A key culprit that makes it more difficult for older women to get pregnant is the health of their eggs. Older eggs are more likelyto have abnormalities that will prevent them from developing into healthy babies if fertilised.
Scientists are working on ways to enhance the quality of eggs for women who have tried IVF but have not gotten pregnant because of problems with their eggs, an area of research Oktay calls “exciting.”
The procedure, called AUGMENT, is highly experimental and not yet FDA-approved. Some scientists warn that it’s too soon to know whether the procedure is safe or effective. But there’s already an indicator that this experimental technology might work: births.
The first baby conceived using this procedure, a boy named Zain Rajani, was born in April 2014. His mother Natasha Rajani got the AUGMENT procedure done as part of her IVF at a fertility clinic in Toronto, Canada.
How it works
The procedure begins with a small biopsy of a woman’s ovary, Dr. Jon Tilly, who holds the patent for AUGMENT along with Dr. Dori Woods, told Business Insider. The tissue taken from the ovary is processed to yield stem cells called egg precursor cells, which have the potential to become eggs under the right conditions, Tilly says. These cells provide the mitochondria that will be used in the next step of the procedure.
After the woman’s eggs have been retrieved through the normal IVF protocol and are ready for fertilization, the mitochondria taken from her stem cells are injected into an egg along with a sperm cell.
The aged egg, which may have had damaged mitochondria that wouldn’t work as well, then has fresh mitochondria from the egg precursor cells to generate energy.
“The idea is that you’re essentially re-energizing the batteries in the egg so it has all the energy it needs to take a sperm and make a healthy embryo, which then makes a healthy pregnancy,” Tilly said.
What we know so far
Besides Zain Rayani, one other child whose mother had the AUGMENT procedure performed has been born thus far. Oktay, who has been involved with testing the procedure in a clinic in Turkey, reported the birth of a healthy baby girl at the European Society for Human Reproduction and Embryology (ESHRE) annual meeting on June 17.
Also at the ESHRE annual meeting, Dr. Michael Fakih presented the results of 59 women who had the procedure done at his clinic in the United Arab Emirates. Before trying the AUGMENT procedure, the women had started an average of 4.3 IVF cycles each with a total of 4 live births, a clinical pregnancy rate of 4%.
After an average of one cycle each that incorporated AUGMENT, the clinical pregnancy rate for the group of women was 22%, with 11 ongoing pregnancies as of Fakih’s presentation. Similar increases in clinical pregnancy rate were reported for the trials underway in Turkey and Canada.
Proceed with caution
The initial reports look promising, but it’s worth noting the trial sizes to date are very small, only 101 women in total. Much more research will need to be done, with results compared to women who haven’t had the procedure, before whatever benefits AUGMENT may have are clearly seen. The women and the babies will also need to be followed over time.
There are other reasons for caution at this early stage of research.
John Eppig, a reproductive biologist at Jackson Laboratory in Bar Harbour, Maine raised the concern that no animal studies with a control group have been done — a standard practice with experimental medical procedures — yet somehow the procedure is being tried on humans. “We really don’t know” what the consequences of adding mitochondria to an egg cell are, he told Science Magazine.
It’s far too soon to tell exactly what effect AUGMENT has for women trying yet another round of IVF, let alone on the children they bear. Only time and much more research in larger groups of women will determine whether the new technology will be an effective option for older women who have had trouble conceiving.
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