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  • IMAGINE IF ANYONE WHO WANTED TO HAVE A CHILD, WHETHER THEY'RE STRAIGHT, GAY, YOUNG, OLD,

  • CANCER SURVIVOR, OR EVEN SINGLE PARENT

  • COULD CONCEIVE A HEALTHY BABY EASILY?

  • WITH MODERN TOOLS, TECHNOLOGIES, AND THERAPIES ON THE HORIZON,

  • SOME SAY THE END OF INFERTILITY

  • IS IN SIGHT.

  • BUT WILL IT BE A WORLD OF EMBRYO FARMS AND EUGENICS?

  • OR ONE WHERE THE FUNDAMENTAL JOYS OF PARENTHOOD ARE AVAILABLE TO EVERYONE?

  • HOW CLOSE ARE WE TO THE END OF INFERTILITY?

  • INFERTILITY AFFECTS ABOUT 12% OF COUPLES TRYING TO CONCEIVE A CHILD TODAY.

  • AND IT'S A PROBLEM THAT DOESN'T HAVE ONE SIMPLE SOLUTION.

  • - The usual suspects are male factor infertility, tubal factor infertility, ovulation disorderswhen

  • a woman doesn't release an egg;

  • unexplained infertility...

  • One of the, probably, newest infertility factors that we are seeing more and more is age factor.

  • People are delaying their fertility and their childbearing for multiple reasons.

  • ON THE MEDICAL SIDE OF THINGS, THERE'S A LONG LIST OF OPTIONS AVAILABLE TO HETEROSEXUAL

  • PATIENTS, DEPENDING ON THEIR DIAGNOSIS, INCLUDING OPTIMIZATION OF INTERCOURSE,

  • HORMONE THERAPY, AND INTRAUTERINE INSEMINATION

  • And then there is IVF, which is, as we call it, bigger guns.

  • It's more invasive, but also a more successful treatment that we have.

  • IVF STANDS FOR IN-VITRO FERTILIZATION, WHERE EGGS AND SPERM ARE COMBINED IN A LAB, AND THE

  • RESULTING FERTILIZED EMBRYO IS IMPLANTED IN A WOMAN'S UTERUS.

  • - It was a technology that really I think blew people's minds, the idea that we could

  • have reproduction occur outside the body.

  • But these days, It's become part of the natural landscape of human reproduction.

  • BUT FOR SOME COUPLES, IVF WILL ONLY GET THEM SO FAR.

  • - If you're unable to make an egg or sperm, then that means you're unable to use In Vitro

  • Fertilization to have a family.

  • - Infertility is medical.

  • It is the idea that you lack something you need for reproduction.

  • Dysfertility, on the other hand, refers to the social aspect of reproduction.

  • The best examples are gays and lesbians who need, typically, gametes or a surrogate from

  • the other sex in order to help them, and single individuals who might not have a reproductive

  • partner.

  • THAT'S WHY ALL OVER THE WORLD, RESEARCHERS IN LABS LIKE AMANDER CLARK'S BELIEVE THAT

  • DYSFERTILITY DOESN'T HAVE TO BE THE END OF THE STORY.

  • ON THE CUTTING EDGE OF STEM CELL BIOLOGY, THEY'RE DISCOVERING CLUES ABOUT THE CAUSES

  • OF INFERTILITY, AND IN THE PROCESS, MIGHT PAVE THE WAY FOR A NEW METHOD OF REPRODUCTION

  • THAT DOESN'T REQUIRE EGGS OR SPERM AT ALL

  • AT LEAST UP FRONT.

  • INSTEAD, IT RELIES ON INDUCED PLURIPOTENT STEM CELLS.

  • - Basically, you can take skin cells, injected into with this famous cocktail of transcription

  • factors, and make them into pluripotent stem cells.

  • - Induced pluripotent stem cells are made by first taking a skin punch biopsy, for example.

  • And we will grow cells out of the biopsy in a tissue culture plate, and these cells are

  • called dermal fibroblasts.

  • We need to store them under liquid nitrogen and they can stay here for years and years

  • and years until we're ready to reprogram them.

  • So it takes about three weeks to fill up a plate, and it takes about another three weeks

  • to turn those dermal fibroblasts into induced pluripotent stem cells.

  • Oh, that's a beautiful colony!

  • - You could take some of my skin right now, you could take those adult cells and you could

  • return them to an earlier stage in their development where they can become multiple

  • different kinds of cells.

  • WHAT'S EXCITING IS THAT AMANDER'S TEAM HAS ALREADY PROVEN THAT WE CAN USE THIS METHOD

  • TO CREATE GERMLINE CELLS, THE PRECURSORS TO EGGS AND SPERM.

