Lab 1 Assessment
Progesterone elevation on the day of human chorionic gonadotropin administration adversely affects the outcome of IVF with transferred embryos at different developmental stages
The effect progesterone evaluation (PE) during fresh invitro fertilisation (IVF) cycles after hCG administration for oocyte maturation is still unclear. To overcome the possible effect, cleavage-stage embryo’s are replaced with blastocyst-stage embryos before transfer (they are suggested to be unaffected by PE), however it is unclear if the results are reliable. Therefore a study was conducted to investigate the link between PE on the day hCG is administrated and the clinical pregnancy rate (CPR) following IVF/intracytoplasmic sperm injection cycles (ICSI) after embryo transfer at different stages. The levels at which PE had a detrimental effect on CPR was also investigated.
A retrospective study was conducted on a cohort of patients undergoing IVF with gonadotropin and GnRH agonist for ovarian stimulation at a single-centre. Patients were then spilt into two groups, one undergoing cleavage-stage embryo transfer at day 3, and the other undergoing blastocyst-stage transfer at day 5. Patients were assessed clinically to undergo the standard long GnRH protocol or a prolonged protocol.
The pituitary was suppressed by injecting Triptorelin acetate or Diphereline. This was followed by gonadotropin, FSH activity or FSH and LH activity to initiate ovarian stimulation. Oocyte retrieval was conducted and embryo quality graded. CPR was measured as well as implantation rate, fertilisation rate and cleavage rate. Statistical analysis was performed.
It was found that in the day 3 and day 5 group, serum progesterone levels are inversely related to CPR. The detrimental affect of progesterone became evident once serum progesterone reached 1.0ng/ml in the day 3 group and 1.75ng/ml in the day 5 group. The developmental stage at which embryos were transferred was not found to be statistically significant. Therefore it is concluded that on the day that hCG is administered PE was found to decrease CPR in GnRH IVF cycles despite developmental stage of transfer. 
Cut-Off Levels of Anti-Mullerian Hormone for The Prediction of Ovarian Response, In Vitro Fertilization Outcome and Ovarian Hyperstimulation Syndrome
The role of Anti-mullerian hormone (AMH) in the ovary is to inhibit the early stages of follicular development. It appears to be a reliable marker for the number of small antral follicles and as a result can help determine the plan for ovarian stimulation. AMH also decreases from adulthood onwards, and so can help indicate reduced ovarian reserve and dysfunction. Ovarian hyper stimulation syndrome (OHSS) patients have high serum AMH. A study was conducted to compare the average and cut-off AMH levels after oocyte attainment after ovarian stimulation and the association with pregnancy rates. AMH levels endocrinological and pathological risk factor patients were also compared to patients without the risk factors.
Serum and follicular fluid (FF) was collected from patients in their first or second IVF and ICSI cycles. Patients were analysed and their pathological factors compared to normal patients. The correlation between serum and FF AMH levels and the correlation between serum AMH, estradiol, number of follicles, injected dose of recombinant FSH (rFSH - used to induce ovarian stimulation after down-regulation with GnRH agonist) and patient age was analysed. The average and cut-off level of AMH was also evaluated in low, moderate or high responders to ovarian stimulation and pregnancy rates. Three analysis were conducted where AMH levels were analysed. They included one where ovary overreaction was induced (OHSS) and one for polycistic ovarian syndrome (PCOS) which were both compared against the third analysis of normal endocrinological patients.
It was found that AMH levels were significantly higher in FF than serum where AMH levels increased with increasing ovarian response in both. There was a positive correlation present between AMH levels and estradiol, number of follicles, number of retrieved oocytes and number of fertilised oocytes where AMH levels increased with each factor as response increased. There was an inverse correlation with age. The median AMH level in serum (1.76 ng/ml) and FF (2.9 ng/ml) was higher in patients who became pregnant than those who did not (1.0ng/ml in serum and 1.8 ng/ml in FF). AMH cut off level was 0.61 ng/ml in serum and 1.43 ng/ml in FF in low responders, and 1.03 ng/ml in serum and 2.23 ng/ml in FF in high responders. OHSS and PCOS patients had lower level of injected rFSH and higher follicle numbers which suggests higher estradiol than normal patients. A higher number of oocytes were retrieved from OHSS patients. Normal patients had the lowest AMH, PCOS had the highest. In conclusion, AMH can help predict ovarian stimulation response, can be a marker for PCOS and help to avoid OHSS. 
