As well as breakthroughs in miscarriage research, which I talked about in last week’s post, there has been constant progress in the field of in vitro fertilisation (IVF). It has been over 40 years since the first ‘test-tube’ baby, born in the same year as me and, since then, over 1.1 million IVF treatment cycles have taken place in the UK. Despite initial hostility to their work, a team headed by Robert Edwards, Jean Purdy and Patrick Steptoe at the Oldham and District General Hospital were committed to developing a method that would alleviate human infertility, which affects more than 10% of all couples worldwide. Their eventual success in overcoming both the complex scientific and ethical hurdles this entailed has paved the way for the research that continues today.
I had planned to cover this subject in one post, but there is such a lot happening that I was struggling to make it short enough! I’ve begun with four projects that have made the headlines in recent years, and that will hopefully lead to improved IVF outcomes.
The role of the RBMXL2 gene in male infertility
Scientists at Newcastle University have identified the importance of gene RBMXL2, which is similar to a male infertility gene on the Y chromosome found only in men, in regulating the production of fully-functioning sperm. Making sperm and eggs relies upon a special kind of cell division known as meiosis, which involves copying long stretches of DNA into RNA. Without the important RBMXL2 gene, other genes are not expressed properly – they still make RNA, but not accurately, leading to mistakes which eventually block the production of sperm. Understanding how RBMXL2 enables sperm to be made has given experts a clue as to how the similar infertility genes on the Y chromosome work. The RBMXL2 gene was first discovered almost 20 years ago, but no one until now has known what it does or why it is important. Although in the very early stages, this new research offers hope for a greater understanding of male fertility in the future.
Read more here.
Imperial College research into natural hormone kisspeptin
A team at Imperial College London has been working to make IVF a safer procedure using the natural hormone kisspeptin to stimulate egg development instead of the usual fertility drugs. Ovarian hyperstimulation syndrome (OHSS) is a potentially life-threatening side effect triggered by IVF drugs and their research has shown that kisspeptin can effectively and safely trigger egg maturation in women, especially those at high risk of OHSS.
Following a successful clinical study conducted at Hammersmith Hospital in 2014 and 2015, the team has recently received support from a US pharmaceutical company to conduct a larger randomised control trial, which is required to take the compound forward to development. It is hoped that eventually kisspeptin will be included as standard clinical practice in IVF treatment.
HFEA report into egg freezing
A report from UK regulator the Human Fertilisation and Embryology Authority (HFEA) towards the end of last year into egg freezing revealed the practice is becoming more popular as a way for women to preserve their fertility, as long as the eggs are frozen below the age of 35. Egg freezing is still relatively uncommon – just 178 women had treatment using their own thawed eggs in 2016, with only an 18% birth rate – but the number of egg freezing cycles has more than doubled since 2013, helped by improved clinical techniques such as the fast-freezing ‘vitrification’ method. Women are freezing their own eggs for two primary reasons; because they are undergoing medical treatment such as chemotherapy or have other medical conditions that reduce fertility, and for elective or social reasons as a way of increasing the chances of having a biologically-related child later in life. It’s an irony that the likelihood of women in their 20s and early 30s needing to use frozen eggs later in life is less than older women as they have more likelihood of conceiving naturally before this – this catch 22 situation is not helped by the current law that only allows eggs to be stored for up to 10 years, and is one reason why there are increasing calls to change legislation.
Image from Pixabay.