Could Ovarian Stem Cells Help Older Women Become Pregnant?

Contrary to more than a half a century of scientific belief that women will never have more eggs than the number they are born with, new research says that stem cells in the ovaries may be actually capable of creating new eggs later on in life.

 

This development could be the key to achieving pregnancy older women, who no longer have enough eggs to reproduce.

 

According to the study, published today in the journal Nature Medicine, researchers from Massachusetts General Hospital used stem cells discovered in the ovaries of Japanese women to effectively create healthy human egg cells.

 

“This is a beginning of perhaps something that could bring in new opportunities,” told Dr. Avner Hershlag, chief of the Center for Human Reproduction in Manhasset, N.Y. to Health Day.

 

Up until now it has been believed that women are born with a set number of eggs, which slowly decreases with age. By the time may women reach 35 years of age the supply is diminished enough to create difficulties becoming pregnant. Therefore, getting pregnant at 45 with a woman’s own eggs, or in some desired cases at age 50 or more, presents a significant challenge.

 

Although this research is promising, experts say that it is still a long way off before we know if these eggs grown from stem cells will actually be healthy enough to create human babies. Furthermore, the cells used in this study were collected from women in their 20′s, not from older women who are usually the age group seeking infertility treatment.

 

“Detection of stem cells in ovaries of young women does not necessarily mean that such stem cells can also be found in ovaries of older women,” Dr. Norbert Gleicher of the CHR in New York point out. However, he added, “in a more optimistic interpretation of this study’s results, one can, however, also conclude that presence of these stem cells opens tremendous new opportunities for research and potential clinical applications in women with aging ovaries.”

IVF Success Rates Not Improved by Preimplantation Genetic Screening, According to CHR Research

November 19, 2012 (New York, NY) – There is no evidence that recent technical improvements in preimplantation genetic screening (PGS) improve IVF pregnancy chances, according to a paper just published online in the Journal of Assisted Reproduction and Genetics1. The review, by two fertility specialists from New York’s Center for Human Reproduction (CHR), raises important questions, as this “new” PGS is actively marketed to patients as “proven” and “established” to increase IVF success rates.

In the late ‘90s, PGS was widely utilized in IVF in attempts to improve pregnancy chances. The assumption was it could eliminate genetically abnormal embryos before implantation, thereby raising implantation and pregnancy rates, and reducing miscarriage rates. For a number of years, thousands of women worldwide underwent PGS under this premise, until a number of investigators, including the authors of this new report, demonstrated that, in practice, PGS actually reduced IVF pregnancy rates, at least in older women. By 2008, the American Society of Reproductive Medicine (ASRM) and other authoritative bodies declared PGS ineffective in improving IVF outcomes.

In recent years, a number of important technical improvements were introduced to PGS, which, unquestionably, improved the accuracy of determining chromosomal abnormalities in embryos prior to transfer. Under the assumption that these improvements would finally confirm the widely held opinion that PGS will improve IVF pregnancy rates, a “new” form of PGS is now, once again, aggressively marketed by commercial interests.

After a thorough review of published studies and ongoing registered clinical trials, the paper concludes that there is no evidence that this reintroduction of PGS to IVF improves pregnancy rates. “As we already pointed out in 2008, evidence suggests that the real reason why PGS was ineffective in its first introduction and, likely, remains ineffective in its current reincarnation, is the wrong patient selection, and not the techniques utilized,” explains Norbert Gleicher, MD, Medical Director and Chief Scientist of CHR. “Until we better identify appropriate patient populations for PGS, new techniques are unlikely to benefit patients and, as previously, may actually reduce IVF pregnancy chances.”

“These new techniques, indeed, further complicate considerations about patient selection,” adds David H Barad, MD, Director of Clinical ART and Senior Scientist at CHR. “With the “new” PGS, embryos have to remain in culture for 5-6 days after fertilization, which many embryos of lesser quality do not survive. Some of these embryos would still lead to pregnancy if transferred on day-3, as in routine IVF cycles.” He continues: “Reported higher pregnancy rates with the ‘new’ PGS are misleading because they exclude patients who started IVF cycles but never made it to embryo transfer.”

The paper concludes that the “new” PGS still has to be considered “experimental” and patients should be advised accordingly. “Patients should be aware that PGS is not in any way proven to better pregnancy chances, and may actually do the opposite in some patients,” warns Dr. Gleicher.

1Gleicher N and Barad DH. A review of, and commentary on, the ongoing second clinical introduction of preimplantation genetic screening (PGS) to routine IVF practice. J Assist Reprod Genet 2012; epub ahead of print. (http://link.springer.com/article/10.1007/s10815-012-9871-2/fulltext.html)