Lab 2 Assessment
|Uploading Images in 5 Easy Steps|
|First Read the help page Images and Copyright Tutorial.
Students cannot delete images once uploaded. You will need to email me with the full image name and request deletion, that I am happy to do with no penalty if done before I assess.
Roles of LIF in embryo implantation
--Mark Hill (talk) 16:55, 3 September 2015 (AEST) The image has been uploaded correctly and contains reference, copyright and student template. You could have also uploaded a larger version of this image as it is quite difficult to read at this size. (5/5)
Lab 3 Assessment
Variability in the practice of fertility preservation for patients with cancer.
<pubmed>26010087</pubmed> This is an interesting article on how reproductive endocrinologists counselled cancer patients on fertility preservation. This is relevant to our group projects because it gives us an idea of what techniques and services are currently being utilised to help women.
Strategies for fertility preservation in young patients with cancer: a comprehensive approach.
<pubmed>24669162</pubmed> This article recognises that as cancer treatment improves the life span of patients, with it comes the treat to fertility. It is a great article as it clearly states what methods are currently available for addressing fertility preservation in males and females.
Clinical guide to fertility preservation in hematopoietic cell transplant recipients.
<pubmed>24419521</pubmed> This article focuses specifically on patients suffering infertility due to hematopoietic cell transplantation. It lists the options available to the patients whether female or male, which are applicable to patients who underwent other treatments and also lists the barriers to fertility preservation.
Fertility preservation in patients with haematological disorders: a retrospective cohort study.
<pubmed>24140311</pubmed> This article addresses fertility treatment in patients with haematological disorders specifically. However, is it a really good article as it is a cohort study comparing patients at various stages in their cancer journey, such as those who have had prior chemotherapy, those who pursued ovarian stimulation and those who did not pursue fertility treatment at all.
Lab 4 Assessment
Week 1 and 2 Development
--Mark Hill (talk) 16:55, 3 September 2015 (AEST) These questions are OK. Negative responses (is not, incorrect) are sometimes hit and miss. The third question needed more in the question. You could have also included links to where the student could see the answer in context. (9/10)
Lab 5 Assessment
What is the difference between gastroschisis and omphalocele?
Both omphaocele and gastroschisis are physical abnormalities present at birth, involving the abdominal wall which consist of protrusion of the internal viscera. Gastroschisis is generally a smaller defect in which the abdominal viscera usually protrude through the abdominal wall to the right of an intact umbilical cord.  Omphalocele, one of the most common birth defects of variable size involves the extrusion of the intestinal tract at the midline through a malformed umbilical cord. It is usually contained by a sac that is continuous with the umbilical cord.  The two conditions are distinguished through their location, size of the defect and whether or not there is a sac covering the extrusion.
Furthermore, in the case of gastrochisis the small bowel and colon have not undergone the normal rotation during development. The dueodenum to the rectum is exposed without peritoneal covering, and floats loosely in the amniotic fluid which causes inflammation. This leads to a shortened intestine with functional abnormalities.  The cause of gastrochisis is still not very clear however there are associated risk factors. Incidence is higher in mothers of a younger age, those who had anaemia during pregnancy, used contraception or consumed alcohol early on in pregnancy.  A potential theory regarding the cause is intrauterine vascular occlusion of the right umbilical mesenteric artery which explains it’s occurrence to the right of the umbilical cord. This consists of arterial infarction, umbilical ring rupture and intestinal evisceration which is consistent with occasional intestinal atresia. 
On the otherhand, omphaocele which has a higher incidence than gastrochisis consists of a familial occurrence. Birth order is unimportant, however higher incidence was reported in increasing maternal age, with a higher rate of miscarriage occurring due to the abnormality. Omphalocele can be induced in animals through the use of irradiation, hypoxia and cytotoxic substances. There is almost always observation of incorrect roation. The cause of omphaocele remains unknown, however it is suggested that in omphacele and gastrochisis the malformation is due to developmental defects during embryological folding accountable for ventral closure. Therefore, one suggestion for Omphacele is a defect in the inhibition of the lateral wall folds in the abdomen. Another suggestion is the faulty migration of myotomes to the abdomen which results in the incomplete muscular closure within the wall which then inhibits intestinal growth and enlargement. The abdomen is protected from inflammation as a result of the amniotic fluid by the intact sac covering. 