  • - Forming germline is a really special cell type and it's very hard to make.

  • What my lab was able to show is that it is possible to make germline cells from

  • induced pluripotent stem cells.

  • So how can we take these precursor germ cells that we make in the lab, and coax them to

  • move into the next step in development, which takes us one step closer to making the egg

  • and the sperm cell?

  • AND IF THEY'RE SUCCESSFUL, IT WOULD BE HUGE: POTENTIALLY SETTING THE STAGE FOR THE NEXT

  • REVOLUTION IN REPRODUCTION: IN-VITRO GAMETOGENESIS, OR IVG.

  • RESEARCHERS HAVE ALREADY PROVEN THAT IVG CAN BE SUCCESSFUL IN MICE, SO, IT'S NOT IMPOSSIBLE.

  • BUT HOLD UP!

  • DOESN'T CREATING EGGS AND SPERM OUT OF SKIN CELLS RAISE SOME  SERIOUS QUESTIONS ABOUT

  • WHAT REPRODUCTION EVEN MEANS?

  • JUST AS IVF WAS HOTLY DEBATED WHEN IT FIRST ARRIVED ON THE SCENE,

  • IVG HAS SPAWNED SOME CONCERNS.

  • - One is this idea that   we'll end up with these huge embryo farms.

  • That instead of producing five or six embryos and choosing one of them, maybe you would

  • produce a thousand embryos, and decide amongst the thousand which to reproduce.

  • And for some people, that's a very alarming idea.

  • It raises the possibility of eugenics, perfectionism, but also this idea that maybe we'll have a

  • huge market for embryos, buying and selling, or have thousands of embryos per individual

  • stored in a freezer or disposed of.

  • THEN, THERE'S WHAT GLENN CALLS THE 'CELEBRITY SCENARIO' TO CONTEND WITH.

  • Imagine, you go to a hotel, and you find that Brad Pitt was staying at that hotel.

  • You're cleaning the hotel and there's some skin of Brad Pitt's left on the bathtub.

  • From that adult cell, you might be able to use in-vitro gametogenesis to derive a sperm

  • or an egg.

  • And the idea would be, you could reproduce and have a child, that isgenetically

  • speakingBrad Pitt's child, without ever having met Brad Pitt, without ever having

  • talked to Brad Pitt, without him ever consenting to the reproduction.

  • THE BRAD PITT SCENARIO, AS I LIKE TO CALL IT, DOES GIVE US A LOT TO THINK ABOUT AS WE

  • CHANGE OUR DEFINITION OF WHAT IT MEANS TO REPRODUCE.

  • BUT THAT MEANING IS ALREADY CHANGING.

  • AND WITH SO MANY TOOLS ALREADY IN OUR BABY-MAKING TOOLBOX,

  • AND MORE TO COME ONLINE SOON,

  • HOW CLOSE ARE WE TO THE END OF INFERTILITY?

  • - In-vitro gametogenesis and making a gamete, for example, an egg, that we could use for

  • research purposes I believe is about five to 10 years away.

  • The challenge will be translating this work from a research lab into the clinic so that

  • it can be used to help couples overcome infertility.

  • - So, we are nearing the end of many forms of infertility.

  • People who have mitochondrial diseases can use mitochondrial replacement therapies.

  • People who have other diseases might be able to use gene editing.

  • Women who have uterine factor infertility can already use a uterus transplant if it's

  • available in their location.

  • - With the whole IVG thing, that's maybe sounding like a science fiction now.

  • But even the whole IVF was a science fiction 50 years ago.

  • But there is a lot of research going on in that direction.

  • And I do believe that probably in maybe, you know, 30, 40 years, maybe even 10 years, we

  • will have some clinical applications.

  • - And the idea that that which can be imagined in fiction, can become fact within a generation,

  • suggest to me that there's huge numbers of other reproductive revolutions still ahead

  • of us that people still haven't even conceived of yet.

  • ONE THING'S FOR SURE - OUR YOUTUBE CHANNEL IS FERTILE GROUND TO GROW YOUR NERDY KNOWLEDGE.

  • SO BE SURE TO SUBSCRIBE, AND COME BACK FOR NEW STORIES FROM THE FRONTIERS OF SCIENCE.

  • THANKS FOR WATCHING!

IMAGINE IF ANYONE WHO WANTED TO HAVE A CHILD, WHETHER THEY'RE STRAIGHT, GAY, YOUNG, OLD,

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不妊症の終わりまであと少し? (How Close Are We to the End of Infertility?)

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    林宜悉 に公開 2021 年 01 月 14 日
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