An Australian team is pioneering an alternative to in-vitro fertilisation (IVF) that costs a fraction of the price, is less invasive and requires 90 percent less drugs.
Called in-vitro maturation (IVM), the process has been around for years, but a new development has found a way to double the embryo yield in human pre-clinical trials.
Patients, doctors and clinics are all exquisitely sensitive to success rates.Robert Gilchrist
Currently, women have about two thirds of the chance of falling pregnant with IVM compared to IVF but the new process -- born from a collaboration between the University of NSW, the University of Adelaide and a Belgian university hospital -- is set to change that, as well as making pregnancy possible for those who may find IVF difficult, such as cancer patients and women with sensitive, polycystic ovaries.
University of New South Wales Oocyte Biology Research Unit head Robert Gilchrist said infertility treatment was a results-driven industry.
"This technique has been around actually for as long as IVF but the reason why it is not currently widely used is because the success rates are lower than IVF," Gilchrist said.
"What our research project is aiming to do is bridge that gap. It looks like a very small gap but patients, doctors and clinics are all exquisitely sensitive to success rates."
How does IVF differ to IVM?
Standard IVF requires women to take follicle stimulating hormones to stimulate egg cell growth before they are removed from the ovary.
IVM retrieves eggs while they are still in the immature stage, and brings them to maturity in a cell culture, so eggs are in the lab for the period where hormones would usually be injected into the woman.
Currently 5 million babies have been born via IVF while 5000 have been born via IVM and the current IVM success rate is about 30-35 percent.
The breakthrough is due to two new molecules -- cumulin and cAMP -- which are added to the IVM eggs in the laboratory to help them mature to the point that they resemble eggs harvested for IVF. Cumulin is a growth factor that was discovered at the University of Adelaide.
To understand how many drugs a woman needs to take while undergoing IVF, UNSW School of Women's and Children's Health head William Ledger talks us through it:
"The woman's starting on drugs the week before her period is due and these drugs used for pituitary down regulation have side effects of inducing temporary menopause.
"She may experience hot flushes, night sweats, mood swings, loss of libido and other fairly distressing complications.
"Then she'll have 12-14 days of a daily injection of follicle stimulation hormone, which makes the egg follicles grow.
"Those injections don't have major side effects, but they cause many large ovarian follicles to develop and in someone prone to be sensitive to these drugs -- usually young women with polycystic ovaries, they may develop too many eggs or make too much estrogen hormone and fall into the trap of having ovarian hyper stimulation syndrome."
The major reason women drop out from having more than one IVF cycle is the emotional and physical burden of treatment.William Ledger
During the month-long process, Ledger said women also needed three trans-vaginal ultrasounds and five blood tests.
"The major reason women drop out from having more than one IVF cycle is the emotional and physical burden of treatment," Ledger said.
"In contrast, the IVM process is over with in just a few days and is much less emotionally and physically challenging."
The new, improved IVM treatment is awaiting US Food and Drug Administration approval and researchers anticipate it will be three to five years until it's available in Australia, if proven safe.