A New Drug Could Increase a Woman’s Fertility by Six Years

A New Drug Could Increase a Woman’s Fertility by Six Years

Researchers plan to make a drug that extends egg viability in worms usable for women hoping to extend their fertile windows

According to Coleen Murphy, a professor at Princeton University, “One of the most important characteristics of ageing is the loss of reproductive ability in mid-adulthood. As early as the mid-30’s, women start to experience declines in fertility, increased rates of miscarriage and maternal age-related birth defects. All of these problems are thought to be caused by declining egg quality, rather than a lack of eggs.” Luckily, researchers studying Caenorhabditis elegans (C. elegans), which are microscopic worms, found a way to inhibit the production of low-quality eggs in them.

They were able to do this by extending the fertile window in C. elegans by a small percentage. They hope to apply this newfound ability to humans one day.

  • Scientists chose to study C. elegans due to the many genes they share with humans
  • A group of proteins called Cathepsin B proteases cause low-quality oocytes, which are known as unfertilized eggs
  • If this experiment is applied to humans, it could extend their fertility by 3 to 6 years


C. elegans

These microscopic worms are a popular model organism for research due to the variety of genes they share with humans, their short generation time, and high production of offspring. They are therefore one of the easier organisms to work with compared to pigs or mice. Certain types of longevity genes are shared by both humans and worms. Because of this, researchers chose this organism to use when experimenting on processes that may cut down on the production of low-quality eggs that occur as a result of ageing.


Cathepsin B proteases

These proteins lead to lower-quality oocytes, or unfertilised eggs, as a woman continues to age. They are found in both humans and C. elegans. During their experiments, researchers administered an inhibitor to halt Cathepsin B activity during the middle of a worm’s reproductive period. What resulted was an increase in the worm’s egg quality despite the late injection of the inhibitor. Another experiment knocked out the gene that produces Cathepsin B completely. This ended up extending the worms’ fertility by 10 percent.


Application for humans

According to Nicole Templeman, who works for Murphy’s lab, the experiment that successfully knocked out cathepsin B genes could create a “three- to a six-year extension of your reproductive period” if applied to humans. While the cathepsin B inhibitor is not ready to be used in humans, it will greatly benefit women hoping to bear children during the later years of their lives for whatever reasons they may have.

While the reproductive decline is a natural part of ageing, researchers lament that interventions to slow this loss of reproductive success are lacking. Luckily, this experiment is the first of many steps to address this issue.

Sen. Tammy Duckworth Joins the Growing List of Women Having Babies in Their Forties

Sen. Tammy Duckworth Joins the Growing List of Women Having Babies in Their Forties


Senator Tammy Duckworth

Sen. Duckworth is the first U.S. senator to have a baby while serving

The Democratic senator from Illinois is having a baby at 49 years old. This will be her second child. Nowadays, it has become more common for women her age to conceive a child.

  • In 2016, the percentage of women who have ever given birth was higher than it was ten years earlier.
  • In a way, the country’s fertile and business cycles are interrelated.
  • Chances of health complications for your baby increase as you grow older.


These older women are reversing a 40-year-old trend

According to a research study conducted by the Pew Research Center, 86% of women ages 40 to 44 were recorded to have been mothers in 2016, whereas only 80% of women in this age group had children back in 2006. “Not only are women more likely to be mothers than in the past, but they are having more children,” the report said.

One interesting statistic that the report found was that most women in this age group who have never married have still had a baby. There has been a rise in women who have never wed by the end of their childbearing years. Among them, a majority have at least one child.


The economy may be related to the rise and fall of birth rates

“The Great Recession intensified this shift toward later motherhood, which has been driven in the longer term by increases in educational attainment and women’s labor force participation, as well as delays in marriage,” said the Pew report. “Given these social and cultural shifts, it seems likely that the postponement of childbearing will continue.”

In terms of why women may wait to have children, one reason is that their desire to focus on their career. Also, houses are expensive, and couples are inclined to wait and save for a down payment before starting a family. Senator Duckworth herself wrote on Twitter that, “I’m hardly alone or unique as a working parent, and my daughter Abigail has only made me more committed to doing my job and standing up for hard-working families everywhere.”


There are health risks that come along with having a baby later in life

The chances of having a baby with Down Syndrome increase from 1 in 100 at age 40 to 1 in 30 at age 45. Mothers who give birth in their 40s also have a higher chance of having to go through C-sections because of complications, low birth weight, and stillborn babies. According to the Mayo Clinic, women are more likely to develop gestational diabetes and high blood pressure during pregnancy if they conceive after they are 35.

It is important to note that you are not alone if you decide to have a child at a later age. There are plenty of resources available to help you. Don’t be afraid to reach out to your physician if you have any questions or concerns regarding your pregnancy.

