Applications of CRISPR/Cas9 in Reproductive Biology

Total Page:16

File Type:pdf, Size:1020Kb

Applications of CRISPR/Cas9 in Reproductive Biology Applications of CRISPR/Cas9 in Reproductive Biology Faheem Ahmed Khan, Nuruliarizki Shinta Pandupuspitasari, Huang ChunJie, Hafz Ishfaq Ahmad, Kai Wang, Muhammad Jamil Ahmad and ShuJun Zhang* Key Laboratory of Agricultural Animal Genetics, Breeding and Reproduction of the Ministry of Education, College of Animal Science and Technology, Huazhong Agricultural University, Wuhan, Te People’s Republic of China. *Correspondence: [email protected] htps://doi.org/10.21775/cimb.026.093 Abstract into genes that interact with environment to develop Genome editing is unravelling its benefts in wide a specifc phenotype. Although extensive studies areas of scientifc development and understanding. have been carried out but still the understanding Te advances of genome editing from ZFNs and of genes and its function is far from understanding TALLENs to CRISPRs defnes its wide applicabil- because genes are diferentially expressed. Te pre- ity. Reproduction is the fundamental process by sent advances in genome editing technologies takes which all organisms maintain their generations. a leap towards endogenous genome modifcation, CRISPR/Cas9, a new versatile genome editing which gives rise to several opportunities to deal tool has been recently tamed to correct several with diseases and undesired phenotypes (Khan et disease causing genetic mutations, spreading its al., 2016). arms to improve reproductive health. It not only Te continuous update to knowledge reservoir edits harmful genetic mutations but is also applied owes to molecular studies unfolding several impor- to control the spread of parasitic diseases such as tant aspects of genes and their interactions with malaria by introducing selfsh genetic elements, the environment enabling scientists to do forward propagated through generations and population via and reverse genetics model cells and organisms reproduction. Tese applications led us to review to uncover the intricate mechanisms that may be the recent developments of CRISPRs use in repro- taking place. Such studies also open avenues of its ductive biology. practical applications, especially in medicine. Te genome manipulation was frst made possible in the 1970s when E. coli was frst manipulated for thera- Introduction peutic protein production (Itakura et al., 1977). Te blueprint of life and heredity is writen in Te advent of gene silencing methods further genome. Te human body consists of trillions increased the precise understanding of gene func- of cells which are divided in autosomal cells and tion that rely on homologous template. It is very gametes (Soh et al., 2014). Te autosomes consists precise but its application on a large scale remains of two genomes while gametes comprises a single inefcient. To overcome these limitations ZFNs genome. During the process of fertilization the and TALENs are developed which are proteins with two gametes, one from each partner, unite to form DNA-binding domains (Dhanasekaran et al., 2006; a zygote (Hughes and Page, 2015). Te genome is Reyon et al., 2012) that are much more efcient built up of billions of DNA base pairs subdivided than the gene silencing technologies; however, its Curr. Issues Mol. Biol. Vol. 26 94 | Khan et al. wider application is limited by unavailability of genetic studies of fertility, development and control skilled technicians who can make a special targeting of disease-causing vectors. Tis review will focus on protein for each genomic target. applications of the most versatile CRISPR/Cas9 Clustered regularly interspaced short palindro- in reproduction that is the fundamental process of mic repeats (CRISPR/Cas) is the most recent and species survival. accurate tool to target nucleic acids of any nature to modify, edit or disrupt any gene. Te CRISPR/ Cas system can virtually be reprogrammed against Gene drives and CRISPR/Cas9 any genome of interest to achieve required goals. Te selfsh genetic elements constitute gene drive Tis special immune response is developed by systems that are biased towards their own inherit- a unique set of CRISPR array which contains a ance in super-Mendelian fashion (Noble et al., protospacer from invading nucleic acid recognized 2016; Champer et al., 2016). Tese gene drives by short protospacer adjacent motif (PAM) which