Infertility: Scientists out With New Treatment

Posted on: Mon 30-11-2015

A milder and cheaper form of IVF that does not involve giving women powerful drugs has produced better success rates than standard fertility treatment.

The revolutionary technique, known as in vitro maturation (IVM), involves removing immature eggs from the woman and then maturing them in the laboratory before fertilising them.

With IVF, a woman must undergo between 8 to 11 nights of ovary-stimulating hormone injections before her eggs can be retrieved. However, with IVM, women undergo a shorter course— between 3 and 6 days— of hormones known as a “priming phase.”

Once the eggs are retrieved, they’re matured in a laboratory for approximately three days, fertilized and then implanted. They can also be frozen as eggs or embryos to be implanted later.

Clinics that specialize in IVM require a doctor who has expertise in retrieving small eggs and a lab with embryologists who have the skills to look for them, said Dr. Janelle Luk, medical director of Neway Fertility in New York City.

Normally women have to take powerful drugs daily to stimulate the ovaries to produce and grow around a dozen eggs which are then removed and fertilised in the lab. The side effects of the drugs can be serious and even fatal in rare cases if a condition called ovarian hyperstimulation syndrome occurs.

The first babies using in vitro maturation were born in 2007 and studies have shown that the success rate is comparable if not better than standard IVF.

Geeta Nargund, chief executive of the Her Trust and consultant in reproductive medicine at St George’s Hospital in South London, says the technique only really applied to women with polycystic ovary syndrome (PCOS) where cysts cover the ovaries.

Around third of women seeking fertility treatment suffer from PCOS and one in seven couples will have problems conceiving.

The symptoms of this condition include abdominal swelling or bloating due to enlarged ovaries, nausea and vomiting. The condition is so serious that women who think that they may have developed OHSS are warned that they should seek immediate medical attention.

As well as being more successful, the new technique is also cheaper than the standard IVF as it largely avoids the need for drugs, which cost around £1,500 or about N450,000per cycle. 299.50

Historically success rates of IVM have been lower than standard IVF, at 25 per cent compared to around 36 per cent on average.

Oxford Fertility Unit, Britain was licensed to perform IVM in January last year and has achieved success rates of 35 per cent for its first 40 cases and 48 per cent in women under the age of 35.

Ten babies have now been born and one set of twins are now a year old.

Dr Nargund said a team in Denmark are also trying the technique in women without PCOS but have not reported any results yet.

The technique will not work in older women who have few eggs left in their ovaries because many eggs fail to mature in the laboratory and so a relatively high number are needed to start with.

It is thought that around 400 babies worldwide have been born using the IVM technique so far.

Although IVF is considered the standard of care, experts say some women may benefit from IVM.

For starters, since there is less time involved with IVM, women who are undergoing chemotherapy, radiation or plan to have surgery may be good candidates.

IVM may also help women who have a contraindication to the increased levels of estradiol, a form of estrogen, which elevates as the follicles develop and mature. These would include women with an estrogen-sensitive cancer or a history of blood clots.

IVM can also help women who are adverse to injections or who have failed IVF, Luk said.

According to the researchers, women with polycystic ovary syndrome (PCOS) or who are at increased risk for ovarian hyperstimulation syndrome (OHSS)— which affects between 3 and 6 percent of women who go through IVF— may also benefit from IVM. OHSS can usually be managed on an outpatient basis but severe OHSS may lead to blood clots, even death, said Dr. Shefali Shastri, a board-certified reproductive endocrinologist and OB/GYN at Reproductive Medicine Associates of New Jersey in Somerset and Short Hills.

A study in the journal Facts, Views and Vision found that IVM achieved up to a 35 percent clinical pregnancy rate in young women, which is comparable to IVF.

Although there are different protocols for IVF, and there aren’t any randomized controlled trials that have compared IVF and IVM side by side, studies that look at standard IVF cycles show a significantly higher pregnancy rate than IVM, Shastri said.

By: Franka Osakwe

National Mirror News

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