Politics of the ‘Biological Clock’

Politics of the ‘Biological Clock’


‘All women want babies, and career women are unhappy with their “liberation” if it puts their traditional role of motherhood at risk.’ That was the message of “The Clock is Ticking for the Career Woman,” a March 16, 1978, Washington Post article that popularized the concept of the biological clock. The author was Richard Cohen, who is still a columnist with that paper (despite allegations of bullying and possible sexual harassment of a young female aide in the late 1990s and controversial racial remarks in more recent pieces).

In the article, Cohen opened with a description of “Composite Woman,” whose age is “something between 27 and 35” and as if reducing the individual experiences of half of the world’s population into one person wasn’t bad enough, he added: “She’s the pretty one .… Nice figure.” Her job is “wonderful,” and there’s a man in her life. But everything is not wonderful. She looks down and after Cohen assures her that she can talk to him privately, Composite Woman says, “I want to have a baby.” Later, Cohen claims to have gone “around, a busy-bee of a reporter, from woman to woman” and found the same stomach-churning anxiety they all felt about the possibility they might not have children one day.

In my opinion, the best thing to do with such a piece of writing is to forget it. We could probably do that, if it wasn’t for the fact that it was in this article that the term “biological clock” was born.

It’s important to consider Cohen’s piece in context. As Susan Faludi argued in her book Backlash: The Undeclared War Against American Women, two things have frequently triggered backlashes against women’s rights: economic independence and increased control over our fertility. The 1970s seemed to be bringing both. While U.S. women have always worked, the 1970s brought a massive surge of women entering professional and management jobs. Between 1972 and 1985, the number of management roles occupied by women almost doubled, and the landmark abortion case Roe v. Wade happened in 1973.

A conservative section of society didn’t like these changes, and a subtle but strong backlash took root. Their message hid under the guise of acting as concern for unhappy women; those unable to cope with stress, and female movie characters who found “fulfillment” only by giving up their careers. But what did it really come down to? The message that women should ‘get back into the kitchen.’ And Cohen’s article, whether he intended it as an act of misogyny or was simply carried along by the prevailing narrative, nicely fit that theme.

Nearly 40 years later, we still can’t get away from the notion of this biological clock. It persists even though there’s actually relatively little good research about this supposed ‘countdown.’

Real Housewife of Atlanta Kenya Moore Seeks IVF Treatments in Barbados

Real Housewife of Atlanta Kenya Moore Seeks IVF Treatments in Barbados

We’ve watched the drama unfold in the lavish lifestyle of Kenya Moore on The Real Housewives of Atlanta. After a recent quickie marriage and lots of off-camera secrets, Kenya Moore is wasting no time trying to get pregnant. Moore and her new husband Marc Daly have recently been spotted in the Barbados seeking fertility treatments – news exciting enough to make any Real Housewives fan squeal.

The Low-Down on Kenya Moore’s Recent Escapades

Drama both on and off the screen

While dating her ex-boyfriend – Matt Jordan – Kenya Moore was still actively trying to get pregnant. However, at 46-years-old this is often not an easy task, which is why Kenya and new husband Marc Daly have turned to IVF to conceive. A great amount of drama has surrounded Kenya Moore in her search for privacy during her quickie marriage and hoping to keep Daly out of the public eye, bringing to question what’s next for her on The Real Housewives of Atlanta.

Kenya and Marc Choose Barbados for their Fertility Treatments

Reports of the couple looking to start a family

After their private island ceremony, the newlyweds are wasting no time in trying to start a family. The two have been spotted in Barbados at the Barbados Fertility Centre. Why they are looking for IVF treatments in Barbados is still up for discussion, but sources suggest they may be seeking more off-camera privacy, or want fertility treatments at the lower costs offered in Barbados. It’s unclear whether Marc Daly will be staying in Barbados for the entirety of her treatment or whether he will be returning to the US.

Tension with RHOA Producers

Is Kenya Moore ready to give  it all up for the family of her dreams?

It has been reported the Real Housewives of Atlanta producers and Bravo have not been invited to film Moore’s recent marriage. As she shuts out the cameras for the personal time she seeks for her family planning, producers and fans worry that this could be the end of the road for this Real Housewife. However, it appears that Moore is excited to talk about her experience with IVF in the upcoming reunion show. And let’s face it – we’re all excited for a potential new baby on The Real Housewives of Atlanta, especially if it’s a Moore-Daly baby.

With family planning being such an exciting, emotional time, it’s important to respect the wishes of all couple trying to conceive – even if their entire lives appear to be in the public eye. For now, we wish Kenya Moore and Marc Daly the best of luck in their fertility journey, and look forward to sharing with them the excitement of a new baby.

