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Fertility and IVF: An Exploding Field of Research and Changes

August 6, 2018
Katie Visco

Almost one century ago when scientists initiated hormone and fertility research, it seemed futuristic at the time. But with the famous first IVF baby, Louise Brown, born in 1981 and more to follow, it’s become commonplace today. In fact, IVF has now been used to conceive about 5 million children worldwide. Let that sink in a moment.

However, IVF and fertility research still has a lot of potential for improvement and new findings, and recent studies validate this. Now that technology continues to advance, experts predict fertility treatments will advance and become cheaper and more widespread. Not only that, but research is focusing on the relationship between fertility and diseases and how fertility can be improved despite them.

family
Louise Brown, the world’s first IVF baby, with her parents; we’ve come a long way, but here’s the beginning!

Read further to learn about exciting research and changes in the field of IVF and fertility research:

  • How IVF Will Change
  • Fertility for Cancer Patients
  • Fibroids and Fertility
  • Examining Sperm
  • PCOS, the Brain, and Fertility
  • Fertility and Technology

How Fertility Treatments Will Change in the Future

Perfecting the process of IVF will be able to not only improve fertility but also extend a woman’s fertile years and help couples avoid passing on serious medical conditions to their children. In this section, we’ll share 4 ways fertility treatments are expected to change in the future.

1. More women will freeze their eggs

Egg freezing has been around for many years but it wasn’t until recently (in the past five years or so) that the technique has been perfected. In the past, eggs were frozen slowly, but the freezing process can damage the cell because ice crystals develop inside due to an egg’s high water content. A new technique called vitrification is an ultra-rapid process of freezing eggs so that ice crystals do not have enough time to form. Therefore, in the future it’s possible egg freezing will be a normal thing for women to do in their early 20s.

2. Fertility treatments will use fewer hormones

IVF requires women to receive daily hormone injections for almost two weeks. An experimental procedure called in vitro maturation (IVM) uses much lower doses of hormones with fewer injections and can obtain eggs more quickly. One major benefit of IVM is that it is much cheaper and does not come with the side effects that IVF does.

3. Human skin cells could produce egg cells

A 2016 experiment by Katsuhiko Hayashi at Kyushu University in Japan showed in a 2016 experiment that a mouse’s skin cells could be turned into stem cells, then become mature egg cells. These egg cells were then fertilized with sperm to successfully become baby mice. Amazing, right? This would allow people struggling with infertility to still have children, as the process of making an egg cell would ideally only require human skin cells.

rates
Hayashi’s mice, a result of eggs made from skin cells

On top of this, just this May of 2018, scientists combined two different kinds of stem cells—without even differentiating them into egg and sperm cells—and the early stages of an embryo resulting. Some people even worry that if this worked successfully with humans, it could be the beginning of human cloning. Yikes. But still mind-blowing news.

4. Womb transplants will be an option

A couple years ago in 2014, the first womb-transplant baby was born in Sweden to a woman born without a uterus. The couple to whom the baby was born underwent IVF to produce an embryo. The father touchingly said, "It was a pretty tough journey over the years, but we now have the most amazing baby. He's no different from any other child, but he will have a good story to tell.''

newborn
The first U.S. womb-transplant baby.

Now, the first U.S. womb-transplant baby was born in 2017 in Dallas, Texas. Though women with uterus transplants cannot get pregnant through intercourse, but rather through IVF. Women must also take medications to prevent their bodies from rejecting the new organ. Though the procedure still has a long road ahead of it, the exciting news is that it’s worked. And once it develops more, it will help the 1 in 4,500 girls born without a uterus and the 40% of women with cervical cancer who are still in their childbearing years.

Future Fertility for Prepubescent Cancer Patients

Treatments pediatric cancer patients endure can reduce their chances of having children in the future. However, an experimental treatment available at the University of Pittsburgh Medical Center (UPMC) could preserve fertility for young boys going through radiation.

The treatment is called spermatogonial stem-cell transplantation, and it involves taking a sample of testicular tissue and turning pre-sperm cells into viable samples. Then, when re-inserted into testes, even if they’re damaged by radiation and chemotherapy, the sperm stem cells function as they would naturally and become sperm.

This service is offered to the parents of any prepubescent boy undergoing radiation. If a boy is old enough to give consent, they’re asked a series of questions to ensure they understand and agree to the procedure. If they are too young to give consent, the decision is shifted to the parents or guardian. So far, 110 boys have their samples stored at UPMC.

stuff bear
More research into cancer and fertility will ensure that children don’t struggle with infertility later in their lives after childhood cancer treatment.

A similar treatment is available for prepubescent girls undergoing cancer treatment. This involves harvesting and freezing an ovary to be re-implanted in the future. This process is also in the experimental phase, and UPMC currently has 25 frozen ovaries saved.

For decades, the re-implanting process has been studied on animals, and there has been a success. In animal trials, the samples have been viable for up to 14 years. Health professionals believe that it is time to study the re-implanting process in human subjects.

News on Fibroids and Fertility

Thanks to Uterine Fibroid Embolization (UFE), women with fibroids, which is roughly 35% of women within reproductive age, have a much better chance at remaining fertile after treating their fibroids.

In the past, the only way to treat fibroids, which are noncancerous growths in the uterus, was through surgery, where surgeons would simply have to remove the tumors. Now with UFE, women can eliminate fibroids without having to undergo surgery, dramatically increasing their chances of remaining fertile. Essentially, UFE is a treatment that stops blood flow to the fibroids, causing them to stop growing and eventually die.

