Reproductive Medicine: Science and Ethics - MSc

The practice of reproductive medicine is underpinned by a scientific basis stretching back hundreds of years. New discoveries are being put into medical practice on a regular basis and reproductive medicine research is well known for its translational element. This module will explore the fundamentals of reproductive medicine, Obstetrics, Gynaecology, Urology, Andrology, Managing abnormal pregnancies and pre-term birth, Infectious diseases affecting reproduction, Sex determination, reproductive endocrinology, cancer and fertility, causes of infertility and Genetics. This module will be science-based, informed and led by the scientific and medical literature and modern discoveries. Specifically:

• What is reproductive medicine? (Darren Griffin)

• Obstetrics, Gynaecology and Urology (Michael Summers)

• The science of Andrology (Sheryl Homa)

• Managing abnormal pregnancy and premature birth (Vimal Vasu)

• Infectious disease and reproductive medicine (Gary Robinson)

• Sex determination (Peter Goodfellow)

• Endocrinology and Reproduction (Michael Sumners)

• Cancer and Reproduction (Bill Gullick/ Dan Lloyd)

• The causes of infertility (Darren Griffin)

• Infertility and Genetics (Darren Griffin)

• Genetics and Pregnancy (Darren Griffin)

Around 1-2% of all babies in the UK are born by IVF, with varying figures in many other countries. Internationally, reproductive medicine generally, and IVF in particular, is an area in which the UK is world-leading. This module will explore the many aspects of practical IVF (including ICSI, and PGD) and the factors that affect it. A feature of the module will be the presentation of similar issues from different perspectives e.g. that of the clinician, the counsellor and the laboratory manager.

A career as a scientist in reproductive medicine (e.g. clinical embryologist) is a popular path. Although the proposed module does not aim to address the specific goal of training prospective clinical embryologists in how to perform their operational tasks (such training is provided in-house in a highly regulated clinical environment and leads to a vocational qualification), this module will give students a realistic expectation of the likelihood of them excelling in, and enjoying this popular career path. This module will thus explore the basics of lab technique and good practice, pipette making, egg collection and in-vitro maturation, sperm assessment, insemination, ICSI, embryo grading, assisted hatching, spreading and preimplantation diagnosis. For obvious reasons embryos from non-human model species (e.g. mouse, bovine, pig) will be used. Specifically:

• Referral categories for IVF (Laurence Shaw)

• The IVF laboratory (Alan Thornhill)

• IVF and ICSI (Alan Thornhill)

• Preimplantation Diagnosis and Screening

• Careers in reproductive medicine (Darren Griffin, Alan Thornhill)

• Practical course (Darren Griffin, Alan Thornhill)

The module aims to develop understanding and practical skills in molecular biology, based around interactive workshops, practical sessions and group work. The module will involve practical sessions covering key practical and transferable skills in molecular biology and biotechnology. The module will feature an extended mini-project focused on CRISPR-Cas9-based genome editing - a cutting-edge technology with wide application in the biological sciences – alongside presentation of findings in extended written report format to provide experience of the dissemination platform widely used in biological research. 

"BIOS8600"

This module will develop the advanced research skills that are required in modern biological research and transferable across biological research disciplines. This will include the development of skills in bioinformatics, statistical analysis, research publication and peer review through a combination of online exercises, seminars and group work. These skills will be discussed, enhanced and contextualised in tutorials that consider their application of these skills through consideration of literature and case studies drawn from the field of reproductive medicine. 

The curriculum will focus on the issues of reproductive rights, reproductive justice and the appropriate limits on reproductive autonomy. Topics covered will include moral and legal status of the embryo and fetus and the 'right to life' as it applies in this context; the regulation of embryo research and assisted reproductive technologies; surrogacy; contraception, abortion, sterilisation and the legal regulation of pregnancy.

Recent events have illustrated the importance of ensuring that science is communicated effectively to non-scientific audiences. This module considers best practice in science communication, making use of case studies that illustrate its importance in developing an informed and empowered public, while developing skills in different modes of communication that enhance future employability.

This module describes the anatomy, physiology, pathology, and therapy of the blood and blood forming tissues, including the bone marrow. It covers a wide range of disorders including haematological malignancies, infection with blood-borne parasites that cause malaria, and inappropriate clotting activities such as deep vein thrombosis.

Haematology:

An introduction to haematology: module outline, aims and objectives

Haemopoiesis and the bone marrow

The red cell: structure and function

Inherited abnormalities of red cells

Anaemias: acquired and inherited

White blood cells in health and disease

An introduction to haematological malignancies

Bleeding disorders and their laboratory investigation

Thrombophilia

Blood-borne parasites

Blood transfusion:

The ABO and Rhesus blood group systems

Other blood group systems

Blood banking techniques

Bioinformatics Data sources & Sequence analysis: Databases and data availability. Using sequence data for analysis – sequence searching methods, multiple sequence alignments, residue conservation, Protein domains and families.