The Truth about Older Mothers

The Truth about Older Mothers

Years of rumors, poor medical practices, and false information have led women to believe that having a child after the age of 30 would lead to birth defects and mental illnesses. But what if you aren’t ready? What if you want to wait? Maybe you haven’t found the right guy. Maybe you aren’t financially where you want to be. Professors, Doctors, and Psychologist discuss the benefits of waiting until you’re 30 in an article written by ScienceDaily. Mothers who wait are more likely to have smarter and better- behaved children.

Read more about the facts and discover the truth, here.

35 is the new 25?

35 is the new 25?

Honey, let’s wait.

The untold benefits about waiting until you’re ready.

It’s the thing to do

A paradigm shift is taking place in the developed world, couples are waiting to have children.

A study conducted by the CDC (Center for Disease Control and Prevention) from 2000 to 2014 showed that the average age for a mother increased from 24.9 to 26.3. This may not sound like a giant shift in age, but this study spans across all states, all ethnicities, and all religions. Directly displaying 3 large underlying factors:

  1. More educated women are waiting till they are established in their careers
  2. Sex education has influenced the way we conceive children
  3. Medical advancements have allowed women to choice when they want kids

Smarter Kids

The mothers maturity could be the number one influence when it comes to raising a kid.  Women who are waiting till their 30’s to have babies are more likely to have the advantage when compared to a younger mother. These  “advanced maternal mothers”, mothers ages 30+, are more likely to have the resources to better equip themselves, and the baby. According to Dr. Alice Goisis, a researcher at London School of Economics and Political Science, these mothers are more likely to take care themselves during pregnancy; being less likely to smoke, and more likely to breast-feed.

In a study published in the International Journal of Epidemiology looked at the cognitive abilities of children, born to mother around age 35-39, and found that they tested significantly better than those of children born to mothers of ages 25-29.

Possible reasons for this:

  • Change in parenting attitudes
  • Change in educational or socioeconomic levels
  • Better family support

“The mothers have more psychological flexibility, more cognitive flexibility, more ability to tolerate complex emotional stimuli from the children” said Tea Trillingsgaard, psychology professor at Aarhus University in Denmark.

The Dangers of Pregnancy after 35

The Dangers of Pregnancy after 35

As couples wait longer to have children, focusing on education and careers rather than family planning, it is not uncommon for women to delay pregnancy into their 30’s. Despite the rising age of first-time moms, fertility experts still warn of the dangers of women giving birth after age 35. As women age, not only does the opportunity to get pregnant decrease, women are more likely to suffer a miscarriage or have other pregnancy complications.

Learn more about the dangers of pregnancy after age 35 with the American Pregnancy Association and USA Today with this video.

Egg Cryopreservation: Make The Right Decision For You

Egg Cryopreservation: Make The Right Decision For You

Article by Dr. Carolyn Givens on egg cryopreservation and how it’s being used to extend the fertility window provided by Boss Magazine. 

One of the things those who work in technology, science, and modern business know is that everything is changing and nothing is static. Many of these changes will have significant impacts on our lives.

It is possible that the latest movement we are seeing in the reproductive medicine arena will have the greatest impact on working women and working couples since the introduction of birth control pills. This is the practice of freezing one’s eggs—oocyte cryopreservation—or embryos in order to preserve the ability to reproduce and delay childbearing to a later age.

Just this October, the National Center for Health Statistics—a division of the U.S. Centers for Disease Control and Prevention—released a report that during 2013 to 2015, approximately half of women between the ages of 15 and 44 expected to have at least one child in the future. The average number of children these women expected to have in the future was 2.2.

This statistic has increased by four percent since 2002. Considering that many educated and career-oriented women don’t even get married before age 35, how can women fit this expectation into their lives?

A Short History

IVF technology has finally caught up with the social revolution that started 50 years ago when women became able to control their fertility. Now, rather than reacting after the fact to the reality of the aging ovary, we are proactively trying to circumvent the evolutionary vestige of optimal reproduction in the teen years and stop the biological clock dead in its tracks.

The first successful pregnancy via oocyte cryopreservation was reported by Dr. Christopher Chen of Singapore in 1986; Dr. Lilia Kuleshova’s patient was the first to result in a live birth in 1999. From the mid-1970s to 2006, an estimated 300,000 to 500,000 successful human births resulted from the use of cryopreservation.

The egg freezing process takes patient commitment from home as well as a minor surgical procedure. The process requires two weeks of hormone injections, and two to three injections per day, culminating with a minor surgical procedure to collect the eggs. The in vitro lab personnel then freezes the eggs through fairly successful modern techniques.

Why Cryopreservation?

Cryopreservation was originally developed for women who had been diagnosed with cancer and wanted to have children after the cancer had been treated. If she had not yet begun chemotherapy or radiotherapy, her eggs could be collected and frozen for the chance at pregnancy post treatment.

