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Interview with Dr Norbert Gleicher at COGI Amsterdam 2016
Views of Dr Norbert Gleicher on what his three studies presented at COGI can teach us about PGS
A. I presented three basic science studies today, two from Cambridge and one from Rockefeller University, which addressed some of the most basic questions in early human embryology. Specifically, two principal questions: one, how does an embryo implant? This has been a black box up until now, and this was addressed by two very similar studies from both of those laboratories on both sides of the Atlantic. The third study addressed the question: What happens to an abnormal embryo in an animal model, mouse, after blastocyst stage? Both of these questions have great clinical relevance to infertility practice in general.
Q. How can the work done by Prof. Magdelena Zernicka-Goetz and her group potentially help you in your clinical setting?
A. Magdelena’s work at Cambridge is really extraordinary at a number of levels. First of all, she developed the in vitro implantation model that both she and the Rockefeller group in New York later used in humans. The Rockefeller group advanced that to some degree for human application.
Secondarily, she, so far alone, examined the question what happens to a chromosomally abnormal embryo? At least what happens to a chromosomally abnormal mouse embryo? It is likely that her principal findings in the mouse model are also applicable to the human.
The two embryo implantation studies are so remarkable because they demonstrated that human embryos, up to day 14 after fertilisation, can completely normally develop without any input from the mother. That is really, absolutely remarkable. It raises a question about our understanding of implantation in general, because we live under the assumption that the implantation process, obviously to a very large degree, is dependent on the mother and here, in an in vitro model, those embryos implant and develop completely normally without an ounce of maternal contribution.
These two studies really induce us to re-think our concepts about human embryo implantation.
Her second study following mice through after blastocyst stage, and demonstrating that even if the inner cell mass is chromosomally very abnormal, most, if not all, result in pups will be chromosomally normal, strongly suggest that embryos have an incredible capability of self-correcting if they are chromosomally normal at blastocyst stage. This has very big potential importance for the very active discussion of PGS that is currently going on in the infertility community with many proponents of the procedure, many opponents of the procedure, which think that it is a worthless procedure. I am one of those, because if an embryo, indeed, can self-correct to such a degree after blastocyst stage, what would be the purpose of biopsying and determining at blastocyst stage whether the embryo is normal or not? These studies have the potential of greatly affecting our future practice.
Q. What is your take home message?
A. My take home message from all these studies is that we should work in closer collaboration with our colleagues in basic science. I think that is really the principal conclusion from all of this, because what is unfortunately happening in our area of practice is that we have spectacularly knowledgeable colleagues in basic biology doing amazing research and what they learn barely makes it to the clinicians and, on the other hand, many of our colleagues in basic science really do not have the connections to clinicians to understand what their findings in basic science could clinically mean.
If I am allowed to make a little self-plug here, it is exactly for that reason that we and others in the next week are holding a conference in New York City on translational reproductive biology and clinical reproductive endocrinology, with exactly that in mind. I think we need to get basic scientists and clinicians more often together so that they can interchange their knowledge