are considered as means to eradicate insect-borne helps the host resistant to its own immune response diseases including malaria, zika and dengue (Ham- (Bolotin et al., 2005; Barrangou et al., 2007). Te mond et al., 2015). Naturally found gene drives simple machinery of CRISPR/Cas system makes it are in the form of transposons, commonly known a technology of choice in various biotechnological as jumping genes (Charlesworth et al., 1989) or platforms including gene therapy, genome editing those causing segregation distortion (Tao et al., and therapeutic production. Te CRISPR/Cas9 2001) and Medea elements (Chen et al., 2007). provides an efcient way to make targeted double- Te discovery of CRISPR/Cas9 genome editing stranded breaks (DSBs) in DNA that can knock out technology has made it possible to create synthetic any gene through non-homologous DNA repair gene drives that can change the dynamics of natural pathway (NHEJ) and can stimulate template-based populations (Champer et al., 2016). homologous repair through homology directed It is noteworthy that synthetic gene drives are repair (HDR) (Khan et al., 2016). Te CRISPR/ widely studied and have potential to widely eradi- Cas9 system requires only the design of the new cate the protozoal, viral and helminthic diseases sgRNA against target, as compared to ZFNs and that causes a huge human disease burden (Zama- TALENs that needs special protein for each target. nian and Andersen 2016). Synthetic gene drives to Gene drives is a technique that can enhance the control vector-borne diseases have two principal inheritance of a particular gene to increase its preva- objectives: population modifcation or population lence in the population (Windbichler et al., 2011). suppression (Burt, 2003, 2014). Te eradication In natural populations, genes sometimes gain a of the vector, for example mosquitos carrying ftness bias that does not depend on the organism. the malaria parasite, is an example of population Te genes in a sexually reproducing organisms have suppression. In contrast, if an allele important to a 50% chance of being inherited by ofspring, but disease resistance is introduced into a vector, or some genes somehow gain an evolutionary advan- if an allele is transferred to a vector that makes it tage such that they are passed on to more than unable to transfer pathogen to host, this is a form 50% of ofspring. Tis phenomenon is considered of population modifcation gene drives. Te con- as natural ‘gene drives’ that initially is found in cept of such synthetic gene drives is derived from single organism and then is slowly transferred, over natural gene drives but its progress was very slow generations, to the whole population. Artifcial until the use of the versatile CRISPR/Cas9 system gene drives can be a very useful way to control (Zamanian and Andersen, 2016). Te recent the vectors of several diseases, including malaria applications of CRISPR/Cas9 in Drosophila for (Hammond et al., 2015), dengue and zika trans- mutagenic chain reaction (Gantz and Bier, 2015) mited by mosquitoes. Te CRISPR/Cas9 system and to achieve gene drives in malarial mosquito vec- can be efciently utilized to create artifcial gene tors that converts autocatalytic heterozygous locus drives that can render mosquitoes sterile. Apart to homozygous locus rendering mosquito unable to from disease control, CRISPR/Cas9 can be used to transmit malaria by spreading antimalarial efector study several fertility-related genes in males, hence genes through mutagenic chain reaction (Gantz providing an important platform for molecular et al., 2015). Furthermore, this mutagenic chain Curr. Issues Mol. Biol. Vol. 26 Applications of CRISPR/Cas9 in Reproductive Biology | 95 reaction was utilized recently against Plasmodium the population. Ofen an endonuclease targeting falciparum vector Anopheles gambiae to spread X chromosome is designed for such drives in het- female sterility genes, hence targeting the reproduc- erogametic X/Y species. A schematic illustrating tion capability of Anopheles gambiae (Hammond et endonuclease gene drives is shown in Fig. 8.1. al., 2016). Tese studies open powerful avenues Tese approaches emphasizes the role of to control several other mosquito borne vector CRISPR/Cas9 genome editing technology beyond diseases including flarial nematodes by eradicating the study of fertility related genes and mechanistic LF genes in