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| Sunday, 10 March 2002 |
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Features |  |
| News Business Features Editorial
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by Carol Aloysius
He was part of the team that produced the first `Test Tube Baby' in Asia in 1983 followed by the first GIFT (Gamete Intra Fallopian Transfer) baby in 1985 in Asia. The first babies in the world delivered through Micromanipulation in 1989, were also from his lab at the National University of Singapore (NUH). He was also the principal investigator in a team that produced the world's first blastocyst transfer baby and the world's first zona-free blastocyst transfer baby. Despite these unique `firsts' which Sri Lankan born Professor Ariff Bongso has chalked up during a thirty year period of innovative, trail blazing research, he might have remained in comparative obscurity. That is, if it had not been for his ground breaking work with a unique kind of cell known as a Stem Cell - an incipient unit of human or animal tissue. which, when programmed with genetic instructions, can alter and grow to become "any type of cell in the body" and could thus be used to repair the ravages of old age, damage and disease. It was a flash of divine inspiration that made him research in this new revolutionary field of science. In 1993 he helped to develop a breakthrough technique to grow fertilised human egg into a five day old embryo outside the mother's womb, giving scientists that long awaited access to embryonic stem cells. It was this discovery that led Bongso and others to find ways of isolating the cells and develop methods whereby a colony of stem cells could be multiplied outside the womb in a lab dish to be transformed later into specialised tissues and organs to replace diseased cells. It is largely this pioneering research work that earned Dr. Bongso the title of `Father of Stem Cells', besides placing him in the midst of one of the bio-tech industry's hottest sectors, indirectly involving him in a controversial debate that has aroused mixed emotions world wide.The public outcry against stem cell research in the US led to its ban by the Bush regime. Britain on the other hand has recently announced its decision to setting up the world's first bank of frozen stem cells from human embryos next year. It was not however a desire to talk about his pioneering work in Stem cell research that brought Prof. Bongso to Colombo last weekend. Rather, it was to create public awareness on the new Assisted Reproductive Technology (ART) available to infertile couples who are desperate to have a child of their own, and which are available at the NUH. which currently boasts of a very high rate of success in assisted fertility. As a research professor and the Scientific director of the Assisted Reproductive Technology and Andrology Program at the NUH Singapore Prof. Bongso is eager that childless couples in his own homeland should also benefit from these advanced techniques. But how? At an extremely interesting and thought provoking public seminar on `Recent Advances in Fertility Treatment, Sunday,' probably the first of its kind, and organised by the Lions club of Battaramulla Central in association with Region 1 of district 306 C, and sponsored by the Hilton Hotel, Prof. Bongso told a very receptive audience of men and women that sub fertile couples that two visits to his lab at the NUH was all that was necessary for a single complete treatment using the new ART techniques. "Of course the success of the treatment would depend on several factors, the most important being the age of the woman. A young, healthy woman stands a good chance of conceiving after the first complete treatment. A childless couple can have any number of treatments provided they can pay for them." Cost per complete treatment can vary from about US 700 to US 800 dollars). But the good news is that even these visits may not be necessary in the near future. According to Prof. Bongso a State-of-the-art hospital built on the lines of the NUH in Sri Lanka, and using ART techniques, is on the cards, and expected to take shape by next year. The idea in setting up such a hospital here, he explained was to help sub fertile couples to obtain treatment in their own motherland rather than going to Singapore." Today we see an increasing number of sub fertile couples coming to our hospital in Singapore. I want to reverse this traffic and enable such childless couples to obtain their treatment in their own homeland." The cost of the treatment however will be virtually the same as in Singapore, due to the tests, he told a disappointed audience. Explaining the ART procedure he said that it involved one or several techniques of bringing the egg and sperm together. "Simple techniques that involve the deposition of the husband's unwashed sperm by the doctor into the vagina (Artificial Insemination) or the deposition of washed husband's sperm directly into the uterine