Infertile woman gives birth after experimental treatment
Scientists caution that this new method of conception won't assist all women who have primary ovarian insufficiency.
Tue, Oct 01, 2013 at 10:05 AM
A 30-year-old woman in Japan who was thought to be infertile recently gave birth to a healthy baby boy thanks to an experimental fertility treatment, researchers report.
The woman had stopped having regular periods due to a condition called primary ovarian insufficiency, in which the ovaries fail to produce normal amounts of estrogen and do not release eggs regularly.
The researchers removed an ovary, treated it outside the body, and reimplanted it. The treatment stimulated the production of follicles, which are structures that surround developing eggs.
Then, the researchers collected eggs from the woman, fertilized them in a dish with her husband's sperm, and transplanted the embryos into the woman. She gave birth after 37 weeks of pregnancy.
However, the treatment will not work in all women with primary ovarian insufficiency, and currently has a low success rate, the researchers said. [5 Myths About Fertility Treatments]
Only about half of the 27 women in the study (48 percent) were candidates for the treatment, and just five out of 13 women who received the therapy produced viable eggs. Just two became pregnant (one has yet to give birth).
Although more work is needed, the researchers said they hope the technique could help women with primary ovarian insufficiency and other types of early menopause, such as menopause caused by cancer treatment. The researchers, from Stanford University in Palo Alto, Calif. and St. Marianna University School of Medicine in Kawasaki, Japan, speculated that it will be several years before the technique is used outside an experimental setting.
Women are born with all of the eggs they will use in their lifetimes, but the eggs need to mature inside follicles. Typically, one follicle matures each month, and releases an egg.
About 1 percent of women of reproductive age have primary ovarian insufficiency. The cause is often unknown, although it can be due to follicle damage. While women with this condition may spontaneously become pregnant, egg donation is usually the only way for them to have a child, the researchers said.
Previously, the researchers showed that blocking a particular cellular pathway, called the PTEN pathway, stimulated dormant follicles in mice and human ovaries to produce eggs. Iin the new study, the researchers employed a technique that has been used in the past to simulate follicles.The technique, called ovarian fragmentation, involves cutting the ovary into pieces.
The researchers found that when ovarian fragmentation was combined with treatment to block the PTEN pathway, the two treatments together activated more follicles than either treatment alone.
After performing these two treatments on the ovary outside the body, small pieces of the ovary are transplanted near the fallopian tubes. Women also need to take drugs to help stimulate the follicles.
One day, it may be possible to get the same results as ovarian fragmentation by blocking a separate pathway, without the need to cut the ovaries, said the researchers, who plan to study this.
The study is published this week in the journal Proceedings of the National Academy of Sciences.
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