Transdisciplinary Research in
Reproductive Medicine
Jeff Nisker MD PhD FRCSC
Schulich School of Medicine & Dentistry University of Western Ontario
Transdisciplinary 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 Research
1.
2.
3.
4.
biomedical science
clinical science
health systems and services
social, cultural, environmental and other aspects that
effect the health of populations
Projects should consider multiple pillars
Mixed 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 Cube
biomedical science

clinical
practice
Problem of High Order Multiple Pregnancy in Canada
•
SOGC Initiative (Barrett, Bocking et al JOGC 2000)
•
CIHR Conference (2002)
“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 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 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 Project
1.
2.
3.
4.
5.
preparing grant
REB approval
informal meeting
formal meetings
papers
Project 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 Areas
1.
2.
3.
ethical and legal concepts of a “healthy” embryo
informed choice regarding fertility conservation in
children with cancer
ethical and legal considerations of embryo “donation”
a. to hESC research
b. to other patients
4.
5.
6.
7.
ethical and legal considerations of oocyte “donation”
health policy development in ARGTs
stem cell research
other ethical and legal issues of ARGTs
Project 8 – Publications
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
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.
Ram N. Regulating Consent to Human Embryo Research: A Critique of Health Canada’s Proposal.
Health Law Review 2005; 14(2): 19-27.
Baylis F. Embryological Viability. American Journal of Bioethics 2005; 5(6): 17-18.
McLeod C. “’Embryo Autonomy? What about the Autonomy of Infertility Patients?” American
Journal of Bioethics 5(6), 2005: 25-26.
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.
McLeod C, Baylis F. Feminists on the Inalienability of Human Embryos Hypatia 2006; 21(1): 1-14.
Nisker J “Compassion as Well as Clarity”, J Obstet Gynaecol Can ” [Let] Feb 2006; 28(2): 121
Nisker J, Baylis F, and McLeod C. “Preserving the Reproductive Capacity of Girls and Young
Adolescent Women with Cancer: Informed Choice,” Cancer, in press.
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.
Ram N. Britain's New Preimplantation Tissue-Typing Policy: An Ethical Defense. Journal of
Medical Ethics in press.
McLeod C. “For Dignity or Money: Feminists on the Commodification of Women’s Reproductive
Labour” (11,063 words), Oxford Handbook of Bioethics, in press.
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.
Mykitiuk R, Nisker JA, “Lenses and ‘Healthy’ Embryos”, in preparation.
Structural and Functional Annotation of the Human
Genome for Disease: R Hegele and M Shier
Theme 5 (Nisker): Ethical, legal, and societal implications
of research into monogenic-related heart disease and breast
cancer
Sub-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
Health 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