Protein Bioinformatics Methods: Protein structure and function prediction. Prediction of binding sites/interfaces with small ligands and with other proteins. Bioinformatics analyses using protein data.

Genomics: An introduction to the analysis of genomic data, primarily focussing on the data available from genome sequencing – how it can be used to study genetic variants and compare genomes (i.e. comparative and functional genomics).

The module deals with basic neuroanatomy and molecular and cellular neurobiology, such as transmission of signals within the nervous system and sensory perception. It explores more complex functions of the nervous system, e.g. behavioural and cognitive functions including learning, memory, emotions and appetite control. Throughout the module both the normal nervous system and disorders that arise as a consequence of abnormalities will be covered.

A synopsis of the curriculum

The module overviews the importance of studying ageing, the organisms and methods used to do so and considers how organisms age together with providing a detailed understanding of the processes and molecular mechanisms that govern ageing.

Introduction

Importance and principles of ageing research

Why do organisms age and theories of ageing: e.g. Damage theory, telomeres, genetics and trade off theories.

How ageing and lifespan is measured

Overview of processes and pathways controlling ageing

Methods in ageing research

Model Organisms: Benefits and problems associated with studying ageing in model organisms. Including: Yeast, worms, flies, mice, primates.

Systems approaches to studying ageing: e.g. high throughput DNA/RNA sequencing, high throughput proteomics and, metabolomics. Pros and cons of these methods, what we have learned from them.

Signalling pathways that control ageing

Insulin signalling pathway and Target of Rapamycin (ToR) pathway

Organisation of pathways and the molecules involved, how they were discovered to be implicated in lifespan and ageing, ways of modelling and studying their molecular detail in animals e.g. genetic/ epistasis analysis

The processes downstream of these pathways that allow them to control lifespan/ageing e.g. stress resistance, autophagy, reduced translation, enhanced immunity etc…

Cross-talk between pathways.

Dietary restriction, lifespan and ageing

How dietary restriction works in different organisms, what signalling pathways and processes it affects.

Diseases of ageing

What these are e.g. Alzheimer's, Huntington's

Overview of 'normal ageing’ associated processes e.g. muscle weakening.

How they can be studied in model organisms and the importance of ageing research for treating these disorders.

Ethics of ageing research

Pros and cons of studying ageing with a goal of extending human lifespan e.g. insurance, health system, social, psychological implications.

This module introduces and develops knowledge in the key area of genome maintenance. Students will learn how loss of genomic integrity leads to enhanced cancer incidence, and how biological processes and the environment contribute to genetic instability. The cellular mechanisms that lead to cancer incidence, together with those that protect cells from the onset of carcinogenic processes will be reviewed. This module will also examine the use of DNA damaging agents in cancer therapies, and incorporate practical experience of investigating the cellular responses to DNA damage.

The aim of this module is to give students a basic understanding of molecular and cytogenetic techniques and their applications in the field of clinical diagnosis e.g. for infertility or prenatal diagnosis and biological research. Throughout the course there will be both theoretical and practical elements to the course enabling them to have hands-on experience with molecular cytogenetic tools. Students will be examined on both theoretical and practical elements to assess hands-on skills and understanding of the techniques involved. They will be provided with a lab book in which they should take notes during each of the sessions, the quality of this will also be assessed.

Students will undertake an independent research project that will be designed by the student, in consultation with an academic supervisor, to address specific research questions. Students will be trained in key techniques relating to the project, and will work independently under the supervisor's guidance to design and execute experiments that will address the questions formulated earlier.

During the Spring term, students are assigned to supervisors by the project co-ordinators (members of academic staff, generally the co-ordinators of the individual MSc-T programmes). Students then meet with their project supervisor to discuss the general subject matter of the project and obtain guidance on background reading, following which the student and supervisor work together to design the project. Orientation sessions are provided covering laboratory health and safety and research ethics.

The research activities take place in the Summer term and vacation. Students are expected to dedicate 600 hours to their project work. Of this time, students taking "wet-lab" projects will spend at least 11 weeks working full time in a laboratory setting planning, carrying out and documenting experiments, with the remainder of the time allocated to background reading and report writing. There are informal opportunities to discuss the project work and relevant literature with the supervisor and other laboratory staff on an ongoing basis. Formal meetings may be arranged at the discretion of the student and supervisor.

Students undertaking "dry-lab" projects analyse published information (e.g. literature, databases) or unpublished data sets are expected to spend the same amount of time on their projects as "wet-lab" students. "Dry-lab" students are expected to meet with their supervisor at least once a week to discuss progress and ideas and to resolve problems.

At the end of the formal project time, students are allowed time to complete the final project report, although they are encouraged to start writing as early as possible during the Summer term. The supervisor provides feedback on content and style of a draft of the report, which should be in the style of a scientific report for publication in an appropriate scientific journal. In addition, students are expected to deliver their findings as a poster in a symposium organised by the School.

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