wild populations that can be done by pathways but provide a robust platform to spread creating population suppression drives by spread- desired gene drives efciently in natural popula- ing genes that compromise reproductive capacity tions to control various vector-borne diseases of and limit the mosquito populations transmiting human health importance. Wuchereria and Brugia nematodes, the main aetio- logical agents of LF transfer in humans (Zamanian and Andersen, 2016). Genome engineering and Te other kind of gene drive is sex-linked mei- reproductive biology otic drive that occurs when certain alleles are biased Te gene modifcation in primates remains a chal- at meiotic level and hence are transferred to gam- lenge because of their long life cycles and hence etes and ultimately to ofspring. Several such kinds make editing impractical. Te gene introduction of meiotic
Recommended publications
  • Reproductive Technology in Germany and the United States: an Essay in Comparative Law and Bioethics
    ROBERTSON - REVISED FINAL PRINT VERSION.DOC 12/02/04 6:55 PM Reproductive Technology in Germany and the United States: An Essay in Comparative Law and Bioethics * JOHN A. ROBERTSON The development of assisted reproductive and genetic screening technologies has produced intense ethical, legal, and policy conflicts in many countries. This Article surveys the German and U.S. experience with abortion, assisted reproduction, embryonic stem cell research, therapeutic cloning, and preimplantation genetic diagnosis. This exercise in comparative bioethics shows that although there is a wide degree of overlap in many areas, important policy differences, especially over embryo and fetal status, directly affect infertile and at-risk couples. This Article analyzes those differences and their likely impact on future reception of biotechnological innovation in each country. INTRODUCTION ..................................................................................190 I. THE IMPORTANCE OF CONTEXT.............................................193 II. GERMAN PROTECTION OF FETUSES AND EMBRYOS ...............195 III. ABORTION .............................................................................196 IV. ASSISTED REPRODUCTION .....................................................202 A. Embryo Protection and IVF Success Rates................204 B. Reducing Multiple Gestations ....................................207 C. Gamete Donors and Surrogates .................................209 V. EMBRYONIC STEM CELL RESEARCH......................................211
    [Show full text]
  • KEMRI Bioethics Review 4
    JulyOctober- - September December 20152015 KEMRI Bioethics Review Volume V -Issue 4 2015 Google Image Reproductive Health Ethics October- December 2015 Editor in Chief: Contents Prof Elizabeth Bukusi Editors 1. Letter from the Chief Editor pg 3 Dr Serah Gitome Ms Everlyne Ombati Production and Design 2. A Word from the Director KEMRI pg 4 Timothy Kipkosgei 3 Background and considerations for ethical For questions and use of assisted reproduction technologies in queries write Kenyan social environment pg 5 to: The KEMRI Bioethics Review 4. Reproductive Health and HIV-Ethical Dilemmas In Discordant Couples Interven- KEMRI-SERU P.O. Box 54840-00200 tions pg 9 Nairobi, Kenya Email: [email protected] 5. The Childless couple: At what cost should childlessness be remedied? pg 12 6. Multipurpose Prevention Technologies As Seen From a Bowl of Salad Combo pg 15 7. Case challenge pg 17 KEMRI Bioethics Review Newsletter is an iniative of the ADILI Task Force with full support of KEMRI. The newsletter is published every 3 months and hosted on the KEMRI website. We publish articles written by KEMRI researchers and other contributors from all over Kenya. The scope of articles ranges from ethical issues on: BIOMEDICAL SCIENCE, HEALTHCARE, TECHNOLOGY, LAW , RELIGION AND POLICY. The chief editor encourages submisssion of articles as a way of creating awareness and discussions on bioethics please write to [email protected] 2 Volume V Issue 4 October- December 2015 Letter from the Chief Editor Prof Elizabeth Anne Bukusi, MBChB, M.Med (ObGyn), MPH, PhD , PGD(Research Ethics). MBE (Bioethics) , CIP (Certified IRB Professional). Chief Research Officer and Deputy Director (Research and Train- ing) KEMRI Welcome to this issue of KEMRI Bioethics Review focusing on Reproductive Health Ethics.
