John Buster
Encyclopedia
Embryo transfer
Embryo transfer refers to a step in the process of assisted reproduction in which embryos are placed into the uterus of a female with the intent to establish a pregnancy...
from one woman to another resulting in a live birth. It was performed at the Harbor-UCLA Medical Center
Harbor-UCLA Medical Center
Harbor–UCLA Medical Center is a 570-bed public teaching hospital located at 1000 West Carson Street within the unincorporated Los Angeles County area of West Carson, California...
, reported in July 1983, and led to the announcement of the first human birth February 3, 1984. In the procedure, an embryo
Embryo
An embryo is a multicellular diploid eukaryote in its earliest stage of development, from the time of first cell division until birth, hatching, or germination...
that was just beginning to develop was transferred from one woman in whom it had been conceived by artificial insemination
Artificial insemination
Artificial insemination, or AI, is the process by which sperm is placed into the reproductive tract of a female for the purpose of impregnating the female by using means other than sexual intercourse or natural insemination...
to another woman who gave birth to the infant 38 weeks later. The sperm used in the artificial insemination came from the husband of the woman who bore the baby.
This scientific breakthrough established standards and became an agent of change for women suffering from the afflictions of infertility and for women who did not want to pass on genetic disorders to their children. Donor embryo transfer has given women a mechanism to become pregnant and give birth to a child that will contain their husband’s genetic makeup. Although donor embryo transfer as practiced today has evolved from the original non-surgical method, it now accounts for approximately 5% of in vitro fertilization recorded births.
Prior to this, thousands of women who were infertile, had adoption as the only path to parenthood. This set the stage to allow open and candid discussion of embryo donation and transfer. This breakthrough has given way to the donation of human embryos as a common practice similar to other donations such as blood and major organ donations. At the time of this announcement the event was captured by major news carriers and fueled healthy debate and discussion on this practice which impacted the future of reproductive medicine by creating a platform for further advancements in woman's health.
Dr. Buster and other members of the UCLA research team were featured on, The Today Show, NBC News
NBC News
NBC News is the news division of American television network NBC. It first started broadcasting in February 21, 1940. NBC Nightly News has aired from Studio 3B, located on floors 3 of the NBC Studios is the headquarters of the GE Building forms the centerpiece of 30th Rockefeller Center it is...
, Good Morning America
Good Morning America
Good Morning America is an American morning news and talk show that is broadcast on the ABC television network; it debuted on November 3, 1975. The weekday program airs for two hours; a third hour aired between 2007 and 2008 exclusively on ABC News Now...
, Oprah Winfrey
Oprah Winfrey
Oprah Winfrey is an American media proprietor, talk show host, actress, producer and philanthropist. Winfrey is best known for her self-titled, multi-award-winning talk show, which has become the highest-rated program of its kind in history and was nationally syndicated from 1986 to 2011...
, Phil Donahue
Phil Donahue
Phillip John "Phil" Donahue is an American media personality, writer, and film producer best known as the creator and host of The Phil Donahue Show. The television program, also known as Donahue, was the first to use a talk show format. The show had a 26-year run on U.S...
and showcased in leading print publications such as the New York Times, New York Times Magazine, Los Angeles Times
Los Angeles Times
The Los Angeles Times is a daily newspaper published in Los Angeles, California, since 1881. It was the second-largest metropolitan newspaper in circulation in the United States in 2008 and the fourth most widely distributed newspaper in the country....
, Wall Street Journal, People Magazine, and Time Magazine.
This work established the technical foundation and legal-ethical framework surrounding the clinical use of human oocyte
Oocyte
An oocyte, ovocyte, or rarely ocyte, is a female gametocyte or germ cell involved in reproduction. In other words, it is an immature ovum, or egg cell. An oocyte is produced in the ovary during female gametogenesis. The female germ cells produce a primordial germ cell which undergoes a mitotic...
and embryo donation, a mainstream clinical practice, which has evolved over the past 25 years. Building upon Dr. Buster’s groundbreaking research and since the initial birth announcement in 1984, well over 170,000 live births resulting from donor embryo transfer have been and continue to be recorded by the Centers for Disease Control(CDC) in the United States to infertile women, who otherwise would not have had children by any other existing method.
