ovarian

Artificial eggs and sperm- are they on the horizon ?

Sperm-eggs-synthetic-artificialCould a cure for real cure for infertility be on the horizon? Today many causes for infertility can currently be successfully treated such fertility issues caused by damage to fallopian tubes, ovulation disorders, endometriosis and low sperm counts or motility. These treatments currently available to us include fertility drugs, insemination, surgery and IVF. However, there are still issues in assisting women have very few or no eggs left or men who produce no sperm at all. This is a particular problem for women since women produce all they eggs they will in a lifetime while still in their mother's womb, and by their mid 40s have hardly any normal eggs left. These couples can be successfully treated only with the use of donor eggs or sperm. While these donor procedures are often quite effective, the children who result from these pregnancies do not carry the DNA of one or both of the parents. This is a problem since most couples who seek out the help of a Reproductive Medicine specialist want their own genetic children. With our current state of reproductive science this may not be possible.

One potential way around this would be using stem cells in the lab using cloning technologies.  A group of scientists at the Weizmann Institute in Rehovot, Israel and Cambridge in the UK have brought us a little closer to this cure, figuring out how to more efficiently get these stem cells to grow into cells that will eventually develop into eggs and sperm. Their findings were recently published in the journal Nature.

The researchers have yet to take the next step; producing eggs and sperm from these stem cells. While it may become technically feasible, besides the technical issues, there are ethical concerns, perhaps even greater than when IVF when first introduced to overcome before this proceeds. IVF was enormous breakthrough when it was developed, but it is still merely a replication of natural conception, albeit in a laboratory dish. If this next step is even possible, it could bring reproduction to entirely new level. These technologies may make it possible to have genetic children without ovaries, without testes and without age limits, shattering our concepts about parenthood, even more so than it is today. It is not clear if society is ready for this yet.

PCOS, inflammation and pregnancy

PCOS-on-ultrasoundPolycystic ovarian syndrome (PCOS) is one the most common hormone problems in women of reproductive age as well as one of the most common causes for female infertility. While infertility caused by PCOS is often amenable to treatment, women with PCOS often have more complicated pregnancies, including problems such as gestational diabetes and pre-eclampsia.  One of the common threads with these issues is their association with inflammation. It turns out there may now be a link explaining why PCOS patients have more complications. A recent study shows that markers of inflammation are higher in PCOS women and become even worse when these women get pregnant. It could be that inflammation is the common link between in PCOS and a number of pregnancy complications.

Preimplantation genetic testing for the breast cancer gene

PGD-embryo-pivfThe use of Preimplantation Genetic Testing (PGD) enables fertility doctors to screen embryos for genetic diseases such as Cystic Fibrosis or Sickle Cell Anemia, permitting couples at high risk to avoid transmitting these diseases onto their children. PGD is done as part of an IVF cycle. A biopsy is taken when the embryo reaches the 8 cell or the blastocyst stage, and tested for the specific gene we are concerned about. This same technology can also be used to test for genes that do not necessarily cause a disease but put an individual at risk for other serious diseases. One such genetic mutation, called the BRCA 1 and 2 gene, puts affected women at very high risk for developing breast and ovarian cancer. The risk of developing these cancers in affected women is so high that many women (such as Angelina Jolie) chose to have their breasts and/or ovaries surgically removed just to prevent cancer. Since we know the genetic sequence of the BRCA mutation, it is possible to screen embryos for it, and prevent transmitting the gene onto one's daughters. This article in the Wall Street Journal tells the story of a family who decided to go that route.

September is PCOS Awareness Month

PCOSultrasound This month is the time to recognize Polycystic Ovarian Syndrome  (PCOS), the most common hormonal disorder in women of reproductive age. It is hormone imbalance that includes irregular or absent periods, and production of higher than normal levels of male hormones such as testosterone which can result in symptoms such as facial hair, acne and hair loss. It is also a metabolic problem that can cause weight gain and lead to diabetes, high blood pressure.and heart disease. Additionally, it is one of the most common causes for infertility and something most Reproductive Endocrinologists see on a daily basis.  For information from Resolve or the PCOS Association, click on the links.