Potentially exciting information for women with PCOS who dream of having children biologically

Polycystic Ovary Syndrome (PCOS) is a gynaecological disorder that affects an estimated 5 million women in the United States. Some of the symptoms of PCOS are ovarian cysts and highly irregular periods, which lead to infertility in a lot of the women who deal with this disorder.

Women who take advantage of advanced fertility treatments, like IVF, often still struggle to conceive — a heartbreaking side effect of PCOS.

Researchers looked at 1,5000 women who suffer from infertility and PCOS, and found that those who received IVF treatment were more likely to conceive if frozen embryos were implanted, instead of fresh embryos. 49 percent of women who used frozen embryos were able to conceive on the first try, compared to 42 percent of women who used fresh embryos. Findings also showed that those who used frozen embryos had less miscarriages.

Despite these optimistic findings, the researchers still warn us about specific complications related to frozen embryos.

Preeclampsia, a pregnancy complication that leads to high blood pressure, was more common in women who used frozen embryos. And tragically, five newborns from the frozen embryo group died, while all newborns from the fresh embryo group survived.

Dr. Christos Coutifaris of University of Pennsylvania wrote an editorial in the research, and mentioned that this research alone may not be “significant enough” to encourage women to only use frozen embryos. Dr. Coutifaris mentioned that a 42 percent pregnancy rate is still great news, and that “In selected cases, especially for women who [have Ovarian Hyperstimulation Syndrome as a result of PCOS], the approach to freeze all the embryos is prudent.”

The researchers also stated that more research would have to be done on women who do not have PCOS in order to clarify the findings. Still, this could lead to easier pregnancies for millions of women.

Menopause reversal restores periods and produces fertile eggs

Never too old?

Women who have already passed through the menopause may be able to have children following a blood treatment usually used to heal wounds

MENOPAUSE need not be the end of fertility. A team claims to have found a way to rejuvenate post-menopausal ovaries, enabling them to release fertile eggs, New Scientist can reveal.

The team says its technique has restarted periods in menopausal women, including one who had not menstruated in five years. If the results hold up to wider scrutiny, the technique may boost declining fertility in older women, allow women with early menopause to get pregnant, and help stave off the detrimental health effects of menopause.

“It offers a window of hope that menopausal women will be able to get pregnant using their own genetic material,” says Konstantinos Sfakianoudis, a gynaecologist at the Greek fertility clinic Genesis Athens.

“It is potentially quite exciting,” says Roger Sturmey at Hull York Medical School in the UK. “But it also opens up ethical questions over what the upper age limit of mothers should be.”

Women are thought to be born with all their eggs. Between puberty and the menopause, this number steadily dwindles, with fertility thought to peak in the early 20s. Around the age of 50, which is when menopause normally occurs, the ovaries stop releasing eggs – but most women are already largely infertile by this point, as ovulation becomes more infrequent in the run-up. The menopause comes all-too-soon for many women, says Sfakianoudis.

The age of motherhood is creeping up, and more women are having children in their 40s than ever before. But as more women delay pregnancy, many find themselves struggling to get pregnant. Women who hope to conceive later in life are increasingly turning to IVF and egg freezing, but neither are a reliable back-up option .

The menopause also comes early – before the age of 40 – for around 1 per cent of women, either because of a medical condition or certain cancer treatments, for example.

“It offers hope that menopausal women will be able to get pregnant using their own genetic material“

To turn back the fertility clock for women who have experienced early menopause, Sfakianoudis and his colleagues have turned to a blood treatment that is used to help wounds heal faster.

Platelet-rich plasma (PRP) is made by centrifuging a sample of a person’s blood to isolate growth factors – molecules that trigger the growth of tissue and blood vessels. It is widely used to speed the repair of damaged bones and muscles, although its effectiveness is unclear.. The treatment may work by stimulating tissue regeneration.

