Procedures Embryos

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The Stem Cell Resource

IVF clinics and "banks" of donated embryos provide human embryos for research. The Stem Cell Resource (SCR) is a non-profit affiliation of La Jolla IVF clinic and the Burnham Institute for Medical Research which offers an option for patients who have had successful in vitro fertilization procedures and who have completed their families to voluntarily donate the remaining embryos for research. The clinical arm of the SCR receives embryos from donors' IVF clinics and codes them so that there is no identifying information provided to the researchers who will work with the embryos. The SCR works under Institutional Review Board (IRB)-approved informed consent and standard operating procedures, and provides all of the documentation materials, shipping services and storage at no cost to the donor. Researchers who wish to use the donated embryos must have IRB and Embryonic Stem Cell Research Oversight Committee (ESCRO) approval to conduct human embryo research, and must apply to a scientific review committee that judges the quality of the proposed research project. Details about the SCR are provided in Appendix 21.1.

Sources of embryos

Most embryos donated for research are those that are frozen, in excess of a patient's reproductive needs, and are donated after successful pregnancies. Frozen embryos vary considerably in quality. The techniques for cryopreservation differ from clinic to clinic and have evolved over time, so embryos may have been frozen by different methods and at different stages. Embryos may be frozen at the two-pronuclei (2PN) stage, on day 3 (eight-cell) stage, or as blastocysts. We strongly recommend that a trained IVF embryologist thaw the embryos and culture them to blastocyst stage using conventional embryo culturing techniques.

Although most embryo donations are made after they are cryopreserved, embryos are sometimes discarded (and can be donated) before they are frozen. The most likely reason for discarding embryos is because they have chromosomal abnormalities or disease-associated mutations. Pre-implantation genetic diagnosis (PGD) is a procedure performed when there is a concern that the embryos may be abnormal; it is often performed when the chances of trisomy 21 are increased because the oocytes are provided by a woman older than 40. PGD can also be used to detect specific genetic diseases, such as cystic fibrosis, Tay Sachs disease, and hereditary cancers. PGD is generally performed by extracting one cell (blastomere) from the eight-cell embryo 3 days after fertilization, and while the remaining embryo develops for 2-3 more days to the blastocyst stage, the blastomere is analyzed by PCR to detect specific mutations or fluorescent in situ hybridization (FISH) for chromosomal analysis of the interphase nucleus.

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