In October 2012, the American Society for Reproductive Medicine (ASRM) lifted the experimental label from the technology for women with a medical need, citing success rates in live births as the reason. As such, several other groups of women are now able to use this method.

Today, there are several different groups of women that opt to use oocyte cryopreservation technology for the opportunity to get pregnant later down the line.

Some women in their 20s and 30s are not ready to be mothers, whether they have a partner or not. Around 80 percent of women working outside the home are interested in pursuing their careers before having children. 
The ability to freeze their eggs gives women the opportunity to wait to get pregnant until they are ready: when the right partner comes along, they are ready to take a small break from their career, or they have the desire to be a single mother. This option gives women peace of mind that if they want children in the future, it’s possible.

Many couples also pursue this avenue. Whether it’s wanting more time to be married without kids, time to travel, or work hard on careers, more couples are waiting longer to bring children into the family.

And there are a few companies in Silicon Valley that are honoring this want of their young female employees: Facebook, Google, and Apple are among a very few number of companies that will cover the cost of cryopreservation for their female employees.

The reason? Women were asking for the option. These companies see it as an opportunity to empower women to build their careers and then build their family on their own time, not on the time determined by a biological clock that might lessen a woman’s ability to participate in the workforce.

A Doctor’s Perspective

Many women coming in for egg freezing consultations say that they want the “insurance” of having frozen their eggs.  It is important for women to clearly understand the realities of what egg freezing is, and what it is not.

Currently, there is no test that can tell us if the unfertilized eggs are good or not. We can run blood tests and do ovarian ultrasounds, but they only tell us the quantity of eggs we might be able to capture right now and nothing about quality.

As it turns out, the quality of a woman’s eggs is best predicted by her age. That is because female age is highly correlated with the probabilities of an egg turning into an embryo that has normal chromosomes.

So, the younger women are when they freeze their eggs, the fewer eggs they will need in the future to have a family. But I still caution all my prospective elective fertility preservation patients that even a woman in her early 30s may not make good quality eggs. We won’t know that until she uses them in the future.

So why should a single 30-something woman consider undergoing two weeks of hormone injections, a surgical procedure, and the out-of-pocket cost of $12,000-$15,000?

There are alternatives: get pregnant now using an anonymous sperm donor and raise your child(ren) as a single mom, or wait for the perfect mate and then deal with the realities of getting pregnant or not at the time you both are ready.

Most women or couples decide on oocyte cryopreservation to expand their chances of being able to fulfill one of life’s overarching goals: to pass on one’s genes, to experience the deep love of a parent for a child, and to avoid having to suffer the pain of infertility to do so. With the egg freezing technology that exists today, this “peace of mind” is something that can be offered which did not exist before.

More Articles on Fertility Research: 

These Fertility Advancements Will Blow Your Mind

KNOWHEN Ovulation Kit Tests Fertility Via Saliva, Not Urine

IVF Success Rate Poised To Improve With New Research

Rejuvenating The Chance of Motherhood?

Rejuvenating The Chance of Motherhood?

An article by Karen Weintraub about a start-up company (OvaScience) giving women over 40 new hope provided by MIT Technology Review. 

Last April, Omar and Natasha Rajani rented a hall, invited 130 guests, and hired a magician to entertain the little ones. In Natasha’s family, first birthday parties are major celebrations. And the Rajanis, who live in Toronto, felt particularly enthusiastic because for a long time they weren’t sure they’d ever be able to throw one.

Natasha, 35, struggled for four years to get pregnant. She and Omar, 40, tried naturally at first; then they used hormones, which led to an ectopic pregnancy, in which the fertilized egg implants outside the uterus—usually in the narrow fallopian tube—and must be removed. Then more hormones. Then in vitro fertilization (IVF). Nothing worked.

Natasha’s obstetrician next offered an unusual option: the couple could try a new method meant to improve the odds of IVF, provided by a Boston-area company called OvaScience. The approach called Augment (for Autologous Germline Mitochondrial Energy Transfer), is so far available only in Canada and Japan.

(OvaScience hasn’t yet sought approval from U.S. regulators). It required the doctor to gather cells from one of Natasha’s ovaries and harvest their mitochondria—the tiny power plants that fuel our cells. These extracted mitochondria would then be injected into one of her eggs along with her husband’s sperm, and the embryo would be transferred to her uterus during a standard IVF procedure. According to OvaScience, the extra energy from the ovarian mitochondria would give her egg a boost, promoting fertilization.

“What Natasha and I liked it was it was kind of like self-treatment,” says Omar. “We thought that it was something that was safe, and it was almost like the body treating and healing itself. We were very, very excited about the opportunity to try it.”

