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Front. Med.    2019, Vol. 13 Issue (6) : 627-638    https://doi.org/10.1007/s11684-019-0697-5
REVIEW
What will the future hold for artificial organs in the service of assisted reproduction: prospects and considerations
Mara Simopoulou1,2(), Konstantinos Sfakianoudis3, Petroula Tsioulou1, Anna Rapani1, Polina Giannelou1,3, Nikolaos Kiriakopoulos1, Agni Pantou3, Nikolaos Vlahos1, George Anifandis4, Stamatis Bolaris5, Konstantinos Pantos3, Michael Koutsilieris1
1. Department of Physiology, Medical School, National and Kapodistrian University of Athens, Mikras Asias, 11527, Athens, Greece
2. Assisted Conception Unit, 2nd Department of Obstetrics and Gynecology, Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens, Vasilissis Sofias str., 11528, Athens, Greece
3. Centre for Human Reproduction, Genesis Athens Clinic, Papanikoli, 15232, Athens, Greece
4. Department of Histology and Embryology, Faculty of Medicine, University of Thessaly, 41500, Larisa, Greece
5. Assisted Conception Unit, General-Maternity District Hospital “Elena Venizelou,” Plateia Elenas Venizelou, 11521, Athens, Greece
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Abstract

Assisted reproduction provides a wide spectrum of treatments and strategies addressing infertility. However, distinct groups of infertile patients with unexplained infertility, congenital disorders, and other complex cases pose a challenge in in vitro fertilization (IVF) practices. This special cohort of patients is associated with futile attempts, IVF overuse, and dead ends in management. Cutting edge research on animal models introduced this concept, along with the development of artificial organs with the aim to mimic the respective physiological functions in reproduction. Extrapolation on clinical application leads to the future use of infertility management in humans. To date, the successful clinical application of artificial reproductive organs in humans is not feasible because further animal model studies are required prior to clinical trials. The application of these artificial organs could provide a solution to infertility cases with no other options. This manuscript presents an overview on the current status, future prospects, and considerations on the potential clinical application of artificial ovary, uterus, and gametes in humans. This paper presents how the IVF practice landscape may be shaped and challenged in the future, along with the subsequent concerns in assisted reproductive treatments.
Keywords artificial ovary      artificial uterus      artificial gametes      assisted reproduction      considerations      in vitro fertilization     
Corresponding Author(s): Mara Simopoulou   
Just Accepted Date: 13 June 2019   Online First Date: 17 July 2019    Issue Date: 16 December 2019
 Cite this article:   
Mara Simopoulou,Konstantinos Sfakianoudis,Petroula Tsioulou, et al. What will the future hold for artificial organs in the service of assisted reproduction: prospects and considerations[J]. Front. Med., 2019, 13(6): 627-638.
 URL:  
https://academic.hep.com.cn/fmd/EN/10.1007/s11684-019-0697-5
https://academic.hep.com.cn/fmd/EN/Y2019/V13/I6/627
Fig.1  Factors affecting the future implementation of artificial organs in assisted reproduction.
Fig.2  Outline of the review content. AO, artificial ovary; AU, artificial uterus; AGs, artificial gametes; ART, assisted reproductive technologies.
Artificial organs In vitro experiments employing human cells Animal model experiments Clinical trials on humans Fields of future implementation of artificial reproductive organs in assisted reproduction
Clinical application Application in the IVF laboratory Research application
AO Yes [21] Mouse [6,9,15–20,22] No Ovarian function restoration
Fertility preservation/ maintenance		 Oocyte culture
In vitro maturation of oocytes		 Toxicity tests
Investigate folliculogenesis
AU Yes [45]a Goat [46]
Shark [49]
Lamb [50]
Rat [51]
Rabbit [52]		 No Absolute uterine etiology
RIF
Unexplained infertility
Surrogacy replacement		 Embryo culture Toxicity tests
Investigate implantation procedure
AGs No Mouse [85] No Enable genetic parenthood Test IVF consumables and conditions Toxicity tests
Investigate gametogenesis
Tab.1  Technical overview of current status and limitations and possibilities regarding future direction on the clinical application and research of artificial organs in assisted reproduction
Fig.3  Graphical representation of ART patients benefiting from future application of artificial organs. AO, artificial ovary; AU, artificial uterus; AGs, artificial gametes; ART, assisted reproduction technologies; RIF, recurrent implantation failure; POF, premature ovarian failure; POR, poor ovarian reserve; DOR, diminished ovarian reserve; AMA, advanced maternal age.
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