At present, the mainland is facing a new situation of high-quality population development. At the sub-venue of the "High-end Seminar on Advances in Reproductive Medicine" of the 2024 China Health Science and Technology Innovation and Discipline Construction Conference and the High-quality Development Conference of Chinese-style Modern Hospitals, a number of well-known experts shared the new progress in the field of reproductive medicine in mainland China. The seminar was chaired by Professor Zhang Songying, academic leader of the Department of Obstetrics and Gynecology and Reproductive Center of Sir Run Run Run Shaw Hospital, Zhejiang University School of Medicine, and Professor Sun Fei, discipline leader of the Center for Male Reproductive and Sexual Medicine, summarized the meeting.
Exploring the mysteries of early life is crucial
Huang Hefeng
Academician of the Chinese Academy of Sciences, Dean of the School of Medicine of Zhejiang University
Huang Hefeng, Academician of the Chinese Academy of Sciences and Dean of the School of Medicine of Zhejiang University: Chronic non-communicable diseases mainly refer to a large group of diseases with a long course of disease, complex etiology, and serious impact on the health of patients, including cardiovascular and cerebrovascular diseases, cancer, chronic respiratory diseases and diabetes. Chronic disease prevention and management throughout the life cycle is essential. Health management throughout the life cycle does not begin at birth, but from the mother's health management during pregnancy. For example, there is an urgent question in the field of reproductive medicine: does the undesirable internal environment of women of childbearing age, such as high blood sugar, affect the health of their offspring through genetic changes in oocytes? Studies in mouse models of gestational diabetes have shown that the high glucose environment in the womb of female mice can alter the DNA methylation of embryos, resulting in abnormal glucose tolerance in offspring. Therefore, in order to reduce the risk of chronic diseases in offspring, we should advance the prevention and screening of underlying diseases to the preconception stage. This is essential for promoting human health throughout the life cycle.
Wang Hongmei
Director of the State Key Laboratory of Stem Cell and Reproductive Biology, Institute of Zoology, Chinese Academy of Sciences
Wang Hongmei, Director of the State Key Laboratory of Stem Cells and Reproductive Biology, Institute of Zoology, Chinese Academy of Sciences: Embryonic development is not an isolated process, and requires the development of "soil" - placenta and uterine support. We used non-human primates for in vitro embryo culture studies and successfully cultured embryos up to 25 days post-fertilization, providing a valuable model for studying early embryonic development. In addition, we aim to unravel the specific mechanisms by which the placenta supports fetal development by mapping cells and establishing placental stem cells and organoids. In the future, artificial embryos will become a powerful tool to solve major human diseases. To further promote the research on the early development of human embryos, and to provide a new direction for elucidating the mechanism of early pregnancy and the treatment of diseases.
Goofy
Researcher and professor of developmental biology at the Institute of Zoology, Chinese Academy of Sciences
Gao Fei, researcher and professor of developmental biology at the Institute of Zoology, Chinese Academy of Sciences: Our more than 20 years of research have shown that gamete development depends not only on the gametes themselves, but also on the somatic cells in the gonads (Sertoli cells and steroid-producing cells). We pay particular attention to the Wt1 gene, which is expressed in gonadal cells before and after sexual differentiation and plays an important role in gonadal development. Our study found that in individuals lacking the Wt1 gene, Sertoli cells differentiate into Leydig cells. In addition, in the absence of the Wt1 gene, the somatic cells cannot develop, the sex differentiation is incomplete, and "sexless" individuals will appear. These findings not only deepen the scientific community's understanding of the regulation of gonadal cells during sex differentiation, but also provide a new perspective for infertility treatment.
Male and female reproductive research goes hand in hand
Sun Qingyuan
Researcher and chief scientist of the Second People's Hospital of Guangdong Province
Sun Qingyuan, researcher and chief scientist of the Second People's Hospital of Guangdong Province: Mitochondria are energy factories in cells, and their mutations may lead to a series of mitochondrial diseases. The mechanism of sperm mitochondrial clearance is our research direction. Relevant studies have shown that autophagy is key in sperm mitochondrial clearance. We have constructed a system to safely and effectively remove mitochondria and their DNA from nuclear donor embryos during mitochondrial replacement. After optimization, the system is expected to further improve the clinical mitochondrial replacement efficiency, thereby providing a new strategy for blocking hereditary mitochondrial diseases through assisted reproductive technology.
Business Army
Chairman of the Andrology Branch of the Chinese Medical Association, Chief Physician of the Department of Urology of the Eastern Theater General Hospital
Shang Xuejun, Chairman of the Andrology Branch of the Chinese Medical Association and Chief Physician of the Department of Urology of the Eastern Theater General Hospital: In order to standardize the clinical diagnosis and treatment of male infertility, the Andrology Branch of the Chinese Medical Association organized the compilation of the "Guidelines for the Diagnosis and Treatment of Male Infertility (2022 Edition)". The guidelines not only discuss in detail the etiology, diagnosis and treatment of male infertility, but also emphasize the importance of assisted reproductive technologies and prognostic factors. In addition, the guidelines put forward the principles of individualized and precise treatment, and detailed a variety of treatment methods. At the same time, the guidelines also emphasize the importance of couples treating together, and call for strengthening scientific education to raise public awareness of male infertility problems.