In the round of IVF that Natasha had after trying the new procedure, she got pregnant with a boy, Zain, now almost two. It doesn’t matter, the ­Rajanis say, whether Augment was the reason for the successful pregnancy. All they know is that it felt like a miracle. They have a toddler with an always-sunny disposition—“He’s just an absolute joy of a child,” Natasha says—and two more frozen embryos that might one day become his siblings.

Whether Augment made the difference in Zain’s conception could have far-reaching implications for how we think about both infertility and aging. Infertility affects more than 10 percent of American women—a number that is rising as many women wait longer before considering parenthood. Female fertility starts to decline after age 35. Among women who turn to assisted reproduction techniques such as IVF, only 40 percent of attempts by those under 35 result in a live birth, while 2 percent of those among women over 44 do—largely because of a dwindling number of eggs and a decline in their quality.

Not only could OvaScience’s procedure help many women whose fertility has declined with age, but it would be one of the first successful efforts to slow the body’s relentlessly ticking clock, providing tantalizing clues for ways to halt aging more generally.

Company co-founder and Harvard University genetics professor David Sinclair says conquering the overall aging process is a matter of when not if. “We are at a point where we know how to extend lifespan in mammals, and now there’s a race to see who can prove that we can do this in humans,” Sinclair says. Female fertility, he says, is one of the first bodily systems to break down with age, and he sees reversing infertility as a gateway to reversing aging itself. The goal, Sinclair proclaims, is “to have revolutionary technologies like OvaScience available to everybody—and not to just treat fertility, but another 2,000 age-related diseases, from diabetes through Alzheimer’s.”

Despite Sinclair’s enthusiasm, it’s possible—even likely, some scientists say—that OvaScience’s procedure did nothing at all. For one thing, IVF is notoriously unpredictable. The Rajanis might have just gotten lucky the second time, just as they were unlucky the first.

More than a dozen interviews with experts in fertility and early development reveal little scientific justification for what was done to Natasha Rajani’s eggs and those of the 300 other women who have gone through the procedure, which costs an IVF clinic from $6,000 to $7,000. (The fee that clinics charge patients will vary.) The company harvests the mitochondria from what it believes are immature egg cells found in the ovarian lining; the idea is that these so-called egg precursor cells have fresher mitochondria than the aging, mature eggs. But there is little convincing evidence that they are what ­OvaScience says they are: cells with the power to turn into eggs. And even if such egg-­precursor cells exist and their mitochondria are more youthful than those in a woman’s eggs, does it prove that such an energy boost can improve fertility?

“There is very little data supporting the benefit of these procedures, and often the biological rationale is incoherent,” says Jacob Hanna, an expert in embryonic stem cells at the Weizmann Institute of Science in Israel, who reviewed ­OvaScience’s information at the request of MIT Technology Review. “I hope the company can provide robust data and experimentation on these approaches… It sounds more at the moment like voodoo, or alchemy.”

So is OvaScience leading a breakthrough in battling one of the most fundamental processes of aging, or selling false hopes with little scientific justification?

Youthful Marriage
The founding of OvaScience came about as a marriage of two of medicine’s most audacious and often controversial areas: anti-aging research and infertility research. The company accurately traces its precise origins to the work of the reproductive biologist Jonathan Tilly, now at Northeastern University in Boston. Beginning with a 2004 paper, Tilly has been challenging decades of scientific dogma that girls are born with their whole life’s supply of “primordial” egg cells, which will eventually mature into eggs. After puberty, this stock of eggs develops at the rate of about one a month, and it never renews. The decline in female fertility around 35 occurs as this supply dries up, and menopause strikes when the eggs run out. But Tilly’s research suggested—first in mice and then in people—that the lining of the ovary contains the makings of new supply. If Tilly is right about his conclusions, solving infertility might be just a matter of finding these egg precursor cells and triggering them to mature.

Sinclair says it was natural for him to collaborate with Tilly, who was then at Harvard. Tilly’s work touched on subjects that fascinated Sinclair: how the body ages and what might be done to slow that process. “I’d been trying to figure out what are the primary reasons we grow old and why don’t cells function the older we get,” Sinclair says.

Sinclair introduced Tilly to two biotech entrepreneurs, Rich Aldrich and Michelle Dipp, with whom Sinclair had previously run an anti-aging company called Sirtris Pharmaceuticals. That company was based on Sinclair’s research into sirtuins, proteins that may slow the aging process and can be activated by resveratrol, a compound most found in red wine. Sirtris was sold to GlaxoSmithKline in 2008 for $720 million (GSK closed down its Sirtris facility in 2013, absorbing the sirtuin work into its research efforts), and the biotech investors were looking for their next big play. When the potential partners asked Tilly how he might commercialize his research, ­Sinclair says, Tilly came up with the idea of Augment, using the precursor cells to rejuvenate aging eggs. (Tilly declined to comment for this story.) That was enough for the group to create ­OvaScience, where Dipp served as CEO until last summer.