cavity (IUI) are not usually considered as ART", he noted. "In ART we stimulate the woman's ovaries with hormones to increase egg numbers, recovering these eggs from the ovaries using ultrasound and a long needle inserted through the vagina under sedation. No anaesthesia, no drugs are administered. The eggs are fertilised in separate lab dishes with the husband's washed sperm and then transferred (upto 3 fertilised eggs) back into the womb of the woman." What happens to the excess embryos? "They are frozen for future attempts. If they are not needed they are either donated (free), thrown away or else given for further lab research work, at the discretion of the couple. Most couples prefer to throw them away which is a pity", he noted. Other techniques linked to the ART procedure which were presented at the Seminar included GIFT (Gamete Intra-Fallopian Transfer, a procedure adopted for patients with "unexplained infertility", IVF of In Vitro Fertilisation, largely used for women with blocked tubes where the sperms and eggs cannot meet due to blockage, ICSI or Intra Cytoplasmic Sperm Injection designed for men with poor sperm counts, and TESA or Testicular Sperm Extraction used on men who do not produce any sperm. Another technique designed for older infertile patients and couples who have failed repeated cycles of ART is Blastocyst or Extended culture 'Transfer. Speaking to the Sunday Observer after the seminar, Professor Bongso said that he would gladly assist in helping to set up the new ART hospital in Sri Lanka - provided it follows the same rules and adheres to the same high standards of quality and service as the NUH. Answering a question by the writer as to whether stem cell research would be done at the new hospital envisaged in Sri Lanka, he was quick to reject such a possibility. "It will be a hospital to help sub fertile couples to conceive with the help of Assisted Reproductive Techniques. I do not see any need for research in stem cells which is a very specialised field, and is already being carried out in Singapore and elsewhere, thus ensuring a steady supply of tissues for the use of Sri Lankan couples here." What is really important to this conscientious researcher is that the doctors and the rest of the staff manning it are able to give patients a genuine service, He emphasised the importance of providing patients with a sterile, sophisticated laboratory complete with equipment to perform these advanced new techniques. "They should also have a highly qualified and trained staff of embryologists who can provide efficient and caring service such as we do at the NUH", he said. Doctors must be honest with their patients and not give them false hopes, just to make money", he warned. Ultimately, the goal of this trail blazing pioneer in biotech research, is to make the proposed new hospital for fertility in Sri Lanka a model for the entire South Asian region. He expressed confidence that Dr. Rohana Hathotuwa who has had wide exposure to the new techniques, and Dr. Thanuja Wimalananda, a former pupil of his,and the only clinical Embryologist in Sri Lanka, who were both attached to the Ninewells Care Mother and Baby Hospital at Kirimandala Mawatha, would take the initiative to ensure that the same protocol adhered to in the NUH is followed once the hospital starts operating. "They are both eminently capable of delivering the goods" he said. He plans to visit Sri Lanka at least twice before the hospital begins operations, with his staff to ensure that lab facilities etc are adhered to. "A sterile lab is of utmost importance in ensuring the success of our new methods, as the sperm is very vulnerable to bacteria and will not hatch if germs or bacteria exists in the immediate environment", he said. Answering a final question I asked him on what he considered as the most recent developments in stem cell research, Wi Bongso said that his team had produced six cell lines of different ethnic backgrounds. "We have also produced the first pure nerve cell line which can be used to cure Parkinson disease, Alzheimers as well as all nerve related illnesses. Christopher Reeve - alias Superman incidentally is one of those `hopefuls' who believes that this will help him to walk again. Additionally, we have produced Heart cell lines. The nerve, heart and pancreas are our main targets because diseases related to these areas are the commonest. We also hope to produce new blood cells for HIV patients and for liver diseases". In fact we're producing cells for almost every disease. So we're looking at a time when we can make all diseases curable." But human beings may have to wait for another decade at least to reap the benefits of that research, since tests are only being carried out on animals at present. "Hopefully by then, we will have a tissue to replace almost every diseased cell in the human body. We are looking at a future when no disease will be beyond a cure", he says with great optimism. |
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