MONDAY, September 30, 2013 — A new technique known as "in vitro activation” (IVA) may help infertile women give birth, according to a new study published in the Proceedings of the National Academy of Sciences. Researchers from the St. Marianna University School of Medicine in Kawasaki, Japan developed the technique, which has so far resulted in one birth and another pregnancy.
The researchers tested the technique in 27 women diagnosed with primary ovarian insufficiency, a condition affecting 1 percent of women, in which the ovaries don’t produce the estrogen necessary to develop and release eggs for ovulation. However, women with the condition still contain immature eggs in the follicles of their ovaries, and IVA stimulates the production of those immature eggs to help women with the condition conceive.
"For patients with primary ovarian insufficiency, egg donation is the only option for bearing a baby," Kazuhiro Kawamura, MD, PhD, associate professor of obstetrics and gynecology at the St. Marianna University School of Medicine, said in a statement. "These patients are eager to find a way to become pregnant with their own eggs."
The procedure involves removing either a piece of or the entire ovary, stimulating it to encourage the immature eggs to grow, and implanting the ovary back before administering in vitro fertilization drugs to encourage ovulation.
“This group of women has a reduced number of follicles, but they still have them,” Carl Herbert, MD, medical director of the Pacific Fertility Center in San Francisco. “The researchers are trying to rescue those follicles and the eggs they contain. When they do that, some of those eggs may be viable.”
But the viability of the eggs is just one part of the equation, Dr. Herbert said.
“The big question is about the quality of those eggs,” he said. “We know that by the time a woman gets to age 44, only 1 in 20 of her eggs is chromosomally normal. It’s important to look at the genetic makeup of these eggs and the potential child.”
The technique could offer hope for the first time to women with this condition, Herbert said.
“Other techniques, such as in vitro fertilization, aren’t an option for these women because their bodies don’t respond to the medication,” he said. “We can use donor eggs, but not their own.”
And while the technique was only tested in women with this condition, it’s possible that it could be expanded to treat other reasons for infertility, such as chemotherapy or early menopause, he added.
Herbert said the fact that IVA has already proved successful means that the technique could be available sooner than later, but said there are still many hurdles to overcome.
“When these things come out, other people need to replicate it,” he said. “You’re talking about a woman having two surgeries, one to remove the ovary and another to implant it, then undergoing IVF and a pregnancy. It’s going to be expensive and somewhat dangerous.”
However, he said that if the final procedure does become mainstream, it will likely look very different than what the researchers did today.
“As more people try the procedure, maybe we’ll find out a way that it can be done easier, even without surgery,” he said. “This procedure could lead to many more things."
Last Updated: 9/30/2013