Jackson Kirkman-Brown is the Science Lead at Birmingham Women’s Hospital Fertility Centre and Director of the Centre for Reproductive Science at the University of Birmingham. Jackson closed the day with an inspirational talk to trainees about his work to preserve the fertility of severely injured servicemen. Jackson’s interest in this area began in 2009 when he was approached by a serviceman who was on leave in the UK for two months, having been injured in Afghanistan, and who asked whether his sperm could be stored prior to his return to the front line. This encounter led Jackson to think about how he and his team could do more for these guys and their care. Jackson learned that many soldiers who were seriously injured by Improvised Explosive Devices (IEDs) often experienced severe genitourinary injuries. Jackson’s interest in such injuries was from the point-of-view of a fertility specialist and upon looking into the research he discovered that there was no data about fertility post genitourinary injury to servicemen.
One early development that Jackson contributed to was the design of what is called a ‘combat nappy’ – a detachable piece of armour that clips to the belt and which is designed to protect the pelvic area. Jackson then conducted some research into the effect of genitourinary injuries on fertility before the pelvic protection was developed and he also studied a large cohort of soldiers in Afghanistan who had used pelvic protection. From this work, Jackson learned that with the use of pelvic protection, injury from IEDs was having no effect on the sperm or fertility of survivors. Up until recently, until Afghanistan, people were dying with genitourinary injuries arising from IEDs. Battlefield trauma healthcare has improved so much in recent years that servicemen are surviving with serious genitourinary injuries. And in the last four years, Jackson Kirkman-Brown and his team in Birmingham have contributed substantially to the care and to the preservation of the fertility of such servicemen. For example, they have developed and influenced radical changes to procedures and practices so that fertility can be preserved. Previously, a serviceman with a severe genitourinary injury would have had his damaged genitals removed up until the point of clean flesh. Jackson and his team have influenced the implementation of a changed procedure so that no removal takes place in the field so that sperm harvesting can take place when the injured serviceman is being operated on in Birmingham less than 2 days after sustaining their injury.
This sperm recovery programme started in March 2010. There have been 34 cases of attempted recovery since then; 29 of these cases have had successful retrieval. 3 babies have been born using sperm from the recovery programme (one of whom has Jackson as his middle name) and 3 are on the way. All of this work has generated interest and demand from beyond the confines of the UK armed forces. Jackson and colleagues are now sharing their practice worldwide and accepting civilian patients into their clinic, such as cricketers who have experienced some similar injuries in their line of fire.
Jackson finished his talk by drawing out a number of key lessons for new healthcare science trainees from his stories. His principal messages were:
- Unleash your creative and entrepreneurial spirit. In all of our fields there will be opportunities to be creative, to think differently, to make change. To make these happen, collaborate, build a team around you and the change can be big and significant.
- If you see something in your area that you think you can improve, don’t hide away from it, but explore how you can improve it. Equally, do not become consumed by it; ensure you look after yourself and have some downtime.
- A change that might seem quite small, involving a limited number of people can have a massive effect on the way patients are living their life. The sperm storage and recovery work has allowed patients to get on with and to change their lives.
- Know your science and then think about how it can impact end-to-end for the patient. If it’s something where you think something better can happen, go after that change with energy.
- Keep the passion that brought you here. Keep it and other people will follow you, particularly when you muck in, explore and collaborate with others.
- Don’t be complacent; always look to improve. Everyone always can.