Education
Dr. Buster attended Stanford UniversityStanford University
The Leland Stanford Junior University, commonly referred to as Stanford University or Stanford, is a private research university on an campus located near Palo Alto, California. It is situated in the northwestern Santa Clara Valley on the San Francisco Peninsula, approximately northwest of San...
and earned both his medical degree and residency training in obstetrics and gynecology from the University of California
University of California
The University of California is a public university system in the U.S. state of California. Under the California Master Plan for Higher Education, the University of California is a part of the state's three-tier public higher education system, which also includes the California State University...
at the Los Angeles School of Medicine, where he later completed fellowship training in reproductive endocrinology and infertility.
Career
Dr. Buster is a highly experienced physician who has dedicated almost four decades of his career to research, private practice, and the teaching of Reproductive Endocrinology and Infertility. He is Board Certified in Obstetrics and Gynecology and in the subspecialty of Reproductive Endocrinology and Infertility with special expertise and international recognition for his contributions in preimplantation embryology, early pregnancy loss, female hormone replacement, and infertility.Dr. Buster currently serves in the Division of Reproductive Endocrinology and Infertility at Women & Infants Hospital
Women & Infants Hospital
Women & Infants Hospital of Rhode Island is a women and infants' hospital in Providence, Rhode Island. It is the primary teaching hospital in obstetrics, gynecology, and newborn pediatrics for in Warren Alpert Medical School at Brown University...
in Providence, RI and also in the Division of Reproductive Endocrinology and Infertility at Tufts Medical Center
Tufts Medical Center
Tufts Medical Center is a medical institution in Boston, Massachusetts occupying space between Chinatown and the Theater District....
in Boston.
He is engaged full time in the private practice and in clinical teaching of Reproductive Endocrinology and Infertility in both institutions. He continues to participate and consult in numerous clinical research programs.
As an academician, Dr. Buster has held positions as professor of obstetrics and gynecology and served as director of the Division of Reproductive Endocrinology and Infertility at UCLA School of Medicine, the University of Tennessee College of Medicine
University of Tennessee College of Medicine
The University of Tennessee College of Medicine is one of six graduate schools of the University of Tennessee Health Science Center in downtown Memphis...
, Baylor College of Medicine, and Warren Alpert Medical School of Brown University
Brown University
Brown University is a private, Ivy League university located in Providence, Rhode Island, United States. Founded in 1764 prior to American independence from the British Empire as the College in the English Colony of Rhode Island and Providence Plantations early in the reign of King George III ,...
.
Research
Dr. Buster’s forty years of research and clinical practice in reproductive medicine include numerous published studies in steroid physiology, pre-implantation embryology, pregnancy loss, and menopausal hormone replacement therapy.One of Dr. Buster’s earliest research studies focused on steroid hormone radioimmunoassay (RIA). He reported an RIA for the androgen prohormone, dehydroepiandrosterone sulfate (DHEA-S), the direct measurement of which was shown to be possible in un-extracted serum. Refined versions of his methodology are used today in the diagnosis and management of androgen excess disorders in women (7).
Dr. Buster’s development of a simple nonchromatographic RIA to measure un-conjugated estriol in pregnancy serum led to more refined versions of this method that are used today in the early diagnosis of chromosomal abnormalities in mid-trimester pregnant women (8). He also described for the first time the simultaneous progression of multiple androgens, progestins, and estrogens concentrations in maternal blood throughout all three trimesters of pregnancy and into the onset of labor.
