Fertility and Infertility (Lincoln)

Code

MEDS3065

School

Medical Education Centre

Level

3

Credits

10

Semesters

Autumn UK

Summary

Infertility affects around 1 in 6 couples throughout the world.  Advances in scientific research are continually increasing our understanding of the condition and expanding treatment options.  Advances in medical science also open up new ethical dilemmas and regulatory issues.  In this module the morphology, cellular and molecular biology of gamete and embryo development will be considered.  Normal development of gametes, fertilisation and implantation will be studied along with some common abnormalities.  How assisted reproductive technologies came about and how they have been used in both humans and non-human mammals will be explained and some consequences of their use will be discussed.  The latter will include fertility control and some issues raised by advances in reproductive technology.   Environmental influences on fertility and the impact of industrial toxicants on reproduction will also be discussed.

We begin with a general introduction to the subject, the extent of the problem, some historical developments, underlying concepts of germ cell renewal and endocrine/paracrine feedback mechanisms.  Next comes a focus on mature gametes (sperm and egg), their development and the mechanisms of fertilisation. Some events in cell recognition and pre-implantation embryo development will be examined including some coverage of maternal/ paternal genome expression and genomic imprinting.  Embryo implantation will be discussed as a process and in relation to maternal-fetal dialogue; the concept of the fetus as an allograft will be introduced. How germ cells become mature sperm and ova will be discussed along with the biotechnology associated with assisted reproductive technologies including some clinical investigations of human infertility, artificial breeding in non-human mammals and cryopreservation of germ tissues. There will be opportunities to discuss aspects of ethical and moral issues raised by infertility and ARTs.  We will also touch on genetic and cellular sexual determination and differentiation. Fertility control, both now and into the future, will be considered along with some of the impacts of environmental and industrial toxicants on fertility.
 

Target Students

Year 3students registered on the BMedSci based in Lincoln (A10L). Places are limited on this module. Students are reminded that enrolments which are not agreed by the School in advance may be cancelled without notice.

Classes

• One 2-hour workshop
• One 2-hour seminar
• Two 1-hour lectures each week for 6 weeks

Independent study – 84 hours. Although much of the module will be delivered as taught sessions, students will be expected to complete significant amounts of independent study in preparation for the journal club, mid-course test and the final assessment in order to consolidate their learning and demonstrate understanding of the subject area.

Assessment

• 100% Coursework: One 2,000 word essay produced individually

Assessed by end of spring semester

Educational Aims

Learning Outcomes

The students will achieve learning outcomes within the GMC’s Outcomes for Graduates (2018) as follows, (for “Newly qualified doctors” read “Students”):

Outcomes 1 − Professional values and behaviours 

• 2 c  summarise the current ethical dilemmas in medical science and healthcare practice; the ethical issues that can arise in everyday clinical decision-making; and apply ethical reasoning to situations which may be encountered in the first years after graduation 

• j  recognise the potential impact of their attitudes, values, beliefs, perceptions and personal biases (which may be unconscious) on individuals and groups and identify personal strategies to address this 

• s  access and analyse reliable sources of current clinical evidence and guidance and have established methods for making sure their practice is consistent with these

Legal responsibilities 

• 4 Newly qualified doctors must demonstrate knowledge of the principles of the legal framework in which medicine is practised in the jurisdiction in which they are practising, and have awareness of where further information on relevant legislation can be found.

Dealing with complexity and uncertainty 

• 6e  recognise how treatment and care can place an additional burden on patients and make decisions to reduce this burden where appropriate, particularly where patients have multiple conditions or are approaching the end of life . 

Safeguarding vulnerable patients 

• h  recognise where addiction (to drugs, alcohol, smoking or other substances), poor nutrition, self- neglect, environmental exposure, or financial or social deprivation are contributing to ill health.

• 9c  recognise and show respect for the roles and expertise of other health and social care professionals and doctors from all specialties and care settings in the context of working and learning as a multi- professional team. 

Outcomes 3 − Professional knowledge. Applying biomedical scientific principles 

• 22. a  explain how normal human structure and function and physiological processes applies, including at the extremes of age, in children and young people and during pregnancy and childbirth 

• b  explain the relevant scientific processes underlying common and important disease processes 

Health promotion and illness prevention 

• 25 a  explain the concept of wellness or wellbeing as well as illness, and be able to help and empower people to achieve the best health possible, including promoting lifestyle changes such as smoking cessation, avoiding substance misuse and maintaining a healthy weight through physical activity and diet

• c  evaluate the environmental, social, behavioural and cultural factors which influence health and disease in different populations

Clinical research and scholarship 

• 26 Newly qualified doctors must be able to apply scientific method and approaches to medical research and integrate these with a range of sources of information used to make decisions for care.

Conveners

• Professor David O'Brien