Effective fertility treatment without the drugs

What if you could improve your chances of getting pregnant without going through the stress and expense of IVF? Thanks to Australian and Belgian researchers, an enhanced form of IVF’s less invasive sister, in vitro maturation (IVM), may be on the horizon.

IVF (in vitro fertilisation) requires women to inject themselves with high doses of follicle-stimulating hormones for up to 12 days in order to stimulate egg cell growth before these cells are removed from the ovary. While the use of hormone drugs is a proven treatment, its use comes with the risk of discomfort and medical complications — not to mention significant expense for both the patient and the healthcare system.

IVM, on the other hand, retrieves eggs while they are still in the immature stage and brings them to maturity in cell culture, all with minimal hormone stimulation. However, clinicians usually recommend IVF because pregnancy rates after IVM have been lower. Now, a research team led by UNSW’s Associate Professor Robert Gilchrist, in collaboration with the University of Adelaide, UZ Brussel at Vrije Universiteit Brussel (VUB) and Cook Medical, is looking to even the odds.

“The aim of our research has been to restore, as far as possible, the natural processes that occur during egg maturation,” said Associate Professor Gilchrist, who is based at UNSW’s School of Women’s and Children’s Health.

After discovering a new growth factor, called cumulin, the scientists added it to egg cells in the laboratory in combination with small signalling molecules called cyclic AMP-modulators. Initial experiments using the technique in pigs showed an improvement in egg quality and a doubling of the embryo yield compared to the existing IVM method. In a preclinical trial on human eggs, the researchers likewise found an improvement in egg quality and a 50% increase in embryo yield.

“We have demonstrated that it is possible to improve egg quality and embryo yield with next to no drugs, using potent growth factors produced by the egg,” Associate Professor Gilchrist said.

“We have a 50% increase in the efficiency of IVM, which brings it to the level of IVF — which means that in the future, this could be an alternative to IVF.”

Professor Michel De Vos, from UZ Brussel, added that the use of IVM reduces the risk of ovarian hyperstimulation syndrome (OHSS) to zero. “Young women facing cancer treatment, who wish to preserve their fertility but often don’t have time to freeze their eggs, will also benefit from this breakthrough,” he said.

With the technique currently awaiting FDA approval, the researchers are conducting safety studies to ensure that altering the conditions of egg maturation does not affect the long-term health of offspring. And even if it is accepted into clinical practice, Associate Professor Gilchrist does not necessarily see it replacing IVF entirely.

“We hope that in the future we will have both IVF and IVM available for patients, depending on their individual needs,” he said.