculoskeletal and central nervous system anomalies.
Week 7 Assessment
1. Although it is currently thought that thyroid C cells originate from cephalic neural crest cells, growing evidence suggests that the embryonic origin may in fact be from Sox17+ anterior endoderm. This study traced Wtn1 expressing cells to determine neural crest origin. Wtn1 expression occurs in the dorsal neural tube and is necessary for neural crest cell expansion. Foregut endoderm origin was established from tracing Sox17 expression, as it is known that transient expression of Sox17 occurs during formation of endoderm. Through fate mapping, the study in mice found that thyroid C cells derived from Sox17+ anterior endoderm, rather than Wtn1 expressing neural crest progeny. However, Wtn1 neural crest cells play a role in the development of thyroid connective tissue. Through lineage tracing, it was also found that in thyroid C cell precursors, the transcription factors Foxa1 and Foxa2 are differentially expressed. These transcription factors are commonly expressed in endoderm organs, and were also found in the thyroid bud and pharyngeal pouch, from which the ultimobranchial bodies that give rise to the thyroid emerge. Within embryonic thyroid C cells, the two transcription factors are coexpressed.
2.Tooth Development consists of ectoderm, mesoderm and neural crest ectomesenchyme involvement. The Ameloblasts produce enamel. Odontoblasts derive from neural crest mesenchyme and form predentin which calcifies to form dentin. The periodontal ligament secures the tooth in the bone socket, acts as a shock absorber, transmits chew forces from bone to tooth and relays sensory information.
This Group Project has a lot of potential. Information is presented in an engaging way through an introductory video documenting a case, timeline providing retrospective insight as well as diagrams detailing the complex processes in a concise manner. I also found some subsections interesting and relevant, including the discussion on ethics, Current research areas, as well as the glossary which provides a quick reference.
Although I understand you intend to elaborate more on certain areas including current research, the project does seem a little thin in regards to text. There are many papers that are linked with no explanation. For example, with regards to the table under prohibitions, I am confused as to what exactly those countries prohibit (all genetic modification? mitochondrial techniques only?) and also whether there is any more nuance to the discussion (do they ban different things?). Of course, one could click through the links under each country, but i think some text before the table itself would only add to your project and bring more context to the table itself. Diagrams themselves can also be referred to in the text (as you would find in a textbook), to add context and create a more cohesive wikipedia page (e.g. for Pronuclear transfer). In terms of the information provided, a little deeper exploration or discussion about certain issues including the reasoning behind ethics arguments may be relevant. If the articles listed under the headings are anything to go by, it seems you intend to do this.
Finally, some proofreading will be very beneficial in polishing up the wikipedia page. There are some sentences like "And it effectiveness in doing so. And the processes that occur in the oocyte when this method is used" under Human Embryo Model, which may well do with some editing. I would like to add that the referencing has been fantastic and consistent. Good Luck!
I found this Wikipedia page particularly interesting. A wide assortment of visual media including histological slides, ultrasound images, geographical maps, tables, flow diagrams and hand-drawn images, all add a richness and balance to the text. This page does well to direct the reader's attention with highlighted text as well, to make for an aesthetically pleasing article. In particular, i found the hand-drawn diagram particularly intelligent and impressive.
In terms of text, i think this article is of adequate complexity and provides educational value to its intended audience of fellow university students. However, more diagrams to accompany the pathophysiological mechanisms and simplify the process may be of benefit. The text under 'Causes' is informative, but there is an imbalance of information for the various subsections within that heading. I assume, you intend to elaborate on those subsections that seem a little thin. It may be more effective to break up the 'genetic factors' section to a simple list of genetic influences, with details of studies relevant to that factor alongside it. This way, you don't have to read through several paragraphs to get to a particular gene/information point. Also, some arrows pointing to the actual cysts explicitly in the histological slide may be useful, as already done in the Ultrasound slide.
Finally, although the Wikipedia page is organised logically and contains particularly relevant sections, it may do with some more. As an age old issue, I'm interested in the epidemiology of PCOS and a bit about its history (or where/when we know what we do about it). Other than that, the page looks pretty good and reads well too.
This Group Project is impressively detailed and provides a comprehensive view of male infertility detailing the normal process as well as the various disorder types and causes. The wikipedia page flows logically, provides excellent summaries and may well be an excellent educational resource. The video chosen is fantastic and tables have been used well to present information quickly.
I find that the Introduction is clear and concise. However, i feel it may be improved further by an introductory visual. Other than that, the page has many relevant diagrams and images. In terms of the 'development of gonadotropin preparations', it does seem a little out of place as it isn't particularly referred to in the text. I understand timelines add a richness to the text and can give perspective, but i feel that it may be of more relevance if given regarding male infertility treatments as a whole, rather than gonadotropin preparations. Of course, you can always have both.
Other than that, I am quite impressed with this wikipedia page. It is referenced well and information is backed with reference to the findings of various studies. A final tip may be to add a simple glossary for ease of reference as opposed to having to scroll back up to the section (e.g. varicocele) to remind oneself of the meaning. However, it should be commended that jargon was defined well throughout the article.
This Group Project covers a wide breadth of topics in a very easy to understand manner. The types of chemotherapy treatments or drugs for example, were very easy to read and understand. The various tables and histological slides employed also make for an interesting and easy to digest wikipedia article. The visual aids detailing the IVF process was also well appreciated and balanced well with the text.
However, I feel that in general there should be more visual media to accompany the text. An issue of a current image I have (patient undergoing chemotherapy) is that I don't think it adds much to the wikipedia page and is not informative. Furthermore, I was hoping there would be an introduction to the wikipedia page that would explicitly detail what it aims to cover. This would provide more structure and give a logical flow to the wikipedia page. Another way to improve the logical flow, is to subdivide sections into male and female (e.g. surgeries and drugs, the transition from surgeries for males to drugs for female infertility was abrupt and disorienting). The top half of the page may be made less verbose through the use of more jargon e.g. in the Radiation section "cells can't grow and divide" etc. Naturally, a glossary is also a convenient reference point that may be included.
Also, there is an imbalance in detail with more input within cancer cells section than other sections more directly relevant in ART including IVF. However, I do understand this Group Project is still a work in progress. Overall, there is a lot of potential in the wikipedia page.
This wikipedia article is impressively organised and easy to follow. It is sufficiently detailed, and despite being content heavy it has a good layout as it is well spaced out. This article is well referenced as well, a testament to the work that has been put in.
I understand that the advantages and disadvantages are listed as bullet points. Have you thought of organising it in a table? It may be a way to include a 'visual aid' in order to reach a balance in terms of visual/text content. Generally, more diagrams will only improve this article. Cohesion between the visual and written text may be increased by referrals to the diagrams/images throughout e.g. human blastocyst biopsy as opposed to a caption only. Also, having a section directly comparing the genetic techniques/purpose/effectivity/results in a table may be interesting.
Overall, wonderful work. In my opinion this is definitely a frontrunner and particularly difficult to critique.
Week 10 Assessment
Hyaloid artery supplies the developing lens and is surrounded by the vitreous. Developing lens consists of lens fibers which derive from surface ectoderm.
Vision - Lens Development --Development Overview
PMID 26244658 look at this <ref><pubmed>26244658</pubmed>
here's the list