Lab 7 Assessment
Thyroid hormone transporters and deiodinases in the developing human hypothalamus.
Thyroid hormone (TH) is required for human brain development including hypothalamic development and for proper function. Originally the fetus relies on maternal TH supplies before its own thyroid hormone is functional. However, once its TH receptors are established neurological impairment can occur with a lack of TH.
Friesema et al. (2012), studied the expression of thyroid hormone transporters and deiodinases in the developing hypothalamus. In their study they investigated the expression of D2, D3, and TH transporters MCT8, MCT10 and OATP1C1 to determine the timing of TH signaling in hypothalamic nuclei at different developmental stages. Postmortem hypothalamic specimens were obtained from fetus’ from 17 weeks gestation to 29 months old children. The tissue was fixed, immunocytochemically stained, and intensities were scored by visual inspection.
It was found that D3 (TH inactivator) and MCT8 (for T3 uptake in cells) were present in the youngest samples at 17 weeks gestation where lateral hypothalamic zone differentiation takes place. T3 is degraded and not produced at this point, protecting the brain from early maturation. D2 is expressed after 17 weeks gestation. MCT8, MCT10 and OATP1C1 were expressed with different intensities among subjects during the late second trimester when the hypothalamus starts to take on an adult-like structure. Towards the end of gestation TH transporters and D2 decreased whilst D3 increased indicating a lower demand for T3. TH transporters then increase after birth at term before returning to adult-like levels. It was concluded that there are hypothalamic variations in deiodinases and TH transporters during fetal and neonatal development, however it is unclear if this is physiologically relevant. 
Embryonic layers and tissues that contribute to the developing teeth.
Teeth are derived from ectoderm, mesoderm and neural crest cells. The epithelium originates from oral ectoderm and mesenchyme from cranial neural crest cells. The neural crest cells move from the neuro-epithelium margins laterally and ventrally filling the facial prominence with mesenchyme to form the hard and soft tissue within teeth which include dentin, dental pulp, alveolar bone and periodontal ligament. The oral epithelium thickens and cells proliferate to form the dental lamina which invaginates into the mesenchyme which condenses below to form the dental papilla. The papilla gets surrounded by the epithelial bud and the adjacent mesenchyme cells form the dental follicle. This is followed by the bell stage where germ cells increase in size and the final shape is being formed. Established last are the ameloblasts (produce enamel) derived from epithelial cells adjacent to the papilla and odontoblasts (produce dentin) which come from the outer papilla layer and migrate towards the centre. 
Lab 9 Assessment
Group Project 1: Three Person Embryos
Your project instils a great first impression on a visitor to the page! It is a well designed webpage that doesn’t come across as overwhelming and too wordy encouraging and drawing the reader to explore your page. Your choice of content is relevant and provides a good understanding of the topic so far. The introduction is nice and succinct, explaining easily and clearly what the topic is about with a great video that complements the introduction. Together they give the reader good background information on the topic, and are taught in a way that’s easy for someone with no prior knowledge on the topic or in embryology in general to understand.
Furthermore, the timelines you provided, the ethics section and the table on the legal status of the technique is a good way of showing how far the concept has come and good at placing the technique in the context of how it has been translated into modern society. I really like that you have included animal models in explaining the various techniques, provided the current research available, and included further reading. This is very relevant and interesting for other embryology students and researchers who visit your page! The diagrams you have already chosen are very appropriate and explain the technique clearly to visual learners and are very engaging.
In improving on your page I think the main focus is to elaborate on some key points further and add a few more diagrams and pictures so you can maintain a perfect balance of words and images and the engaging layout you already have begun. For example, maybe for the section “hereditary mitochondrial disease” you can talk about the type of hereditary diseases there are. Also, some of your wording and grammar need further editing so make sure you go through and reread your work.
