Assisted Reproductive Technologies and the Developmental Origins of Health and Disease

James H. Segars, MD

Assisted reproductive technologies (ARTs), especially in vitro fertilization (IVF) and intracytoplasmic sperm injection, represent medical breakthroughs that have allowed millions of couples to build families. It was not always so. The story of the development of IVF is a testament to exceptional courage and conviction of medical pioneers who overcame failures and political harassment to bring these methods to the clinic.[1] Ultimately, the achievement was recognized in 2010 by the Nobel Prize for Physiology and Medicine to Dr. Sir Robert Edwards (1925–2013), for his decades of work to accomplish IVF in humans. The work of Edwards built on the work of M.C. Chang (1908–1991), who first demonstrated IVF in the rabbit, and Charles Thibault (1919–2003) who worked on IVF in several species.

While ART has now become the standard treatment for many infertile couples, epigenetic changes attributed to in vitro culture were detected in several animal species and these changes have fueled concern about whether the process of in vitro embryo culture might produce changes in the development of human offspring. The possible future consequences of in vitro culture of gametes and embryos, and their manipulation, represents a current frontier and a challenge for the field of assisted reproduction. To address this challenge, the important question of epigenetic and health-related consequences attributable to ART will be addressed in two issues of the Seminars in Reproductive Medicine by Dr. Micah Hill. As noted in the introduction by Dr. Hill for this issue, there are many related questions raised by this possibility.

Dr. Hill is uniquely suited to address these issues. He is an Associate Professor in the Department of Obstetrics and Gynecology, Uniformed Services University of the Health Sciences, fellowship director for the NIH-USUHS Program in Reproductive Endocrinology and Infertility, and director of the Walter Reed ART Program, the largest ART program in the military. Lieutenant Colonel Hill was a Clinical Research Reproductive Scientist Training (CREST) scholar, having trained at NIH for REI fellowship after completing his residency in Obstetrics and Gynecology at Tripler Army Medical Center and medical training at the Oklahoma State University for Osteopathic Medicine. In addition, Dr. Hill serves on the ASRM Practice Committee, is the current chair of the SART Quality Assurance Committee, and he serves on the SART Executive Council. He has published 75 peer-reviewed manuscripts and has won numerous awards, including the prestigious Lieutenant General Claire L. Chennault and Bailey K. Ashford Awards at Walter Reed. Thus, Dr. Hill brings the perspective of a clinician-scientist with special expertise in ART recognized by national and local positions of leadership in assisted reproduction.

The authors and manuscripts he has assembled will provide the reader with an up-to-date assessment of possible long-term effects of these groundbreaking reproductive technologies 40 years after the birth of Louise Brown.

• Reference

• 1 Jones Jr HW. In Vitro Fertilization Comes to America. Williamsburg, VA: Jamestowne Bookworks, LLC; 2014: 1-10