    [Show full text]
  • Artificial Insemination, Egg Donation, and Adoption
    EH 1:3.1994 ARTIFICIAL INSEMINIATION, EGG DoNATION AND ADoPTION Rabbi Elliot N. Dorff This paper wa.s approred by the CJLS on /Harch 16, 199-1, by a vote (!f'trventy one inf(rnJr and one abstention (21-0-1). K1ting infiwor: Rabbis K1tssel Abel""~ Bm Lion Bergmwz, Stanley Bmmniclr, Hlliot N. Dorff; Samuel Fmint, Jl}TOn S. Cellrt; Arnold M. Goodman, Susan Crossman, Jan Caryl Kaufman, Judah Kogen, vernon H. Kurtz, Aaron T.. :lfaclder, Herbert i\Iandl, Uonel F:. Moses, Paul Plotkin, Mayer Rabinou,itz, Joel F:. Rembaum, Chaim A. Rogoff; Joel Roth, Gerald Skolnih and Cordon Tucher. AlJstaining: Rabbi Reuren Kimelman. 1he Committee 011 .lnuish L(Lw and Standards qf the Rabbinical As:wmbly provides f};ztidance in matters (!f halakhnh for the Conservative movement. The individual rabbi, however, is the (Wtlwri~yfor the interpretation nnd application r~f all mntters of' halaklwh. An infertile Jewish couple has asked the following questions: Which, if any, of the new developments in reproductive technology does Jewish law require us to try? \'\Thich rnay we try? Which, if any, does Jewish law forbid us to try? If we are not able to conceive, how does Jewish law view adoption? TIH:s<: questions can best he trcat<:d hy dividing those issues that apply to the couple from those that apply to potential donors of sperm or eggs, and by separately delineating the sta­ tus in Jewish law of the various techniques currently available. For the Couple May an infertile Jewish couple use any or all of the following methods to procreate: (1) arti­ ficial insemination
    [Show full text]
  • Religious Aspects of Assisted Reproduction
    FACTS VIEWS VIS OBGYN, 2016, 8 (1): 33-48 Review Religious aspects of assisted reproduction H.N. SALLAM1,2, N.H. SALLAM2 Department of 1Obstetrics and Gynaecology and Alexandria Fertility and 2IVF Center, Alexandria, Egypt. Correspondence at: [email protected] or [email protected] Abstract Human response to new developments regarding birth, death, marriage and divorce is largely shaped by religious beliefs. When assisted reproduction was introduced into medical practice in the last quarter of the twentieth century, it was fiercely attacked by some religious groups and highly welcomed by others. Today, assisted reproduction is accepted in nearly all its forms by Judaism, Hinduism and Buddhism, although most Orthodox Jews refuse third party involvement. On the contrary assisted reproduction is totally unacceptable to Roman Catholicism, while Protestants, Anglicans, Coptic Christians and Sunni Muslims accept most of its forms, which do not involve gamete or embryo donation. Orthodox Christians are less strict than Catholic Christians but still refuse third party involvement. Interestingly, in contrast to Sunni Islam, Shi’a Islam accepts gamete donation and has made provisions to institutionalize it. Chinese culture is strongly influenced by Confucianism, which accepts all forms of assisted reproduction that do not involve third parties. Other communities follow the law of the land, which is usually dictated by the religious group(s) that make(s) the majority of that specific community. The debate will certainly continue as long as new developments arise in the ever-evolving field of assisted reproduction. Key words: Assisted reproduction, Buddhism, Christianity, Hinduism, Islam, ICSI, IVF, Judaism, religion, religious aspects. Introduction birth, death, marriage or divorce.
    [Show full text]
  • Outcome of Assisted Reproductive Technology in Men with Treated and Untreated Varicocele: Systematic Male Fertility Review and Meta‑Analysis
    Asian Journal of Andrology (2016) 18, 254–258 © 2016 AJA, SIMM & SJTU. All rights reserved 1008-682X www.asiaandro.com; www.ajandrology.com Open Access INVITED REVIEW Outcome of assisted reproductive technology in men with treated and untreated varicocele: systematic Male Fertility review and meta‑analysis Sandro C Esteves1, Matheus Roque2, Ashok Agarwal3 Varicocele affects approximately 35%–40% of men presenting for an infertility evaluation. There is fair evidence indicating that surgical repair of clinical varicocele improves semen parameters, decreases seminal oxidative stress and sperm DNA fragmentation, and increases the chances of natural conception. However, it is unclear whether performing varicocelectomy in men with clinical varicocele prior to assisted reproductive technology (ART) improve treatment outcomes. The objective of this study was to evaluate the role of varicocelectomy on ART pregnancy outcomes in nonazoospermic infertile men with clinical varicocele. An electronic search was performed to collect all evidence that fitted our eligibility criteria using the MEDLINE and EMBASE databases until April 2015. Four retrospective studies were included, all of which involved intracytoplasmic sperm injection (ICSI), and accounted for 870 cycles (438 subjected to ICSI with prior varicocelectomy, and 432 without prior varicocelectomy). There was a significant increase in the clinical pregnancy rates (OR = 1.59, 95% CI: 1.19–2.12, I 2 = 25%) and live birth rates (OR = 2.17, 95% CI: 1.55–3.06, I 2 = 0%) in the varicocelectomy group compared to the group subjected to ICSI without previous varicocelectomy. Our results indicate that performing varicocelectomy in patients with clinical varicocele prior to ICSI is associated with improved pregnancy outcomes.