Wang Lei
Professor, Institute of Biomedical Sciences, Fudan University
Professor Wang Lei, Institute of Biomedical Sciences, Fudan University: Our team mainly focuses on rare diseases such as egg maturation disorders, and discovered the first pathogenic gene TUBB8 in 2016, which affects spindle assembly and leads to egg maturation failure. We also studied multiple genes related to egg development and embryonic abortion, such as TRIP13 and PABPC1L, revealing the differences in genetic mechanisms between humans and mice. In recent studies, we have revealed the role of de novo mutations in abnormal egg and embryo development, and have identified de novo mutated genes that are enriched only in female infertility patients. These studies provide an important basis for clinical genetic counseling and treatment.
Qin Yingying
He is a second-level professor of Shandong University and the deputy director of the National Key Laboratory of Reproductive Medicine and Offspring Health
Qin Yingying, second-level professor of Shandong University and deputy director of the National Key Laboratory of Reproductive Medicine and Offspring Health: Premature ovarian failure (POI) in women is one of the important factors affecting fertility. To gain a deeper understanding of the etiology and clinical features of POI, we conducted research over a period of 20 years. The data analysis of more than 3,000 POI patients showed that genetic factors accounted for 36% and immune factors accounted for 11% of the etiology of POI, while the proportion of iatrogenic injuries decreased. Through prospective cohort studies, we revealed the progression of POI and established a clinical pregnancy prediction model, which is expected to provide patients with earlier opportunities for diagnosis and intervention.
Assisted reproduction still needs more high-quality exploration
Huang Guoning
He is the head of the Reproductive Medicine Center of Chongqing Maternal and Child Health Hospital and the current chairman of the Reproductive Medicine Branch of the Chinese Medical Association
Huang Guoning, head of the Reproductive Medicine Center of Chongqing Maternal and Child Health Hospital and current chairman of the Reproductive Medicine Branch of the Chinese Medical Association: In the field of reproductive medicine, preimplantation embryo screening has gradually received attention, but the assessment of embryo implantation potential is still facing challenges. Studies have demonstrated that complex and precise epigenetic regulation occurs during early embryonic development, including DNA demethylation and reconstitution, histone modifications, and more. In the process of assisted reproductive technology, the apparent modification of embryos is very susceptible to external influences, so it may be an important research direction to use the characteristics of epigenetic modification to determine the development potential of embryos. At the same time, DNA methylation testing may have the potential to predict embryonic aneuploidy morphology and embryo quality (higher quality embryos with more stable methylation levels), but more clinical trial data are needed.
Sun Yingpu
Chief Scientist of the First Affiliated Hospital of Zhengzhou University, former chairman of the Reproductive Medicine Branch of the Chinese Medical Association
Sun Yingpu, Chief Scientist of the First Affiliated Hospital of Zhengzhou University and former Chairman of the Reproductive Medicine Branch of the Chinese Medical Association: At present, the egg donation model adopted by the mainland emphasizes humanitarian behavior and strictly prohibits commercial transactions, which effectively guarantees the safety and reliability of egg sources. However, the current situation of imbalance between egg supply and demand and illegal underground commercial egg donation, which endangers the reproductive health of some women, it is recommended to improve relevant policies and regulations, improve technical safety, strengthen supervision, avoid the health risks caused by illegal commercial egg donation, and increase the publicity of formal and legal channels.
Sun Haixiang
Director of the Reproductive Medicine Center of the Drum Tower Hospital Affiliated to Nanjing University School of Medicine, and chairman-designate of the Reproductive Medicine Branch of the Chinese Medical Association
Sun Haixiang, Director of the Reproductive Medicine Center of the Drum Tower Hospital Affiliated to Nanjing University School of Medicine and Chairman-designate of the Reproductive Medicine Branch of the Chinese Medical Association: Our team focuses on solving a series of key problems in the field of clinical assisted reproduction: for the problem of asynchronous follicle development, the introduction of GnRHa downregulation technology has realized the optimal selection of "target follicles"; In order to solve the problem of premature ovarian failure, the combination of biomaterials and umbilical cord mesenchymal stem cell therapy was explored to improve the pregnancy outcome of patients with premature ovarian failure. In terms of embryo screening, the AI intelligent embryo evaluation model was used to significantly improve the accuracy and efficiency of embryo selection. In terms of improving the quality of oocytes in elderly women, a large number of basic medical studies have been carried out to provide theoretical support for clinical transformation and the development of assisted reproductive technology.
Finishing: Health News reporter Xia Haibo
Curator: Li Tianshu, Tan Jia
Editor: Wang Jianying, Guan Zhongyao
Proofreading: Ma Yang
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