Other things you should edit include, adding a reference to your introductory paragraph and maybe clarifying that three person embryos are now legal in the UK since your video says “its on the threshold of acceptance”. Also check your copyright on some of the images such as the one that says “Copyright © 2015 BBC. The BBC is not responsible for the content of external sites. Read about our approach to external linking”, I am not sure if this means you are allowed to use it so just clarify this.
Overall, you have great progress on your page so far, it has a great teaching element to it and shows good research and citing into the project!
Group Project 2: Ovarian Hyper-stimulation Syndrome
I’d like to start by commending you on an exceptional choice of key points which you have chosen to research and elaborate on. They provide a good overview of the subject for your readers. They are clearly explained and taught at a peer level without dragging on with irrelevant points. Your introduction is well written, I especially like that you have included the aim of you wikipage in the introduction and the key points you will be focusing on to orient your reader. Including epidemiology was also a good choice as it shows the relevance and impact of Ovarian-stimulation syndrome in society. I also find that including prevention and treatment is great for visitors without an embryology background who are looking for general information on the topic, especially for women who can learn to better reduce their risk since this page is accessible to the public.
Other great aspects of your page include the inclusion of a glossary for readers to refer to when they are unclear on the terminology and that you have used relevant sources. The table used to organize the symptoms makes its easy to read and understand. I particularly liked your section on the pathophysiology. Not only is it explained well but you have included a great hand drawn diagram that is clearly drawn, complements the adjacent paragraphs well and includes a statement with permission to other visitors to reuse it.
Going forward your main focus’ should be conducting further research to complete your remaining key points on the effects on the Newborn and animal models (very relevant for embryology peers). Also, focus on including more supporting diagrams and figures since so far you only have one. A histological image of the ovaries would be very appropriate to your topic. Make sure you read over your page to edit your grammar and wording for example in the phrase “they are given to assistive medication”. Your citing is well done, but make sure when you are referencing websites that you include the retrieval date such as in reference 11.
Overall your page is well written, with my main concern being is it sounds more like a report than a peer teaching page. You can fix this by adding more images, diagrams, figures and tables to break up the text and help to explain your content. Adding a video would also be engaging. Otherwise, great progress!
Group Project 3: Female Infertility & Polycystic Ovarian Syndrome
The progress you have made on your project so far is exceptional. Your key points are clearly taught at a peer level and your choice of headings, diagrams and tables so far has been well thought out. I especially commend you on a great drawing in the top of your page. It is drawn clearly and is a great depiction of the uterus and ovaries from the outside and inside and of Polycystic Ovarian Syndrome. Your introduction and epidemiology is beautifully complemented with the map you have included and the addition of a coloured box to highlight the definition of PCOS as the focus.
It is evident you have conducted wide and extensive significant research that also goes beyond the teaching aspect. This is clear through your inclusion of specific studies, explanation of animal models and cell culture models used in PCOS and the thorough description of your key points due to your extensive research. Well done on using all pubmed articles except for one!
Some suggestions on editing your work would be to briefly mention the cysts in your definition for PCOS since it is a main element of PCOS as depicted in your drawn image at the beginning of your page. The environmental factors are too vague, you could elaborate on this by including examples of environmental factors or explaining why the constant gene pool would indicate environmental factors in the aetiology of PCOS. You could also consider adding an advantages column to your treatment table if it is relevant. Also, while you have provided a great overview of PCOS, maybe also consider adding brief descriptions of other causes of infertility in women since it is your topic area with a focus on PCOS.
Some minor adjustments to make are to remember to add the retrieval date to the website you have used in reference 6. Also, you should increase the size of the map under the definition heading so that the percentages are readable and the country locations more visible and the flow chart under hyperinsulinemia so that it is clearer and the words are more readable by increasing the resolution of your files. The project is coming along great, your thorough effort into the project is evident.
Group Project 4: Male Infertility
I’ll begin by commending you on a well contructed wikipage with a great balance of texts and figures. You have used a great variety of supporting resources which complement your text well and aid in the teaching and the understanding of your key points which you have chosen well and mostly covered sufficiently. I particularly liked that you included a graph, (since you are the first project I see with one) and your widespread use of tables which breaks up the text whilst teaching your content well. Good job on being consistent in using the same colour and formatting in your tables. Your explanations are clear and extensive with the main points covered well. Your topic appears to be well research with a thorough list of references and your citations are correct.