Sinclair hypothesizes that mitochondria are crucial to aging. The idea is simple. Aging cells have old, slow mitochondria; young mitochondria equal young cells. Hence the Augment program to rejuvenate eggs with mitochondria from cells that are younger and more energetic. Sinclair has also cofounded two other companies, MetroBiotech of Boston and CohBar of Menlo Park, California, to develop drugs related to mitochondrial functions. CohBar hopes peptides made by mitochondria could be useful against diabetes, obesity, and Alzheimer’s, among other diseases, while MetroBiotech is pursuing a therapy to treat diseases associated with malfunctioning mitochondria. It is testing a drug that boosts levels of nicotinamide adenine dinucleotide, NAD, a compound involved in energy metabolism in the mitochondria. “The same molecules [in the drug] we think will treat aging itself,” Sinclair says, citing a 2013 paper his team published in Cell.

Sinclair’s interest in aging has become personal. Now 47 and working in a high-stress job at Harvard, he has time to exercise “barely more than once a week.” In addition to his academic and commercial duties, he also sits on the advisory board of InsideTracker, a company based in Cambridge, Massachusetts; that uses levels of glucose, vitamin D, and other blood factors to determine a client’s “inner age,” as opposed to the historical one. In 2011, Sinclair says, he clocked in at 57, a decade and a half beyond his actual age. In July 2015, convinced he was going to die young, he upped his daily doses of resveratrol. He also added MetroBiotech’s NAD precursor, which has yet to be tested in people and is too expensive for anyone who’s not making it use.

Sinclair says InsideTracker’s aging markers now put him at 31. He’s lost the weight he’d been carrying since college and has been allowing himself to eat dessert again because his body can handle it. (Weight loss isn’t his goal, he says, but mitochondria are also responsible for burning fat, so weight loss “might be a side effect” of the treatment.) “The results in mice and my single-person experiment indicate that aging is more reversible than we thought,” he says.

Too Early
In a pristine lab overlooking a busy highway in the Boston suburbs, OvaScience researchers identify and count what they believe are egg precursor cells. This constitute, OvaScience says, about 6 percent of the cells on the surface of the ovarian cortex. In the Augment procedure, an IVF surgeon laparoscopically removes a section of this layer about half the size of a dime. The tissue is shipped to an OvaScience lab, where the mitochondria are extracted and sent back to the fertility clinic. Just before fertilization, the mitochondria are inserted into the egg alongside the sperm. Then IVF proceeds as usual.

Preliminary data suggests that the procedure improves fertility. In its latest study, released at a conference in November, OvaScience reported a 31 percent success rate among 75 patients who had undergone at least one previous round of IVF before trying Augment. It’s notoriously difficult to get right data on fertility clinic results, but in a 2015 study in the Journal of the American Medical Association, British researchers found that about 30 percent of women are successful in their first round of IVF and 16 to 25 percent are successful in each subsequent round (without Augment). So if the results for Augment prove to be real, it increases success rates from about 20 percent to 30 percent per round—a significant, if modest, improvement.

However, those results only record the experience of Augment patients. As is the case in many early research studies, they were not compared with controls, so there’s no convincing evidence that the procedure made the difference. OvaScience expects to get data from two more trials, including about 300 patients, in the second half of 2017. However, ­OvaScience’s patents on the cells and procedures protect the company’s business interests and prevent outsiders from testing its protocol. So there have been no independent trials. I asked one scientist to examine and comment on OvaScience’s Augment research. After looking at the material the company had presented to me, he declined to say anything. There wasn’t any science to review, he said—just anecdotes.

OvaScience plans two other projects for these egg precursor cells. In a program it’s calling OvaPrime, the cells are extracted from the outer rind of the ovary, isolated, and then reimplanted into the main part of the ovary, where they are projected to mature into healthy, viable eggs. The procedure is designed to help women who don’t make enough eggs—about 30 percent of infertile women, according to the Centers for Disease Control and Prevention. The company is doing safety and feasibility trials now and expects to decide soon whether to pursue this approach commercially.

In another program, called ­OvaTure, OvaScience hopes eventually to perform IVF without hormones. Hormones are now needed to stimulate a woman’s body to release as many eggs as possible. But for many women, hormone injections are the worst part of IVF, with the potential to cause mood swings, nausea, vomiting, abdominal pain, and a slight risk of death. With OvaTure, the woman would have some precursor cells removed, and they would be coaxed in a lab dish to mature into fully functional eggs, all without hormones. The company, however, is still studying whether this technique will work.

