Stanford’s second annual Childx conference is off to a great start. This year’s event, taking place today and tomorrow at the Li Ka Shing Center for Learning and Knowledge, has a theme of “Designing Solutions for Maternal and Infant Health.”
“As we learn more and more about the determinants of disease, it becomes more evident that what goes on from conception through the first five or six years of life is defining in terms of the next 60, 70 or 80 years of life,” said Dean Lloyd Minor, MD, in his opening remarks to conference participants.
It’s an exciting time to study the health effects of early-life events at Stanford, he explained, in part because the field of maternal and child health lends itself so well to a precision-health approach, employing new scientific findings in a predictive and proactive way. And while we all want the right medical treatment — precision medicine — when we are sick, precision health goes farther than that, Minor said.
“We’ll know a decade from now if we’ve succeeded if a lot of the conditions that today require precision medicine are no longer on the map the way they are today,” he said.
The day began with three talks about the determinants of health around the time of conception. Magdalena Zernicka-Goetz, PhD, introduced her effort to understand how the embryo is able to repair itself when things go wrong. Her research was motivated in part by her pregnancy with her now-8-year-old son, Simon, she told the audience. When she had a chorionic villus sampling test, she discovered that 30 percent of the cells in Simon’s placenta screened positive for three, instead of the usual two, copies of chromosome 2. She was concerned:
"Quite early in pregnancy, this genetic abnormality appeared," Zernicka-Goetz said. As a mammalian development expert, she decided she wanted to build a model system to find out what happened if abnormal cells spontaneously arose during an embryo’s early cell divisions.
“We found that abnormal cells become eliminated by apoptosis: they undertake self-destruction,” she explained. Not only that, but after apoptosis, the neighboring cells get rid of the debris. “The embryo cleans itself,” she said. “I think it’s absolutely incredible to understand the ability of our embryos to correct errors that may happen in early life.”
Stanford scientists Barry Behr, PhD, and Renee Reijo Pera, PhD, (now also of Montana State University) explained their collaboration to predict which of the embryos created during in vitro fertilization are most likely to lead to viable pregnancies. The timing of early cell divisions holds an important clue to embryo quality, they have demonstrated.
The entire audience sat in rapt silence as Pera showed time-lapse videos of dividing embryos her lab took through a microscope in 2008 — the first complete movie of human embryo development. Behr described how the research has since been translated into an FDA-approved, commercialized diagnostic test that uses time-lapse photography to increase the success of IVF procedures in patients. Starting May 2, Stanford’s IVF lab will be the first to offer the procedure to all of its patients. Behr’s team is also working to assess the elastic properties of embryos, which “like Goldilocks” have to be not too hard, not too squishy – or “just right.” That work could lead to another level of predictive ability for IVF success, he said.
This line of research has profound implications for babies’ health. Better prediction of embryo health allows IVF doctors to transfer fewer embryos, Behr explained, producing more singleton pregnancies among IVF patients and lower rates of the complications and health problems associated with multiple births.
“Human embryo development is amazingly beautiful and amazingly fragile,” Pera said. “Most of our embryos don’t make it.”
Previously: Stanford study: "Squishiness" of embryo may predict its viability, Mastermind or freeloader? Viral proteins in early human embryos leave researchers puzzled and Countdown to Childx: Previewing the "epicenter of innovation" for expectant moms and children
Photo by Saul Bromberger