    [Show full text]
  • Influence of Placental Abnormalities and Pregnancy-Induced Hypertension in Prematurity Associated with Various Assisted Reproduc
    Journal of Clinical Medicine Article Influence of Placental Abnormalities and Pregnancy-Induced Hypertension in Prematurity Associated with Various Assisted Reproductive Technology Techniques Judy E. Stern 1,* , Chia-ling Liu 2 , Sunah S. Hwang 3, Dmitry Dukhovny 4 , Leslie V. Farland 5, Hafsatou Diop 6, Charles C. Coddington 7 and Howard Cabral 8 1 Department of Obstetrics & Gynecology, Dartmouth-Hitchcock, Lebanon, NH 03756, USA 2 Bureau of Family Health and Nutrition, Massachusetts Department of Public Health, Boston, MA 02108, USA; [email protected] 3 Section of Neonatology, Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO 80045, USA; [email protected] 4 Division of Neonatology, School of Medicine, Oregon Health & Science University, Portland, OR 97239, USA; [email protected] 5 Epidemiology and Biostatistics Department, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724, USA; [email protected] 6 Division of Maternal and Child Health Research and Analysis, Bureau of Family Health and Nutrition Massachusetts Department of Public Health, Boston, MA 02108, USA; [email protected] 7 Department of Obstetrics and Gynecology, University of North Carolina, Charlotte, NC 28204, USA; [email protected] 8 Department of Biostatistics, Boston University School of Public Health, Boston, MA 02118, USA; Citation: Stern, J.E.; Liu, C.-l.; [email protected] Hwang, S.S.; Dukhovny, D.; Farland, * Correspondence: [email protected]; Tel.: +1-603-252-0696 L.V.; Diop, H.; Coddington, C.C.; Cabral, H. Influence of Placental Abstract: Objective. Assisted reproductive technology (ART)-treated women exhibit increased risk Abnormalities and Pregnancy- of premature delivery compared to fertile women.
    [Show full text]
  • Assisted Reproduction in Jewish Law Daniel B
    Fordham Urban Law Journal Volume 30 | Number 1 Article 5 2002 Assisted Reproduction in Jewish Law Daniel B. Sinclair Tel Aviv College of Management Academic Studies, Law School Follow this and additional works at: https://ir.lawnet.fordham.edu/ulj Part of the Religion Law Commons Recommended Citation Daniel B. Sinclair, Assisted Reproduction in Jewish Law, 30 Fordham Urb. L.J. 71 (2002). Available at: https://ir.lawnet.fordham.edu/ulj/vol30/iss1/5 This Article is brought to you for free and open access by FLASH: The orF dham Law Archive of Scholarship and History. It has been accepted for inclusion in Fordham Urban Law Journal by an authorized editor of FLASH: The orF dham Law Archive of Scholarship and History. For more information, please contact [email protected]. Assisted Reproduction in Jewish Law Cover Page Footnote Professor of Jewish and Comparative Biomedical Law, Tel Aviv College of Management Academic Studies, Law School. LL.B. (Hons.); LL.M.; LL.D. Ordained Rabbi and formerly Rabbi of the Edinburgh Hebrew Congregation and Dean of Jews College (London). This article is available in Fordham Urban Law Journal: https://ir.lawnet.fordham.edu/ulj/vol30/iss1/5 ASSISTED REPRODUCTION IN JEWISH LAW Daniel B. Sinclair* I. ARTIFICIAL INSEMINATION USING THE HUSBAND'S SPERM ("AIH"): JEWISH AND CATHOLIC POSITIONS This Section is devoted to a survey of Jewish law, or halakhah, in relation to AIH, and a comparative discussion of Jewish and Cath- olic approaches to reproductive technology in general. AIH ac- counts for a small proportion of artificial insemination cases, and is recommended in situations where the husband suffers from ana- tomical defects of his sexual organ or from severe psychological impotence.
