England Research Helping Older Women Have Menstral Cycles Again

Never as well one-time?

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MENOPAUSE need not exist the finish of fertility. A team claims to have plant a way to rejuvenate mail-menopausal ovaries, enabling them to release fertile eggs, New Scientist can reveal.

The squad says its technique has restarted periods in menopausal women, including one who had not menstruated in 5 years. If the results hold up to wider scrutiny, the technique may boost declining fertility in older women, allow women with early menopause to go pregnant, and help stave off the detrimental health effects of menopause.

"It offers a window of hope that menopausal women will be able to become meaning using their ain genetic textile," says Konstantinos Sfakianoudis, a gynaecologist at the Greek fertility dispensary Genesis Athens.

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"It is potentially quite exciting," says Roger Sturmey at Hull York Medical School in the Uk. "Only it also opens upwards upstanding 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 superlative in the early on 20s. Around the historic period of 50, which is when menopause usually occurs, the ovaries stop releasing eggs – but well-nigh women are already largely infertile by this bespeak, equally ovulation becomes more infrequent in the run-up. The menopause comes all-too-before long for many women, says Sfakianoudis.

The age of maternity is creeping upward, and more women are having children in their 40s than e'er 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, only neither are a reliable dorsum-upward selection (see "The pregnancy pause").

The menopause besides comes early – before the age of forty – for effectually 1 per cent of women, either because of a medical status or sure cancer treatments, for example.

"Information technology offers hope that menopausal women will be able to get significant using their own genetic material"

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

Platelet-rich plasma (PRP) is made past centrifuging a sample of a person'south 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 handling may work by stimulating tissue regeneration.

Sfakianoudis'south 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 almanac coming together in Helsinki, Republic of finland, this calendar 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 agone, at the age of 40," says Sfakianoudis. Half dozen months later on the team injected PRP into her ovaries, she experienced her first catamenia since menopause.

Sfakianoudis's squad has since been able to collect three eggs from this woman. The researchers say they accept successfully fertilised two using her husband'southward sperm. These embryos are now on ice – the squad is waiting until there are at to the lowest degree three earlier implanting some in her uterus.

The squad isn't sure how this technique works, just 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'due south possible that growth factors encourage such stem cells to regenerate tissue and produce ovulation hormones. "Information technology's biologically plausible," says Sturmey.

Fertilised eggs

Sfakianoudis's team says it has given PRP in this way to effectually 30 women betwixt the ages of 46 and 49, all of whom desire to accept children. The researchers say they have managed to isolate and fertilise eggs from virtually of them.

"It seems to work in about two-thirds of cases," says Sfakianoudis. "Nosotros meet 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 and then in the coming months.

PRP has already been helpful for pregnancy in another group of women, says Sfakianoudis. Effectually x per cent of women who seek fertility treatment at his dispensary have a uterus that embryos find difficult to attach to – whether due to cysts, scarring from miscarriages or having a sparse uterine lining. "They are the virtually difficult to treat," says Sfakianoudis.

But later on 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 exist desirable for women who aren't trying to conceive. The hormonal changes that trigger menopause can as well make the centre, peel and basic 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 considering 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.

More eggs, please

Steve Gschmeissner/SPL

However, Sfakianoudis's team hasn't yet published any of its findings. "We demand larger studies before we tin can know for sure how constructive the treatment is," says Sfakianoudis.

"I woman had been in menopause for five years. 6 months afterward treatment, she had a menses"

Some accept raised concerns about the prophylactic and efficacy of the process, saying the team should have tested the approach in animals offset. "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 certain that the resulting eggs are OK," says Adam Balen at the British Fertility Society.

To know if the technique actually does improve fertility, the team will as well demand to carry out randomised trials, in which a control group isn't given PRP.

Virginia Bolton, an embryologist at Guy's and St Thomas' Infirmary in London, is also sceptical. "It is unsafe to get excited about something before you take sufficient show it works," she says. New techniques often observe their way into the fertility clinic without strong show, thanks to huge demand from people who are ofttimes willing to spend their life savings to have a child, she says.

If the technique does agree up nether further investigation, it could enhance ethical questions over the upper age limits of pregnancy – and whether there should be whatever. "I lay awake last night turning this over in my mind," says Sturmey. "Where would the line be drawn?"

Health issues similar gestational diabetes, pre-eclampsia and miscarriage are all more common in older women. "Information technology would require a big debate," says Sturmey.

Sperm home test kit

How are the trivial swimmers doing? Low sperm counts or poor sperm quality are behind around a third of cases of couples who can't conceive. A visit to a dispensary for a test tin exist awkward, but a smartphone-based organisation lets men determine whether that's necessary by checking their fertility at home.

Men often observe information technology embarrassing to give a semen sample at a dispensary, says Yoshitomo Kobori at the Dokkyo Medical University Koshigaya Hospital in Japan. So Kobori devised an alternative. "I idea a smartphone microscope could be an easy fashion to look at problems with male fertility," he says.

Kobori and his colleagues came up with a lens less than a millimetre thick that tin be slotted into a plastic "jacket". Clipped on to the camera of a smartphone, it magnifies an epitome by 555 times – perfect for looking at sperm.

To do a home examination, a homo would employ a small amount of semen to a plastic canvas around five minutes after ejaculation and printing information technology against the microscope.

Watch them swim

The phone's photographic camera can then take a 3-second video clip of the sperm. When viewed enlarged on a computer screen, information technology is easy for someone to count the full number of sperm and the number that are moving – key indicators of fertility.

Kobori says the organisation works as well as the software used in fertility clinics. When the team ran l samples through both systems, they got almost identical results. The work was presented at the European Society of Man Reproduction and Embryology meeting in Helsinki this calendar month.

The organization can't appraise the ability of sperm to fertilise an egg. "This method is only the elementary version of semen assay," says Kobori. But that could exist enough for men to identify potential fertility problems, and make up one's mind whether to seek help from a medico.

This article appeared in print nether the headline "Reversing the menopause"

Leader: "Who should we believe when it comes to fertility?"

More than on these topics:

• fertility
• pregnancy and birth
• menopause

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Source: https://www.newscientist.com/article/mg23130833-100-menopause-reversal-restores-periods-and-produces-fertile-eggs/

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