The treatment is not ideal, however. Since UFE blocks blood flow, there is a chance that there could be less blood flow to the uterus overall, resulting in the opposite effect of decreased chances of getting pregnant. In order to solve this problem, Dr. JM Pisco performed a study examining the results of both traditional and “partial” UFE. During partial UFE, only the small arterial branches of the fibroids are blocked, resulting in more blood flow to the uterus compared to traditional UFE.

After the follow-up from the study, Pisco concluded: “Our findings show that UFE is a fertility-restoring procedure in women with uterine fibroids who wish to conceive, and pregnancy following UFE appears to be safe with low morbidity. Women who had been unable to conceive had normal pregnancies after UFE and similar complication rates as the general population in spite of being in a high-risk group.”

mother and son

Examining Sperm

Doctors at the University of Sheffield made a significant discovery recently that will improve the process that tests for the best sperm. Their new process allows for the sperm to be tested without destroying the sample. This means that the sperm can be used immediately for in vitro fertilization. The new method uses low energy pulses also used to test cancer cells. This significant discovery will help doctors know they are selecting the best sperm by looking for molecular differences before impregnating the egg.

PCOS, the Brain, and Fertility

The University of Otago has recently collected research findings that show potential to restore fertility in women suffering from polycystic ovary syndrome, or PCOS. PCOS is a major endocrine disorder. It affects about 1 in 10 women of reproductive age and is one of the main causes of infertility in women. Currently, there is no cure.

Symptoms of the syndrome include elevated levels of androgens (male hormones) in females and irregular periods—which means heavy periods or none at all. Women may also experience excess body and facial hair, acne, pelvic pain, and patches of thick, darker, or leathery skin. PCOS is associated with Type 2 diabetes, obesity, heart disease, mood disorders, obstructive sleep apnea, and endometrial cancer.

The study was conducted in a pre-clinical model and recently published in the Journal of Clinical Investigation Insight. Results from the research show that blocking androgen actions modifies brain circuitry related to fertility, which could help re-set reproductive function to normal levels.

Associate Professor Rebecca Campbell from the University’s Centre for Neuroendocrinology and Department of Physiology says she and her co-investigators are thrilled about their findings. They are potentially significant for women who are suffering from the syndrome and “suggest that despite the early development of brain pathology in some forms of polycystic ovary syndrome, a normal reproductive function can potentially be restored in adult women with the disorder through modifying the wiring in the brain.”

the left brain

There is growing evidence that the brain is involved in PCOS in terms of the syndrome’s development and pathology. Earlier research from Otago has identified changes in specific brain circuits that may underlie the disorder.

In their study on PCOS, Associate Professor Campbell and her team investigated the changes in circuit behavior and whether they can be changed by blocking androgen actions once the disorder has been established.

“We discovered that brain changes occur prior to the onset of puberty, which is before the syndrome appears, suggesting that the brain pathology precedes disease development,” Associate Professor Campbell concluded. The research team also discovered that “despite this early ‘programming’ of neural circuitry, long-term blockade of androgen actions was able to completely restore normal brain wiring and reproductive cycles.”

Associate Professor Campbell says although the work is pre-clinical, it still gives clues to help find potentially effective therapies in treating the reproductive pathology of PCOS in women.

Fertility and Technology

Nanotech, artificial intelligence, wearables and biological engineering continue to change the way women today can conceive. Cutting-edge technologies have changed the fertility game, giving people even more control over if, how, and when people conceive.

Artificial intelligence and predictive analytics

Celmatix uses big data to treat infertility. Located in the heart of New York City’s Financial District, the company provides a web-based data analytics platform called Polaris to help optimize patient management and counseling. With Polaris, physicians are able to identify patients who are ready to start treatment, give patients access to data-driven personalized reports, and simplify communication across their clinical support team.

Life Whisperer is an AI program used to find embryos that will start a viable pregnancy. Using artificial intelligence, the company hopes to improve outcomes for couples attempting to conceive. Because finding the right embryo tends to be a manual and imprecise process, Life Whisperer aims to address this issue by using AI-driven image analysis.

pregnant woman in front of crib

Three-person embryos

Using three-person IVF, an embryo would be created with nuclear DNA from a woman with defective mitochondria, her partner’s DNA, and the healthy mitochondrial DNA from an egg donor. The UK’s Human Fertilisation and Embryology Authority (HFEA) recently advised its government to make this technique legal in order to prevent children from obtaining mitochondrial disease. In the past, three-person embryos have been used to reverse the biological clock of older women.

A start-up company called Darwin Life is currently offering to “rejuvenate” eggs from women using Spindle Nuclear Transfer. According to Darwin Life’s website, it is a method of cloning. This procedure is currently illegal in the U.S.

Uterus and penis transplants

Returning back to the uterus transplant topic, both uterine and penile transplants have begun to show promise. Recently as of April 2018, the world’s first total penis and scrotum transplant were successfully carried out at John Hopkins Hospital for a patient injured while serving in Afghanistan. Back in 2015, the girlfriend of the world’s first penis transplant patient in Cape Town, Africa, became pregnant.

Because there is a severe shortage of available donor organs, scientists have been attempting to grow a patient’s own organs. Organs such as the urinary bladder, urethra, and vagina have successfully been grown from a patient’s cells and transplanted before.

Conclusion

With the IVF process improving and groundbreaking research on fertility and diseases affecting fertility hitting headlines, couples have a better chance than ever before to start a family of their own and bypass bumps along the road. Who knows—maybe the future will give us a world where a couple will never have difficulty conceiving.   

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