    [Show full text]
  • In Vitro Fertilization Christian and Islamic Perspectives on the Ethical
    In vitro Fertilization Christian and Islamic Perspectives on the Ethical Dilemma of In Vitro Fertilization (IVF) Stephanie Sariles Department of Biology; College of Arts and Sciences Abilene Christian University After defining IVF procedures and the associated biomedical ethics with each, I will compare and contrast Christian and Islamic perspectives on IVF. Christianity in general does not accept IVF, because it is an unnatural method of reproduction that can affect Christian traditions such as parenthood and marriage. Despite this view, Protestants, in particular, have opened up to IVF as a method for treating infertility. Islam fully accepts IVF provided the married couple follows Islamic law. Sunni Muslims do not accept gamete donation, but Shi’ite Muslims are more flexible with gamete donation and surrogacy. The development of reproductive Christianity share several similarities in technology has become an answered prayer beliefs and doctrines, however, these for several infertile couples around the religions do not share the same perspectives world. Reproductive technologies, such as in regards to the ethical dilemma of in-vitro artificial insemination and in-vitro fertilization. Islam focuses on the interaction fertilization, have become common options between marriage laws and IVF, while offered by physicians for patients, who Christianity concentrates on the interaction desire to hold their own child in their arms between IVF and a natural order of life even though medically the probability for designated by a sole creator. This them to naturally conceive are low. comparative analysis between two religious Although this scientific development has views of IVF demonstrates that religion is a become a solution for infertility and often factor that contributes to the ethical dilemma viewed as a miracle for some, it has been a of reproductive technologies and influences controversial decision that has caused rifts the societal perspective on IVF.
    [Show full text]
  • GIFT Stands for Gamete Intrafallopian Transfer
    Gamete Intra-Fallopian Transfer GIFT stands for Gamete intrafallopian transfer It is a tool of assisted reproductive technology (refers to treatments used to assist people in achieving a pregnancy.) against infertility. Eggs are removed from a woman's ovaries, and placed in one of the Fallopian tubes, along with the man's sperm. • The first example of GIFT involved primates during the 1970s • The technique was first attempted by STEPTOE and EDWARD • The technology was unsuccessful until 1984. • Then an effective GIFT method was invented by Ricardo Asch at the University of Texas Health Sciences Centre and the procedure resulted in the first human pregnancy. • The GIFT technique was created in hopes of generating an artificial insemination process that mimicked the physiological sequences of normal conception. • The technique was further advanced at the Center for Reproductive Health at the University of California, Irvine, when Asch and his associate Jose Balmaceda employed a newly developed catheter(a tubular medical device used for insertion in canals, passageways, body cavities usually to permit injection or withdrawal of fluids or to keep a passage open) into the GIFT procedure that eliminated the need for general anesthesia in the later stages of the procedure. Oocytes retrieved via laparoscopy (Laparoscopy is keyhole surgery used to examine or operate on the interior of the abdominal or pelvic cavities.) Oocytes and sperms are placed in same catheter (catheter is a thin tube made from medical grade materials serving a broad range of functions. Catheters are medical devices that can be inserted in the body to treat diseases or perform a surgical procedure.