These projects will largely determine just how significant OvaScience’s contribution to fertility and anti-aging science will be. Augment might have a limited effect even if the precursor egg cells are not actually capable of turning into eggs, as many scientists believe. And Stock says at around $7,000 per treatment, Augment is a good deal if it saves families from another round of IVF, which can easily run $10,000 to $15,000 per cycle. But the two more ambitious efforts, OvaPrime and OvaTure, will never work unless ­Tilly’s conclusions are right. His research was roundly criticized by colleagues in 2004, and his later publications did not erase the skepticism. Mice may very well have these egg precursor cells, several scientists say. But large, long-lived animals are quite different from mice regarding reproduction—and Tilly hasn’t yet convinced other researchers that women carry around cells capable of extending their fertility.

Still, more scientists are coming around to the possibility that egg precursor cells exist, says Evelyn Telfer, a reproductive biologist at the University of Edinburgh. Initially quite dubious of Tilly’s findings, she changed her mind after touring his lab, welcoming him into her own, and working with the egg-­precursor cells herself. “As with all things that are new, it takes the time to get into the consciousness of people,” says Telfer, who now collaborates with ­OvaScience. A small study she has recently finished suggests that egg precursor cells may help women regenerate their egg supply after experiencing a catastrophe, like chemotherapy for cancer. “It’s an observation we’ve made, and we have to do a lot more work to find out what these cells are doing to the ovary and why we see an increased number of eggs,” she says.

Regardless of what these cells are, the dozen scientists interviewed—most of whom didn’t want their names associated with the company—questioned the idea of using them to “rejuvenate” older eggs. It’s not scientifically obvious that adding extra energy to egg cells would make them more fertile.

Carol Hanna, a staff scientist at the Assisted Reproductive Technology Core Laboratory at the Oregon Health & Science University in Portland, says she and others in the field sincerely hope that Tilly’s science is accurate, but they feel it shouldn’t have moved so quickly to commercialization. “I think a lot of people fall in that middle—they want to believe it but haven’t seen that one piece of information that convinces them,” she says. Renee Reijo Pera, a reproductive and stem-cell biologist at Montana State University, is even blunter: “Almost everybody thinks that the commercial side of the whole enterprise got way out ahead of the science.”

In most areas of medicine other than fertility, it’s standard practice to prove that something works before offering it to patients. Regulations in many countries, however, allow fertility clinics to try a procedure first and test it years later. As a result, dozens of so-called add-on systems to IVF are available to women with very little scientific justification. Industry leaders defend this approach; the first test-tube baby would never have been born if there had been more regulations. But this lack of rigorous oversight also makes patients vulnerable to abuse, says Carl Heneghan, director of the University of Oxford’s Centre for Evidence-Based Medicine. “The sheer number of treatments that are available tells you they all can’t work,” suggests Heneghan. “People will try anything. That’s where the problem starts.”

But there aren’t many alternatives available to infertile couples, says Jake Anderson-Bialis, a venture capitalist turned fertility advocate who cofounded the patient community FertilityIQ. International adoptions have become much more challenging; IVF is costly and puts women on a hormonal roller coaster, and buying another woman’s eggs if their own are too old can add $30,000 or more to that cost.

Anderson-Bialis says he doesn’t blame OvaScience for taking its products to market before the science is firmly established. The infertility business has always been that way. And in his view, the problem of infertility is so big that it justifies some risk-taking.

Improving the odds
This has been a busy few months for ­OvaScience. In 2016, the company signed on seven new clinics in Canada and Japan, bringing its total to nine worldwide. Harald Stock, who jumped from the board into the CEO’s chair in July, says company officials have begun speaking with the U.S. Food and Drug Administration to explore what it would take to bring Augment to the market in the United States. He will soon decide whether to proceed with the OvaPrime and OvaTure programs. And the company, which had more than $130 million in cash as of September 30, decided to move away from its initial business plan of installing small labs in each of the clinics that use its products, instead relying on a centralized lab, which is cheaper and easier for quality control.

Launching a product and a company takes time and personnel, so Stock says he’s committed to moving slowly and deliberately. “We need to stay disciplined not to get overwhelmed,” he says. “We’re still a 100-some-person company and can’t be everywhere.” The company has chosen to build its business in Canada first because it can cover most of the country from just a few cities, Stock says, meaning there’s no need for a massive sales force. He’s waiting to start marketing until enough clinics have been trained so that anyone who wants Augment can get it.

IVF is a growing business. It’s projected to expand from about $10 billion today to $22 billion globally by 2020. Augment, he says, could help women who fail to get pregnant in the first round of IVF. A bigger prize for the company could be on its other projects. OvaPrime could make it possible for women who lack viable eggs to have biological children, he says. And anyone undergoing IVF would prefer to skip the hormones.

