Ovaries 'reawakened' and baby born to early menopause mother

A new
treatment to stimulate egg production from post-menopausal ovaries has resulted
in the successful birth of a child after testing in a small clinical trial.

Along
with the 26 other women in the study, published in the journal PNAS, the new mother had primary ovarian insufficiency (also known as premature ovarian failure), a condition which
leads to an early menopause.

Speaking to the BBC, senior study author Professor Aaron Hsueh of Stanford University in the USA, said the new technique, called in vitro activation (IVA),
still needed to be refined but could help 25 to 30 percent of women with
primary ovarian insufficiency.

'We think it
could help in two other forms of infertility', he added, 'cancer survivors
after chemotherapy or radiotherapy […] and also women aged 40 to 45 with an
irregular menstrual cycle'.

IVA is
not likely to be applicable to conventional menopause, however.

In the technique, an ovary (or a portion of an ovary) is removed from the patient, treated
outside the body and then re-implanted near her fallopian tubes. The
ovaries are then stimulated to produce eggs with hormone treatments. The woman is then treated with hormones to stimulate
the growth of specialised structures in the ovaries called follicles in which
eggs develop.

In primary ovarian insufficiency, which
affects about one percent of women of reproductive age, the fixed number of
ovarian follicles that women are born with is lower than usual, or eggs are
released more often, causing onset of infertility before the age of 40 as
the eggs run out.

However, 13 participants in the study
were found to have ovarian follicles that contained an immature egg before IVA
treatment. The aim of the treatment was to 'reawaken' these follicles. After IVA treatment, follicle growth was
detected in eight patients, five of whom produced mature eggs that were
collected and used for conventional IVF. One child has so far been born following the procedure and another woman is pregnant.

IVA addresses two cell signalling pathways
discovered in mouse ovaries, one that prevents follicle maturation and one that
promotes it.

Reaction from experts not involved in the
study has been positive, if cautious. Professor Charles Kingsland, of the Royal
College of Obstetricians and Gynaecologists, said: 'It's really clever, but
will it work for everyone? We don't know... we need a lot more investigation to
confirm this is not another false dawn'.

Similarly, Professor
Nick Macklon, from the University of Southampton, told the BBC the technique
was 'potentially a game-changer'.

'It's a very important and very
exciting piece of science, but it is not ready for the clinic', he confirmed. 'It
still needs good randomised control trial data'.