    [Show full text]
  • Does Subsidizing Ivf Decrease Adoption Rates and Should It Matter? I
    University of Minnesota Law School Scholarship Repository Minnesota Law Review 2010 Trading-Off Reproductive Technology and Adoption: Does Subsidizing Ivf Decrease Adoption Rates and Should It Matter? I. Glenn Cohen Daniel L. Chen Follow this and additional works at: https://scholarship.law.umn.edu/mlr Part of the Law Commons Recommended Citation Cohen, I. Glenn and Chen, Daniel L., "Trading-Off Reproductive Technology and Adoption: Does Subsidizing Ivf Decrease Adoption Rates and Should It Matter?" (2010). Minnesota Law Review. 438. https://scholarship.law.umn.edu/mlr/438 This Article is brought to you for free and open access by the University of Minnesota Law School. It has been accepted for inclusion in Minnesota Law Review collection by an authorized administrator of the Scholarship Repository. For more information, please contact [email protected]. Article Trading-Off Reproductive Technology and Adoption: Does Subsidizing IVF Decrease Adoption Rates and Should It Matter? I. Glenn Cohen† and Daniel L. Chen†† Introduction ............................................................................. 486 I. Background on Reproductive Technologies and Adoption ............................................................................. 489 A. Infertility and IVF in the United States .................... 489 B. Adoption in the United States .................................... 493 II. The Policy Debate Over State-Level Insurance Mandates Covering IVF: Do States Have an Obligation to Improve Access to Reproductive Technologies Even If It
    [Show full text]
  • CP.MP.55 Assisted Reproductive Technology
    Clinical Policy: Assisted Reproductive Technology Reference Number: CP.MP.55 Coding Implications Last Review Date: 12/20 Revision Log See Important Reminder at the end of this policy for important regulatory and legal information. Description Diagnostic infertility services to determine the cause of infertility and treatment is covered only when specific coverage is provided under the terms of a member’s/enrollee’s benefit plan. All coverage is subject to the terms and conditions of the plan. The following discussion is applicable only to members/enrollees whose Plan covers infertility services. Infertility is defined as the condition of an individual who is unable to conceive or produce conception during a period of 1 year if the female is age 35 or younger or during a period of 6 months if the female is over the age of 35. For purposes of meeting the criteria for infertility in this section, if a person conceives but is unable to carry that pregnancy to live birth, the period of time she attempted to conceive prior to achieving that pregnancy shall be included in the calculation of the 1 year or 6 month period, as applicable. Assisted Reproductive Technologies (ART) encompass a variety of clinical treatments and laboratory procedures, which include the handling of human oocytes, sperm or embryos, with the intent of establishing pregnancy. The following services are considered medically necessary when performed solely for the treatment of infertility in an individual in whom fertility would naturally be expected and when meeting the accompanying ART criteria in the Policy/Criteria section. Females: 1.
    [Show full text]
  • Assisted Reproductive Technology
    AMERICAN SOCIETY FOR REPRODUCTIVE MEDICINE Assisted Reproductive Technology A Guide for Patients PATIENT INFORMATION SERIES Published by the American Society for Reproductive Medicine under the direction of the Patient Education Committee and the Publications Committee. No portion herein may be reproduced in any form without written permission. is booklet is in no way intended to replace, dictate or fully dene evaluation and treatment by a qualied physician. It is intended solely as an aid for patients seeking general information on issues in reproductive medicine. Copyright © 2018 by the American Society for Reproductive Medicine AMERICAN SOCIETY FOR REPRODUCTIVE MEDICINE ASSISTED REPRODUCTIVE TECHNOLOGY A Guide for Patients Revised 2018 A glossary of italicized words is located at the end of this booklet. INTRODUCTION is booklet will help you understand in vitro fertilization (IVF) and other assisted reproductive technology (ART) that have become accepted medical treatments for infertility. rough these procedures, many couples with otherwise untreatable infertility have given birth to healthy babies. UNASSISTED REPRODUCTION In order to understand assisted reproduction and how it can help infertile couples, it is important to understand how conception takes place naturally. For traditional conception to occur, the man must ejaculate his semen, the uid containing the sperm, into the woman’s vagina around the time of ovulation, when her ovary releases an egg. Ovulation is a complex event controlled by the pituitary gland, which is located at the base of the brain. e pituitary gland releases follicle-stimulating hormone (FSH), which stimulates follicles in one of the ovaries to begin growing. e follicle produces the hormone estrogen and contains a maturing egg.
    [Show full text]