Transdisciplinary Research in Transdisciplinary Research in Reproductive MedicineReproductive Medicine
Jeff Nisker MD PhD FRCSC
Schulich School of Medicine & Dentistry University of Western Ontario
Transdisciplinary ResearchTransdisciplinary Research
“multi-” “more than one”
“trans-” “across”
shift from unidisciplinary to interdisciplinary approaches, and from individualized projects toward collaborative team (JT Klien 1996, D Stokols 1996, National Academy of Sciences 2004)
growing interest and investment in promoting interdisciplinary collaboration is reflected in several large-scale research initiatives, including the establishment of the MacArthur Foundation (RL Kahn 1993)
CIHR’s Pillars of Health ResearchCIHR’s Pillars of Health Research
1. biomedical science
2. clinical science
3. health systems and services
4. social, cultural, environmental and other aspects that effect the health of populations
Projects should consider multiple pillars
Mixed Methods ResearchMixed Methods Research
1. laboratory methods
2. clinical science methods
a) RCT
b) cohort
c) n of 1
3. social science methods
a) survey research
b) qualitative research
(i) interviews
(ii) focus groups
(iii) audience discussions
4. humanities methods
Transdisciplinary Research CubeTransdisciplinary Research Cube
biomedical science
policy re
search
soci
al s
cien
ce clinical practice
Problem of High Order Multiple Pregnancy in CanadaProblem of High Order Multiple Pregnancy in Canada
• SOGC Initiative (Barrett, Bocking et al JOGC 2000)
• CIHR Conference (2002)
““Toward Single-Embryo Transfer” – CIHR (2004)Toward Single-Embryo Transfer” – CIHR (2004)
Tom Kennedy PhD - physiologist - implantation
Gerry Kidder PhD - developmental biologist - roles of gap junctional in intercellular
communication in gametogenesis and embryogenesis
Andy Watson - physiologist, oocyte researcher - molecular control of early
embryonic development
Chris Newton PhD - psychologist - psychological impact of infertility
Jeff Nisker MD PhD FRCSC - repro endo, scientist, ethicist - ethical issues in assisted
reproduction, genetics, cancer; and health policy
Robert Casper MD FRCSC (UofT) - repro endo, scientist-clinical IVF
Sue Varmuza (UofT) - zoologist, molecular geneticist-spermatogenesis and role of
sperm in preimplantation development
Derrick Rancourt (U Calgary) - molecular biologist, stem cell researcher
Co-PIs on projectsCo-PIs on projects
Valt Feyles, MD PhD repro endo, scientist
Steve Power MD PhD repro endo, scientist
Francis Tekpetey PhD IVF scientist
Samantha Brennan PhD philosopher/ethicist
Carolyn McLeod PhD philosopher/ethicist
Françoise Baylis PhD (Dalhousie) philosopher/ethicist
Roxanne Mykitiuk HBA LLB LLM (Osgoode Hall, York U) legal scholar/ethicist
““Towards Single-Embryo TransferTowards Single-Embryo Transfer””
Project 1: (Casper) Lowering E2 to physiologic range during COH and pregnancy rate
Project 2: (Varmuza) Mutations in human homologues of murine spermatogenesis genes among men with idiopathic non-obstructive azoospermia and ICSI.
Project 3: (Kidder) Gap junction communication within the follicle as indicator of oocyte and embryo “quality”; and whether connexin gene mutations underlie some female infertility.
Project 4: (Rancourt) Whether implantation serine proteinase gene (ISO1/strypsin), necessary for hatching and invasion of blastocyst in the mouse endometrium could be indicator of human embryo “quality”.
Project 5: (Watson) Effects of embryo culture conditions on the p38 MAPK signaling pathway and embryonic development
Project 6: (Kennedy) Markers of endometrial receptivity in the rat and human endometrium, and effects of COH protocols on their expression
Project 7: (Newton) Factors influencing patient’s attitudes towards single embryo transfer
Project 8: (Nisker) Ethical and legal issues in ARGTs, particularly regarding single embryo transfer, hESC research, and health policy
Cross-pollination among ProjectCross-pollination among Project
1. preparing grant
2. REB approval
3. informal meeting
4. formal meetings
5. papers
Project 8 - Ethical Issues: Team MembersProject 8 - Ethical Issues: Team Members
Jeff Nisker physician, scientist MD-patient relationship, hESC research, health policy
Francoise Baylis philosopher health policy, eligibility of embryos for donation to hESC research
Carolyn McLeod philosopher reproductive rights
Samantha Brennan philosopher children’s rights
Roxanne Mykitiuk legal scholar legal issues in ARGTs and rights of disabled people.
