Offering a New Lease on Life

August 6, 2019  By Zhou Wenting  Editor: Ling Xiao
Huang Hefeng, president of the International Peace Maternity and Child Health Hospital of China Welfare Institute in Shanghai, has used the "third-generation test-tube baby technique" since 2001 to help with more than 2,000 healthy births at the hospital. [For China Daily]

 

An expert on correcting genetic imperfections, Huang Hefeng provides patients with hereditary diseases the chance to start a family without passing on problematic genes.

Huang Hefeng used to joke that her job was to help people "make people." But after nearly 30 years of progress in assisted reproductive technology, she has now moved from helping couples to conceive to a role that sees her purge genes carrying hereditary diseases from family lines.

In the past, most patients with genetic diseases used to abandon all hope of ever starting a family for fear of passing on problematic genes to their child. But now, using the "third-generation test-tube baby technique" to assess and diagnose problems in the genetic makeup of embryos, Huang is literally offering a new lease of life to these patients.

The technique ensures that only embryos without disease-causing genes will be moved in the mother's womb to block a disease from being inherited from one generation to the next, which allows the dream of having a child to come true for couples suffering from rare or genetic diseases, or those with a high occurrence of tumors in their families.

"I wouldn't dare to suggest that I'm contributing to the whole nation in preventing birth defects, but I can ensure that families who come to me for medical help will be able to have a baby without disease-causing genes," says Huang, president of the International Peace Maternity and Child Health Hospital of China Welfare Institute in Shanghai.

"Every one of the more than 2,000 children born using the technology at our hospital since its clinical application in 2001 have proven to be as healthy as we diagnosed, without exception," she says.

Her medical contributions, including this technology, which has been expanded to be put into use in nearly 50 hospitals across 23 Chinese provinces and municipalities, were awarded the annual top honor by the gynaecology and obstetrics branch of the Chinese Medical Doctor Association on Friday.

A rising number of couples from families carrying genetic tumors are also coming to her for medical help, Huang says. Couples who have three or more family members or immediate relatives who suffer from tumor of any kind are medically deemed as a family of high occurrence of tumors. In the past, this would have been a problem, yet for Huang and her team, they can still help them conceive healthy offspring with the right treatment, she explains.

In recent years, especially since China adopted its second-child policy in 2016, Huang says her patients increasingly include couples with a sick child.

The third-generation test-tube baby technique also benefits children suffering from diseases that can be treated with bone-marrow transplants, which has match rates as low as one in 100,000 in a blood bank, but a success rate is as high as one in four among siblings, according to Huang.

"With the technique, we can pick an embryo whose human leukocyte antigen type matches the couple's first child. When the child is born, the stem cells from his or her umbilical cord blood can be used to treat the brother or sister's disease," she says.

A woman surnamed Yang from Zhejiang province lost her first child during infancy due to hemophagocytic syndrome, a rare and potentially fatal disease with overactive histiocytes and lymphocytes. The mother, a carrier of this disease-causing gene, approached Huang for help and gave birth to a healthy baby last year.

"Since the first clinical consultation with Huang, she has appeared to be courteous and amiable, making me feel at ease. When I hold my daughter, I often think of Huang. I am grateful to her and her professional skills that brought hope to our family," Yang says.

Another of Huang's contributions came in 2013 when she became the first scientist internationally to put forward the theory of "gamete origins of adult disease," which pushed the boundaries of the widely accepted theory of "development origins of adult disease". This theory expounds that the feeding, health and environment of a fetus can result in certain diseases during adulthood, and suggests that the possibility of falling ill in adulthood may be a consequence of changes to the eggs and sperm — even before a new life is formed.

In her study, she saw that the sperm of an obese man before and after losing weight had the same makeup of DNA, but the epigenetic appearances were completely different.

Huang is granted a "fellow honoris causa" (honorary member) by the Royal College of Obstetricians and Gynaecologists in the United Kingdom in November. [For China Daily]

 

"The epigenetic appearance is like clothing for DNA. It's like when a person puts on different clothes, he or she may exhibit different dispositions," says Huang, who raises the theory that epigenetic changes are also inheritable.

She says in laboratory tests, the obesity rates of children conceived when the parents were overweight and after they lost weight showed obvious differences.

Huang also observed from lab tests that mental stress during the phase of planning to have children also affected the health of the offspring.

"If a mouse is caged in an irritating environment every day, the offspring conceived during those times will show a higher incidence of offensive behavior," she says.

Huang's theory led to a ten-year research program by the World Health Organization that has been carried forward in China, India, South Africa and Canada for nearly four years, as a way to test the theory through practice.

The program recruits couples currently planning to have babies, and divides them into a study group and a control group. For the study group, doctors contacted the couples every day to advise them on their exercise regimes and their calorific intake, she explains.

"We focused on obesity, a global health concern, in this study. These children will be followed by our team from birth to the age of five to monitor their health and learning ability," she says.

Such research is also an effort to explore the cause of chronic diseases from the initial developmental stages of life and will shed new light on the pathogenesis of conditions such as metabolic and cardiovascular diseases. In case of breakthroughs, this will contribute to both the patients and to society, Huang says.

She became an academician with the Chinese Academy of Sciences in 2017, the only doctor from the fields of obstetrics and gynecology elected as an academician after the departure of the late Lin Qiaozhi, one of the founders of modern Chinese gynecology.

"As one of the country's top experts in obstetrics and gynecology, professor Huang has always kept in mind the noble tradition of making contributions to human health, changing the destinies of patients suffering from infertility and providing clinical pathways for families to produce healthy offspring," reads an open letter congratulating Huang from the Shanghai Jiao Tong University School of Medicine on becoming an academician.

The International Peace Maternity and Child Health Hospital is affiliated with the university.

Huang says while the aim of her profession has always been to master medical skills and help patients, the decades of her medical career have shown her how the care and empathy that doctors provide also play an important role in consoling patients — and that a combination of the two can often provide the best results.

"For a doctor, staying abreast of the latest developments in medicine can be a real challenge, but I have learned over the years that technical proficiency is not enough, as you have to offer ethical and economical solutions to each of your patients to achieve an overall balance. This should be the pinnacle that every doctor should aim to reach professionally," she says.

She recalls a case last year. A woman from Southwest China, who had a 4-year-old child suffering from an immunodeficiency disease, sought Huang's help to attempt to have a second child using the third-generation test-tube method so that the stem cells from the umbilical cord blood of the new baby could be used to save the older child.

Unfortunately, none of the eight embryos had human leukocyte antigens that match the boy's type, and the mother chose to leave without an embryo — and giving up the chance of having a healthy second child.

"I looked at her when she left and I realized that there are always thorny issues and unknowns in medicine. As a doctor, I hope that every embryo is healthy and finds a successful match, but medicine is an imperfect science and sometimes it takes a bit of luck," says Huang.

"I was very heavy-hearted that day. I was not at fault technically but I actually felt worse about the situation than the mother did. I sat down and tried to write something about the way I felt about it from my own perspective, but I found it hard. For years, I'd only ever written medical records or research papers, never anything personal," she adds.

 

(Source: China Daily)

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