Improving ART (Assisted Reproduction Technology) outcomes

Centres > Centre for Endocrinology & Metabolism > Clinical Andrology > Improving ART (Assisted Reproduction Technology) outcomes

Research Project:
Improving ART (Assisted Reproduction Technology) outcomes


Research Group:
Clinical Andrology

Project Leader:
Prof Robert McLachlan, email robert.mclachlan@princehenrys.org

Many couples rely on Assisted Reproduction Technology (ART) to conceive their children, and more than 3% of all Australian children are conceived using ART. Improving ART success rates, and ensuring the best possible health outcomes for ART-conceived children, is paramount. Male infertility is an important contributing factor in couples seeking ART, with male infertility observed in 1 in 20 Australian men of reproductive age, and in up to half of couples seeking ART.

This research program tackles a number of issues related to male infertility and ART outcomes. For examples, studies have investigated the role of Y chromosome defects in infertile men and have defined their frequency, type and clinical correlates. In severe cases of male infertility, approximately 4% of patients have microdeletions that remove variable copy numbers of key genes involved in sperm production. Screening for Y chromosome deletions is now routine in Australian ART programs.

Another area of research investigates the clinical significance of sperm DNA integrity and whether sperm DNA damage can be reversed by antioxidant treatment. The research has demonstrated a significant correlation between increased sperm DNA damage and poor outcomes for the embryo, supporting the concept that intact sperm DNA is essential to ensure a healthy offspring. This research has also involved the development of methods to comprehensively assess sperm vitality and to quantify sperm DNA damage. These methods can now be used to assess the effectiveness of antioxidant treatments in Randomised Clinical Trials (RCTs).

Intracytoplasmic sperm injection (ICSI) is now used to “bypass” male infertility, by injecting sperm directly into the oocyte. Therefore sperm that were unlikely to have ever been able to fertilise are now routinely used to create embryos during IVF. A major focus of research is on the consequences of using these sperm. For example, will sperm from men with a defined genetic cause of infertility transmit these infertility defects to their children? This current research effort involves multiple centres, with studies aimed at examining the health of young adult IVF offspring.

Major collaborators:

Prof John Aitken – The University of Newcastle
Prof Jane Fisher – Monash University
Prof Jane Halliday – The Murdoch Institute
Dr Karin Hammarberg – Monash University
Prof David de Kretser – Monash University
Prof Michelle Lane – The University of Adelaide
Associate Professor John McBain – Melbourne IVF
Prof Moira O’Bryan – Monash University
Dr Tiki Osianlis – Monash IVF
Associate Professor Luk Rombauts – Monash University

Selected recent publications:

Halliday J, Wilson C, Hammarberg K, Doyle LW, Bruinsma F, McLachlan RI, McBain J, Berga T, Fisher JR, Amor D. Comparing indicators of health and development of singleton young adults conceived with and without Assisted Reproductive Technology (ART) Fertility and Sterility (2014) 101(4):1055-1063

McLachlan RI. When is azoospermic infertility treatable without ICSI? Clinical Endocrinology (Oxford) (2013) 78 (2):176-180

McLachlan RI. Approach to the patient with oligozoospermia The Journal of Clinical Endocrinology and Metabolism (2013) 98 (3): 873-80.

Beyer CE, Kayler B, Osborne E, McLachlan RI, Osianlis T. Supersensitive fluorescent semen analysis: validation on azoospermic and oligozoospermic samples Fertility and Sterility (2012) 98 (4): 843-8

Aitken RJ, De Iuliis GN, Finnie JM, Hedges A, McLachlan RI. (2010) Analysis of the relationships between oxidative stress, DNA damage and sperm vitality in a patient population: development of diagnostic criteria. Hum Reprod. 25: 2415-2620

Krausz C, Giachini C, Xue Y, O’Bryan MK, Gromoll J, Rajpert-de Meyts E, Oliva R, Aknin-Seifer I, Erdei E, Jorgensen N, Simoni M, Ballescà JL, Levy R, Balercia G, Piomboni P, Nieschlag E, Forti G, McLachlan R, Tyler-Smith C.  (2009) Phenotypic variation within European carriers of the Y-chromosomal gr/gr deletion is independent of Y-chromosomal background.  J Med Genet. 46(1):21-31

Aitken RJ, De Iuliis GN, McLachlan RI. Biological and clinical significance of DNA damage in the male germ line. International Journal of Andrology (2009) 32(1):46-56.

McLachlan RI, Aitken RJ, Cram D, Krausz C, O’Bryan MK. Need for standardization and confirmation of STS deletions on the Y Chromosome. Fertility and Sterility (2008) 90:463-464.

McLachlan RI, Rajpert-De Meyts E, Hoei-Hansen CE, de Kretser DM, Skakkebaek NE. (2007) Histological evaluation of the human testis: approaches to optimizing the clinical value of the assessment. Hum Reprod. 22(1): 2-16

Osborne EC, Lynch M, McLachlan RI, Trounson AO, Cram DS. (2007) Microarray detection of Y chromosome deletions associated with male infertility. Reprod Biomed Online 15: 673-680.

Cram DS, Osborne E, McLachlan RI. Y chromosome microdeletions: implications for assisted conception. Medical Journal of Australia (2006) 185:433-4.