John Buster

Dr. John E. Buster

John Edmond Buster (born July 18, 1941) working at the University of California at Los Angeles School of Medicine, directed the research team that performed history's first embryo transfer from one woman to another resulting in a live birth. It was performed at the Harbor-UCLA Medical Center,^[1] reported in July 1983, and culminated in the announcement of the first human birth February 3, 1984.^[2] In the procedure, an embryo that was just beginning to develop was transferred from the woman in whom it had been conceived by artificial 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.^[3][4]

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 10% 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.

Buster and other members of the UCLA research team were featured on The Today Show, NBC News, Good Morning America, Oprah Winfrey, Phil Donahue and showcased in leading print publications such as the New York Times, New York Times Magazine, Los Angeles Times, Wall Street Journal, People Magazine,^[5] and Time Magazine.^[4]

This work established the technical foundation and legal-ethical framework surrounding the clinical use of human oocyte and embryo donation, a mainstream clinical practice, which has evolved over the past 25 years.^[3][4] Building upon Buster's research, and since the initial birth announcement in 1984, well over 200,000 live births resulting from donor embryo transfer have been, and continue to be, recorded by the Centers for Disease Control(CDC)^[6] in the United States to infertile women, who otherwise would not have had children by any other existing method.^[7][8][9]

Professional Recognition

Living Legend - LA BioMed

For this work and in addition to a number of groundbreaking medical advancements in women's health, notably in the field of reproductive medicine Buster received the Legends Award in May 2012. "Legends" are selected based upon their internationally recognized contributions to medicine through research and innovative clinical practice. It was awarded by The Los Angeles Biomedical Research Institute (LA BioMed or LABioMed) located at Harbor-UCLA Medical Center.^[10][11]

Endowed Lectureship - American College of Obstetricians and Gynecologists

In June 2014 the American College of Obstetricians and Gynecologists (ACOG) awarded a permanently endowed lectureship, the John E. Buster, M.D. lectureship on cutting edge reproductive medicine. This lecture is given annually.^[12][13]

Education

Buster attended Stanford University for his undergraduate degree and earned both his medical degree and residency training in obstetrics and gynecology from the University of California Los Angeles School of Medicine, where he later completed fellowship training in reproductive endocrinology and infertility.^[14]

Career

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.

Buster currently serves in the Division of Reproductive Endocrinology and Infertility at Women & Infants Hospital^[15] in Providence, Rhode Island. He is also engaged in private practice and in clinical teaching of Reproductive Endocrinology and Infertility at the Women & Infants/Alpert Medical School (Brown University)^[16] fellowship in reproductive endocrinology and infertility.^[17] He continues to participate and consult in numerous clinical research programs.

As an academician, 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, Baylor College of Medicine, Tufts University School of Medicine and Warren Alpert Medical School of Brown University and also in the Division of Reproductive Endocrinology and Infertility at Tufts Medical Center in Boston.

Research Accomplishments

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.

Female Sexual dysfunction

Buster is a leading researcher in female sexual dysfunction (FSD), a continuum of psychosexual disorders centered on loss of sexual desire with interrelated problems of arousal, orgasm, and sexual pain. Buster has recently outlined awareness and treatment for sexual dysfunction for both the physician and post-menopausal woman.

Buster authored "Sex and the 50-Something Woman: Strategies for Restoring Satisfaction" in the professional journal Contemporary Obstetrics and Gynecology.^[18] The intent was to explain the various causes of what is called female sexual dysfunction (FSD) and the simple interventions obstetrician/gynecologists and primary care physicians can recommend. The article attracted national interest with stories appearing in local media,^[19] creating greater awareness for the treatment and open dialogue for woman.

Original steroid hormone Radioimmunoassays

One of 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.

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. He also described for the first time the simultaneous progression of multiple androgen, progestin, and estrogen concentrations in maternal blood throughout all three trimesters of pregnancy and into the onset of labor.

Hormone Delivery Systems

More recently, Buster helped develop a testosterone delivery system for women researched by Procter & Gamble. It is now marketed in Europe under the brand name Intrinsa. 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. 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.

Subsequently, Buster served as lead investigator in another major study demonstrating the effectiveness of an estradiol mist,^[20] which has pharmacology similar to those of a trans-dermal estrogen patches. Sold in the United States by Perrigo 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.^[21] Buster's Phase III Study for Evamist was published in the Journal, Obstetrics & Gynecology,^[22] in June 2008. In 2015, Gedeon Richter announced it will be selling the drug in Europe under the name Lenzetto.

Medical Management for Ectopic Pregnancy

A University of California at Los Angeles team, under Buster's direction, contemporaneous with a group from Northwestern University, published findings on the first case series of ectopic pregnancies (outside the uterus) treated successfully with 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.

Pre implantation Embryology & Genetics

In the early 1980s, over a period of 4 years, at the University of California at Los Angeles School of Medicine,^[1] 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.^[23] Specifically, the group developed a simple office procedure in which blastocyst, 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 Buster and his team.^[24]

30 years later, Buster updated the uterine lavage technology adapting it to diagnosis and prevention of genetic diseases in embryos. With vastly updated technology, in 2011 Buster founded Previvo Genetics, Inc. He now serves as its Chief Medical Officer^[25] for that company. The technology now being introduced by the company facilitates access to in vivo developed human embryos for use in Pre-implantation Genetic Screening (PGS) and Pre-implantation Genetic Diagnosis (PGD) technologies.^[26] This technique does not require in vitro fertilization.

References

Publications

• 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.
• 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.
• 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.
• Buster JE: The first live birth donation. Sexuality, Reproduction, and Menopause 6:22-28, 2008.
• Center for Disease Control and Prevention/Society for Assisted Reproductive Technology Fertility Clinic Reports, 1994–2006.
• 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.
• Buster JE, Abraham GE: Radioimmunoassay of plasma dehydroepiandrosterone sulfate. Analyt Lett 5:543:551, 1972.
• Buster JE, Freeman AG, Hobel CJ: An algorithm for determining gestational age from unconjugated estriol levels. Obstet Gynecol. Nov; 56 (5): 649-655, 1980.
• 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.
• 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
• 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.
• Carson SA, Buster JE: Ectopic pregnancy. N Engl J Med. Oct; 329 (16): 1174–1181, 1993.
• 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.
• Buster JE, Koltun WD, Pascual MLG, Day WW, Peterson C: Low-dose estradiol spray to treat vasomotor symptoms. Obstet Gynecol 111: 1343–1351, 2008.
• Buster, JE. Principles of Oocyte and Embryo Donation (Sauer M, ed). “Historical "Evolution of Oocyte and Embryo Donation as a Treatment for Intractable Infertility” Chapter 1, pp 1–10. ISBN 0387949607.

External links

• Hypoactive Sexual Desire Disorder
• Time Magazine article
• Gynecological Disorders