In the early 1980s, over a period of 4 years, at the University of California
University of California
The University of California is a public university system in the U.S. state of California. Under the California Master Plan for Higher Education, the University of California is a part of the state's three-tier public higher education system, which also includes the California State University...
at Los Angeles School of Medicine, Dr. Buster and his team developed a revolutionary technique based on in-vivo fertilization and uterine lavage – a method adapted from the commercialization of bovine embryo transfer in the cattle industry – as a means to transfer human blastocysts from fertile woman donors to ovulating or agonadal infertile recipient women (6) Specifically, the group developed a simple office procedure in which blastocyst
Blastocyst
The blastocyst is a structure formed in the early embryogenesis of mammals, after the formation of the morula. It is a specifically mammalian example of a blastula. It possesses an inner cell mass , or embryoblast, which subsequently forms the embryo, and an outer layer of cells, or trophoblast,...
, which had been deliberately created from in vivo fertilization in the donor’s body using infertile recipient’s husband sperm, were transferred to produce pregnancy in an infertile recipient woman. In February 1984, the historical first live birth, followed 3 months later by a second live birth, resulted from these techniques and was reported by Dr. Buster and his team.
A University of California at Los Angeles team, under Dr. Buster’s direction, contemporaneous with a group from Northwestern University
Northwestern University
Northwestern University is a private research university in Evanston and Chicago, Illinois, USA. Northwestern has eleven undergraduate, graduate, and professional schools offering 124 undergraduate degrees and 145 graduate and professional degrees....
, published findings on the first case series of ectopic pregnancies (outside the uterus) treated successfully with methotrexate
Methotrexate
Methotrexate , abbreviated MTX and formerly known as amethopterin, is an antimetabolite and antifolate drug. It is used in treatment of cancer, autoimmune diseases, ectopic pregnancy, and for the induction of medical abortions. It acts by inhibiting the metabolism of folic acid. Methotrexate...
, a cancer chemotherapy agent. This approach became widely accepted in the 1990s and continues to save thousands of women from major surgery customarily associated with ectopic pregnancy, a dangerous and potentially fatal complication of human reproduction.
More recently, Dr. Buster helped develop a testosterone
Testosterone
Testosterone is a steroid hormone from the androgen group and is found in mammals, reptiles, birds, and other vertebrates. In mammals, testosterone is primarily secreted in the testes of males and the ovaries of females, although small amounts are also secreted by the adrenal glands...
delivery system for women researched by Procter & Gamble
Procter & Gamble
Procter & Gamble is a Fortune 500 American multinational corporation headquartered in downtown Cincinnati, Ohio and manufactures a wide range of consumer goods....
. It is now marketed in Europe under the brand name Intrinsa
Intrinsa
Intrinsa is a testosterone patch by Procter & Gamble designed to treat Female Sexual Dysfunction .-Background:FSD covers at least four different conditions: problems with desire, arousal, achieving orgasm, and genital pain. The patch aims to increase libido in women...
. The product – a trans-dermal patch – is designed to deliver chemically identical testosterone directly into the micro vascular circulation-much like an artificial endocrine organ. Dr. Buster was lead investigator in a major study that demonstrated the effectiveness of this patch to treat decreased sexual desire in oophorectomised, postmenopausal women (13). These patches are in use outside of the United States to treat hypoactive sexual desire in women who are deficient of androgens.
Most recently, Dr. Buster served as lead investigator in another major study demonstrating the effectiveness of an estradiol mist, which has pharmacology similar to those of a trans-dermal estrogen patches (14). Sold in the United States by TherRx Corporation under the name Evamist, the spray offers additional margins of safety and convenience over traditional oral and patch-administered estrogen's. Evamist won FDA approval in 2007. Dr. Buster's Phase III Study for Evamist was published in the Journal, Obstetrics & Gynecology, in June 2008.