In the end, though, OvaScience’s market may not turn out to be colossal. IVF has been getting markedly better over the last few years. And freezing embryos and even eggs, which costs about the same as IVF plus an annual storage fee of $500 to $1,000, has recently made it much easier for women to preserve high-­quality eggs into their late 30s and 40s. It’s the age of the egg—not the woman—that seems to matter: women in their 40s fare just as well as younger women if the quality of their frozen eggs is high, says Hal ­Danzer, co-founder of the Southern California Reproductive Center, a fertility clinic in Beverly Hills, California. Freezing embryos, meanwhile, allows labs to select those that are most likely to succeed, and transfer them after the hormones needed to stimulate egg production have left the body.

Improved IVF success rates leave less room for Augment to shine. Still, boosting the odds even somewhat will entice some prospective parents. Danzer says his patients, many of whom put off parenthood for their careers, are desperate to get pregnant. He has referred several patients to clinics in Canada so they can try Augment, though when asked whether he’d use it in his clinic, he says: “I think it’s a little too early to tell.”

More Articles on Fertility News: 

Age-Related Infertility Caused by scarred ovaries

Women Freezing Eggs To Boost Chances Of Pregnancy Later

Could assisted reproduction reduce birth defects for older women?

Age-Related Infertility May Be caused by scarred ovaries

Age-Related Infertility May Be caused by scarred ovaries

Article about women’s inability to produce healthy eggs and other age-related infertility may be caused by ovarian aging provided by Northwestern.

Women’s decreased ability to produce healthy eggs as they become older may be due to excessive scarring and inflammation in their ovaries, reports a new Northwestern Medicine study in mice.

This is the first study to show the ovarian environment ages and that aging affects the quality of eggs it produces. These findings could result in new treatments that preserve fertility by delaying ovarian aging.

Most reproductive research focuses on women’s eggs and trying to understand why their number and quality deteriorate as a woman enters her forties. Deteriorating eggs contribute to infertility, miscarriages, and congenital disabilities.

But in this study scientists examined the age-related reproductive changes that occur in the environment in which the eggs develop, known as the ovarian stroma. The environment in which cells grow and develop can significantly influence their quality and function, but surprisingly little is known about how the ovarian stroma changes with age.

“Under the microscope, eggs from reproductively young and old animals may look identical, but the environment in which they are growing is completely different,” said lead study author Francesca Duncan, executive director of the Center for Reproductive Science at Northwestern University Feinberg School of Medicine. “Ovaries from reproductively old mice are fibrotic and inflamed. There is no way this environment won’t impact the eggs growing in it, and it very likely contributes to their decrease in quality.”

The study was published August 5 in the journal Reproduction. Duncan led the study when she was at the University of Kansas Medical Center.

In this study, researchers analyzed ovarian tissue from populations of reproductively “young” (equivalent to women in their early twenties) and “old” mice (equivalent to women ages 38-45). They consistently identified fibrosis in the reproductively “old” mice. This age period is associated with a decline in reproductive function and egg quality in both humans and mice. In some reproductively “old” mice, up to 35 percent of the ovarian tissue was fibrotic.

Researchers also found a type of immune cell (multinucleated macrophage giant cells) in the ovaries of reproductively “old” mice only. When found in other tissues, these cells are associated with chronic inflammation. They also found ovaries from mice of advanced reproductive age expressed genes and produced proteins that are highly inflammatory.

“Our work establishes fibrosis and inflammation as hallmarks of the aging ovary and lays the foundation for considering the use of anti-fibrotic or anti-inflammatory treatments to delay or counteract the impact of reproductive aging,” said Duncan, also an associate research professor of obstetrics and gynecology at Feinberg.

“People tend to overlook that the egg is growing in a complex environment, and no one has taken a deep look at what is happening to that environment with age,” Duncan added. “It’s an underappreciated area.”

The findings have broader implications for women’s health because ovarian fibrosis is a key feature of polycystic ovary syndrome, a common endocrine system disorder among women of reproductive age, and is also a consequence of chemotherapy and radiation, Duncan said.

Duncan’s research team is currently investigating how to target the ovarian environment to improve reproductive function therapeutically.

This work was supported by the Center for Reproductive Health After Disease (P50 HD076188), the National Centers for Translational Research in Reproduction and Infertility, the Centers of Biomedical Research Excellence (P20 GM104936), the National Center for Research Resources (P20 RR021940), the National Institute of General Medical Sciences (P20 GM103549) and the National Institute of Environmental Health Sciences ‘Training Program in Environmental Toxicology’ (T32 ES007079) of the National Institutes of Health.

#infertility #infertilitysucks #infertilityawareness #infertilitysupport #ttc #ttccommunity

More Articles Related to Age-Induced Infertility and Fertility Research

Women Freezing Eggs To Boost Chances Of Pregnancy Later

Could assisted reproduction reduce birth defects for older women?

Exercise During Pregnancy May Reduce Markers Of Aging In Offspring