While you have included a great table on the types of infertility in males with a brief explanation of each, I feel like this should be elaborated on further. Also, your background information is well written however I feel it is too abrupt. You can include an introductory sentence or paragraph to your subheadings. While it is great that you included a video, I don’t feel like it is relevant to where you have placed it under the causes heading. Since it is more of an overview of infertility in general you can move it to the beginning of the page if you would like to keep it or choose a different video.
While I did say your explanations in general are well written, some areas need more focus, such as your explanation of Varicocele, while you have said that varicocele leads to infertility and explained what is was, it wasn’t clear to me why it causes infertility. Also you should add more significant research beyond the teaching aspect by including some studies conducted and animal models. You can contribute further to the teaching and understanding of your topic by adding your own innovative, drawn diagrams to your great selection of files already added. Just a final formatting point, your images need a higher resolution, most of them are unclear and the words are not very readable. You can edit this by increasing the current 300px resolution to the appropriate pixels.
Great progress overall, good luck with the rest!
Group Project 6: Prenatal Genetic Diagnosis for ART
Your project page is coming along very well so far. You research into the subject seems very extensive and sufficient. You have many citations which have been cited properly. Your long list of references and the many in text citations are evident of the effort and depth that you have gone into your research. Furthermore, you have added a heading on future and current research which further shows the relevance and recent nature of your research beyond the teaching aspect. You have chosen relevant headings and figures so far, explained the key points well and taught the content at a peer level showing a good understanding of the topic. Its great that you have also chosen to include the laws and legal status to show how the topic is relevant to society and how it is being translated from research to the clinic.
While the images you have included so far are engaging and relevant I feel that much more is needed since your research into the topic is very widespread. More images, diagrams and graphs (maybe a graph on the rate of genetic testing use can be helpful) would help to break up the text, balance the page better and make the page more engaging. Also, try to refer to your files in text as well so they may complement your explanations and enhance understanding of the topic. Including your own innovative drawings and searching for relevant videos would also help to teach key points better. When adding your files try to maintain the same formatting, some of your images are added as thumbnails while others are not.
Additionally, you are still lacking an introduction. You have included a heading for it so I assume you will get to it, but make sure its included as its very helpful in orientating your reader and providing some background information for those without a significant scientific background. You should also consider adding a timeline to the section on history, it is more engaging to your viewer and easier to read. I would also recommend adding some more tables, they are visually appealing and also help to break up the text. I suggest you add a table of the diseases tested for, with a brief description of the disease, the specific genetic test used to detect it and at what stage its used. Animal models can also be included to show research into the topic beyond the teaching activities. Finally, make sure you reread over your work and edit your spelling and grammar in some areas.
Good effort overall, well done!
Lab 10 assessment
The cornea is the front layer of the eye covering the iris, pupil and anterior chamber. The cornea is a transparent layer that accounts for 2/3 of the eyes total optic power by refracting light along with the anterior chamber and lens. The cornea in humans consist of 5 layers as shown in the permalink, the Corneal epithelium, followed by Bowman’s layer, Corneal stroma, Descemet’s membrane and corneal endothelium. The corneal stroma and endothelium are derived from cranial neural crest cells and the corneal epithelium differentiates from ectoderm interacting with the developing lens.
Embryology link: Vision – Cornea Development
- Adesola C. Akinkuotu, Fariha Sheikh, Oluyinka O. Olutoye, Timothy C. Lee, Cariciolo J. Fernandes, Stephen E. Welty, Nancy A. Ayres, Darrell L. Cass, Giant omphaloceles: surgical management and perinatal outcomes, Journal of Surgical Research, 2015, 198(2):388-392, http://dx.doi.org/10.1016/j.jss.2015.03.060.
- Jay L. Grosfeld, Thomas R. Weber, Congenital abdominal wall defects: Gastroschisis and omphalocele, Current Problems in Surgery, 1982, 19(4):159-213, http://dx.doi.org/10.1016/0011-3840(82)90048-X
- 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