Publications
1.Buster JE, Bustillo M, Thorneycroft IH, Simon JA, Boyers SP, Marshall JR, Seed RG, Seed RW, Louw JA: Non-surgical transfer of an in vivo fertilized donated ova to five infertile women: report of two pregnancies. The Lancet. Jul 23; 2 (8343): 223-224, 1983.2.Bustillo M, Buster JE, Cohen SW, Hamilton F, Thorneycroft IH, Simon JA, Rodi IA, Boyers SP, Marshall JR, Louw JA, Seed RW, Seed RG: Delivery of a healthy infant following nonsurgical ovum transfer. JAMA. Feb; 251 (7): 889, 1984.
3.Buster JE, Bustillo M, Thorneycroft IH, Simon JA, Boyers SP, Marshall JR, Seed RG, Louw JA: Non-surgical transfer of an in-vivo fertilized donated ovum to an infertility patient. The Lancet. Apr 9; 1 (8328): 816-817, 1983.
4.Buster JE: The first live birth donation. Sexuality, Reproduction, and Menopause 6:22-28, 2008.
5.Center for Disease Control and Prevention/Society for Assisted Reproductive Technology Fertility Clinic Reports, 1994–2006.
6.Buster JE, Bustillo M, Rodi I, Cohen SW, Hamilton F, Simon JA,Thorneycroft IA, Marshall JR: Biologic and morphologic development of donated human ova recovered by nonsurgical uterine lavage. Am J Obstet Gynecol. Sep 15; 153 (2): 211-217, 1985.
7.Buster JE, Abraham GE: Radioimmunoassay of plasma dehydroepiandrosterone sulfate. Analyt Lett 5:543:551, 1972.
8.Buster JE, Freeman AG, Hobel CJ: An algorithm for determining gestational age from unconjugated estriol levels. Obstet Gynecol. Nov; 56 (5): 649-655, 1980.
9.Buster JE, Chang RJ, Preston DL, Elashoff RM, Cousins LM, Abraham GE, Hobel CJ, Marshall JR: Interrelationships of circulating maternal steroid concentrations in third trimester pregnancies: II. C18 and C19 steroids: estradiol, estriol, dihydro-epiandrosterone, dehydroepiandrosterone sulfate, ∆5androstenedione, testosterone, and dihydrotestosterone. J Clin Endocrinol Metab 48 (1): 139-142, 1979.
10.Buster JE, Change RJ, Preston, DL, Elashoff RM, Cousins LM, Abraham GE, Hobel, CJ, Marshall JR: Interrelationships of circulating maternal steroid concentrations in third trimester pregnancies. I. C21 steroids: progesterone, 16ά-hydroxyprogesterone, 17ά -hydroxy-progesterone, 20ά-dihydroprogesterone, ∆5-pregnenolone, ∆5-pregnenonlone sulfate and 17-hydroxy ∆5-pregnenolone. J Clin Endocrinol Metab 48 (1) 33-38, 1979
11.Rodi IA, Sauer MV, Gorrill MJ, Bustillo M, Gunning JE, Buster JE, Marshall JR: The medical treatment of unruptured ectopic pregnancy with methotrexate and citrovorum rescue: preliminary experience. Fertil Steril. Nov;46 (5): 811-813, 1986.
12.Carson SA, Buster JE: Ectopic pregnancy. N Engl J Med. Oct; 329 (16): 1174–1181, 1993.
13.Buster JE, Kingsberg SA, Aguirre O, Brown C, Breaux JG, Buch A, Rodenberg CA, Wekselman K, Casson P: Testosterone Patch for Low Sexual Desire in Surgically Menopausal Women: A Randomized Trial. Obstet Gynecol, 2005 May; 105(5 Pt 1):944-52.
14.Buster JE, Koltun WD, Pascual MLG, Day WW, Peterson C: Low-dose estradiol spray to treat vasomotor symptoms. Obstet Gynecol 111: 1343–1351, 2008.
15. * Buster, JE. "Evolution of Oocyte and Embryo Donation as a Treatment for Intractable Infertility”