Infertility future or investigational therapies

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2] Associate Editor(s)-in-Chief: Sanjana Nethagani, M.B.B.S.[3]

  • Recent advancements in infertility therapy include ovarian tissue preservation, particularly in women undergoing chemotherapy or radiotherapy. This involves freezing the woman's ovary and reimplanting after she has undergone therapy for future fertility. [1]
  • Uterine transplants have been successful in women with mullerian agenesis to achieve fertility. [2]
  • Poor quality of oocytes are seen in older women, which have a higher rate of chromosomal aneuploidy can be treated with ubiquinone or coenzyme Q10 as these play an important role as antioxidants.[3]
  • Administration of letrozole along with gonadotropin stimulation in IVF has been proven to be beneficial, particularly in women with breast cancer. Letrozole decreases concentration of serum estrogen during ovarian stimulation. [4]
  • Mitochondrial transfer from donor oocyte to a mature oocyte of the patient was attempted by Cohen et al, which resulted in a higher success rate and improved embryogenesis. [5]
  • Pre-treatment of patients with androgens has shown improved response to gonadotropin stimulation and general improvement in pregnancy and live birth rates.[6]
  • Time lapse imaging is a cutting edge technology that allows us to view the developing embryo after fertilization and perform a continuous evaluation. TLI has emerged as a superior tool in selection and optimization of embryos for implantation. [7]
  • Pre-implantation genetic screening is done to check for aneupolidy using embryo biopsy using trophectoderm tissue. Screening is also done to check for an elevated amount of mitochondrial DNA which has been associated with poorer outcomes. [8]

References

  1. Practice Committee of American Society for Reproductive Medicine (2014). "Ovarian tissue cryopreservation: a committee opinion". Fertil Steril. 101 (5): 1237–43. doi:10.1016/j.fertnstert.2014.02.052. PMID 24684955.
  2. Brännström M, Dahm Kähler P, Greite R, Mölne J, Díaz-García C, Tullius SG (2018). "Uterus Transplantation: A Rapidly Expanding Field". Transplantation. 102 (4): 569–577. doi:10.1097/TP.0000000000002035. PMID 29210893.
  3. Ben-Meir A, Burstein E, Borrego-Alvarez A, Chong J, Wong E, Yavorska T; et al. (2015). "Coenzyme Q10 restores oocyte mitochondrial function and fertility during reproductive aging". Aging Cell. 14 (5): 887–95. doi:10.1111/acel.12368. PMC 4568976. PMID 26111777.
  4. Pereira N, Hancock K, Cordeiro CN, Lekovich JP, Schattman GL, Rosenwaks Z (2016). [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi? dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27114051 "Comparison of ovarian stimulation response in patients with breast cancer undergoing ovarian stimulation with letrozole and gonadotropins to patients undergoing ovarian stimulation with gonadotropins alone for elective cryopreservation of oocytes†"] Check |url= value (help). Gynecol Endocrinol. 32 (10): 823–826. doi:10.1080/09513590.2016.1177013. PMID 27114051. line feed character in |url= at position 55 (help)
  5. Barritt JA, Brenner CA, Malter HE, Cohen J (2001). "Mitochondria in human offspring derived from ooplasmic transplantation". Hum Reprod. 16 (3): 513–6. doi:10.1093/humrep/16.3.513. PMID 11228222.
  6. Gleicher N, Weghofer A, Barad DH (2010). "Improvement in diminished ovarian reserve after dehydroepiandrosterone supplementation". Reprod Biomed Online. 21 (3): 360–5. doi:10.1016/j.rbmo.2010.04.006. PMID 20638339.
  7. Chen M, Wei S, Hu J, Yuan J, Liu F (2017). "Does time-lapse imaging have favorable results for embryo incubation and selection compared with conventional methods in clinical in vitro fertilization? A meta-analysis and systematic review of randomized controlled trials". PLoS One. 12 (6): e0178720. doi:10.1371/journal.pone.0178720. PMC 5453598. PMID 28570713.
  8. Ravichandran K, McCaffrey C, Grifo J, Morales A, Perloe M, Munne S; et al. (2017). "Mitochondrial DNA quantification as a tool for embryo viability assessment: retrospective analysis of data from single euploid blastocyst transfers". Hum Reprod. 32 (6): 1282–1292. doi:10.1093/humrep/dex070. PMID 28387858.

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