Sfakianoudis’s team has found that PRP also seems to rejuvenate older ovaries, and presented some of their results at the European Society of Human Reproduction and Embryology annual meeting in Helsinki, Finland, this month. When they injected PRP into the ovaries of menopausal women, they say it restarted their menstrual cycles, and enabled them to collect and fertilise the eggs that were released.

“I had a patient whose menopause had established five years ago, at the age of 40,” says Sfakianoudis. Six months after the team injected PRP into her ovaries, she experienced her first period since menopause.

Sfakianoudis’s team has since been able to collect three eggs from this woman. The researchers say they have successfully fertilised two using her husband’s sperm. These embryos are now on ice – the team is waiting until there are at least three before implanting some in her uterus.

The team isn’t sure how this technique works, but it may be that the PRP stimulates stem cells. Some research suggests a small number of stem cells continue making new eggs throughout a woman’s life, but we don’t know much about these yet. It’s possible that growth factors encourage such stem cells to regenerate tissue and produce ovulation hormones. “It’s biologically plausible,” says Sturmey.

 

Fertilised eggs

Sfakianoudis’s team says it has given PRP in this way to around 30 women between the ages of 46 and 49, all of whom want to have children. The researchers say they have managed to isolate and fertilise eggs from most of them.

“It seems to work in about two-thirds of cases,” says Sfakianoudis. “We see changes in biochemical patterns, a restoration of menses, and egg recruitment and fertilisation.” His team has yet to implant any embryos in post-menopausal women, but hopes to do so in the coming months.

PRP has already been helpful for pregnancy in another group of women, says Sfakianoudis. Around 10 per cent of women who seek fertility treatment at his clinic have a uterus that embryos find difficult to attach to – whether due to cysts, scarring from miscarriages or having a thin uterine lining. “They are the most difficult to treat,” says Sfakianoudis.

But after injecting PRP into the uteruses of six women who had had multiple miscarriages and failed IVF attempts, three became pregnant through IVF. “They are now in their second trimester,” says Sfakianoudis.

Fertility aside, the technique could also be desirable for women who aren’t trying to conceive. The hormonal changes that trigger menopause can also make the heart, skin and bones more vulnerable to ageing and disease, while hot flushes can be very unpleasant. Many women are reluctant to take hormone replacement therapy to reduce these because of its link with breast cancer. Rejuvenating the ovaries with PRP could provide an alternative way to boost the supply of youthful hormones, delaying menopause symptoms.

However, Sfakianoudis’s team hasn’t yet published any of its findings. “We need larger studies before we can know for sure how effective the treatment is,” says Sfakianoudis.

“One woman had been in menopause for 5 years. Six months after treatment, she had a period“

Some have raised concerns about the safety and efficacy of the procedure, saying the team should have tested the approach in animals first. “This experiment would not have been allowed to take place in the UK,” says Sturmey. “The researchers need to do some more work to make sure that the resulting eggs are OK,” saysAdam Balen  at the British Fertility Society.

To know if the technique really does improve fertility, the team will also need to carry out randomised trials, in which a control group isn’t given PRP.

Virginia Bolton, an embryologist at Guy’s and St Thomas’ Hospital in London, is also sceptical. “It is dangerous to get excited about something before you have sufficient evidence it works,” she says. New techniques often find their way into the fertility clinic without strong evidence, thanks to huge demand from people who are often willing to spend their life savings to have a child, she says.

If the technique does hold up under further investigation, it could raise ethical questions over the upper age limits of pregnancy – and whether there should be any. “I lay awake last night turning this over in my mind,” says Sturmey. “Where would the line be drawn?”

Health issues like gestational diabetes, pre-eclampsia and miscarriage are all more common in older women. “It would require a big debate,” says Sturmey.

 

SOURCE: NEW SCIENTIST

 

Edinburgh baby born from frozen ovary in UK first

A cancer patient from Edinburgh has become the first UK woman to give birth following a transplant of her frozen ovary tissue.

The mother conceived naturally and gave birth to a baby boy two weeks ago.

Edinburgh University scientists are freezing tissue from the reproductive organs of boys and girls as young as one, which can be re-implanted once they reach adulthood.