Project 8 – Ethical Issues: Research AreasProject 8 – Ethical Issues: Research Areas
1. ethical and legal concepts of a “healthy” embryo
2. informed choice regarding fertility conservation in children with cancer
3. ethical and legal considerations of embryo “donation” a. to hESC research
b. to other patients
4. ethical and legal considerations of oocyte “donation”
5. health policy development in ARGTs
6. stem cell research
7. other ethical and legal issues of ARGTs
Project 8 – PublicationsProject 8 – Publications1. Nisker JA, White AD “The CMA Code of Ethics and the donation of fresh embryos for stem cell
research”. CMAJ Sept. 2005;173(6):621-2. 2. Ram N. Regulating Consent to Human Embryo Research: A Critique of Health Canada’s Proposal.
Health Law Review 2005; 14(2): 19-27.3. Baylis F. Embryological Viability. American Journal of Bioethics 2005; 5(6): 17-18.4. McLeod C. “’Embryo Autonomy? What about the Autonomy of Infertility Patients?” American
Journal of Bioethics 5(6), 2005: 25-26. 5. McLeod C. Letter to editor of the Hastings Center Report on Rebecca Kukla’s “Conscientious
Autonomy: Displacing Decisions in Health Care” (HCR 35(2), 2005: 34-44), HCR 35(5), 2005: 5.6. McLeod C, Baylis F. Feminists on the Inalienability of Human Embryos Hypatia 2006; 21(1): 1-14. 7. Nisker J “Compassion as Well as Clarity”, J Obstet Gynaecol Can ” [Let] Feb 2006; 28(2): 1218. Nisker J, Baylis F, and McLeod C. “Preserving the Reproductive Capacity of Girls and Young
Adolescent Women with Cancer: Informed Choice,” Cancer, in press.9. Daniels K, Feyles V, Nisker K, et al. “Semen donation: Implications of Canada’s Assisted Human
Reproduction Act, 2004 on recipients, donors, health professionals, and institutions” J Obstet Gynaecol Can in press 2006.
10. Ram N. Britain's New Preimplantation Tissue-Typing Policy: An Ethical Defense. Journal of Medical Ethics in press.
11. McLeod C. “For Dignity or Money: Feminists on the Commodification of Women’s Reproductive Labour” (11,063 words), Oxford Handbook of Bioethics, in press.
12. White A, Nisker J, Tekpetey F, Feyles V “Donation of Embryos to Stem Cell Research in Canada: A Free and Informed Choice Process”, in preparation.
13. Mykitiuk R, Nisker JA, “Lenses and ‘Healthy’ Embryos”, in preparation.
Structural and Functional Annotation of the Human Structural and Functional Annotation of the Human Genome for Disease: R Hegele and M ShierGenome for Disease: R Hegele and M Shier
Theme 5 (Nisker): Ethical, legal, and societal implications of research into monogenic-related heart disease and breast cancerSub-themes:
Roxanne Mykitiuk HBA LLB LLM legal scholar York U - conceptions of health, disease, illness, normalcy and disability
Fiona Miller PhD McMaster University - socioeconomic issues of monogenic health services
Michelle Mullen PhD University of Ottawa - Informed choice to participate in monogenic research
Jeff Nisker MD PhD FRCSC UWO - Professional and educational issues in the conduct of monogenic research
Transdisciplinary Graduate Program in Transdisciplinary Graduate Program in Health Sciences, UWOHealth Sciences, UWO
begins September 2006
MHSc and PhD in Health Science
physicians and medical students, law students and lawyers, as well traditional health science professions (nursing, rehab, PT, OT, SP) and students having completed other undergraduate degree programs