The 33-year-old mother had a section of her ovary removed 11 years ago.

She wishes to remain anonymous.

Following her chemotherapy, doctors re-implanted the tissue last year.

Researchers said the new service was open to NHS patients.

'Astonished and overjoyed'

The new mother said: "That the re-implanted tissue took so quickly, came as a really wonderful surprise.

"I'm incredibly appreciative of my oncologist's foresight in sending me for the consultation with the fertility team.

"I had one small surgical procedure before I began my second round of chemotherapy and now, 10 years on, my husband and I have been able to have a family."
She added: "We never thought it would be possible and we are just astonished and overjoyed. We are extremely grateful to all the people involved in this process.

"When you're going through cancer treatment it can be hard to think about the future, but I do think this will offer hope to others that they could one day have a family."

'Real hope'

Prof. Richard Anderson, of Edinburgh University, said: "The storage of ovarian tissue to allow restoration of fertility after cancer treatment in girls and young women was pioneered in Edinburgh over 20 years ago, and it is wonderful to see it come to fruition.

"This gives real hope to girls and young women facing treatment that may cause them to become infertile, and shows how some medical advances can take a long time to show their benefits."

The research has been funded by the Wellcome Trust, Children with Cancer, the European Union and the Medical Research Council.

It has involved close collaboration with the Scottish National Blood Transfusion Service.

 

Scientists reveal simple way of boosting fertility in women - and you need to be outdoors to get it

soaking up the sun

Getting plenty of vitamin D could help boost fertility in women, say experts.

Vitamin D – aka the ‘sunshine vitamin’ – is produced in the skin after exposure to sunlight and can also be found in some foods.

And now scientists from the University of Edinburgh have found a link between vitamin D and ‘reproductive success’.

Their findings come from monitoring a flock of sheep on a remote Scottish island.

But they’re confident the results will be mirrored in other mammals – most importantly humans.

Health and wellbeing expert Jonathan Evans, founder of world-leading supplements firm MANFLU, says the evidence could prove life-changing for many couples desperately trying for a baby.

Findings: Experts reached their conclusions after monitoring a flock of sheep  

He said: “We’ve long known that vitamin D is essential for healthy bones and teeth in humans, and it has been linked to other health benefits.

“When we created our new MANFLU Soup A Hero product we enhanced it with 13 select vitamins and minerals for immune support, to reduce tiredness and support energy release.

"We of course included vitamin D as people can be deficient at this time of year.

“And now this piece of research offers another reason to ensure you’re getting enough, either through plenty of time outdoors or through the right foods, such as our vitamin D enriched ’Soup a Hero’ chicken soup.”

Dr Richard Mellanby, Head of Small Animal Medicine at Edinburgh University's Royal School of Veterinary Studies, says the wild sheep they surveyed on the island of St Kilda were measured for concentrations of a marker linked to vitamin D in the blood.

Sheep with higher levels of vitamin D in their blood at the end of the summer went on to have more lambs in the following spring.

The research has been published in the journal Scientific Reports.

Hope: Health expert Jonathan Evans says the findings are great news for couples trying to conceive

Dr Mellanby says: "Our study is the first to link vitamin D status and reproductive success in a wild animal population.

“Low levels of vitamin D appear to dampen the immune response and make the body almost attack itself.

“And what we have shown for the first time in wild animals is that vitamin D is linked with important life history events, like giving birth.”

The research has also been welcomed by fertility campaigners.

Susan Seenan, chief executive of the Infertility Network UK, said: “What is important to remember when trying to conceive is to try to stay as healthy as possible overall: eating a balanced diet, getting enough exercise and taking care of your emotional health.

“Recent studies suggesting a link between sunshine/vitamin D and improved fertility are interesting; couples may want to consider boosting their sunshine exposure.”

The news comes after a separate study, by Dr Emad Al-Dujaili, of Queen Margaret University, Edinburgh, found that boosting vitamin D intake can raise energy levels.