Our patient Tara writes:
“I cannot say enough good things about Dr. Ziegler. He is kind, compassionate, honest and amazing at what he does. He takes his time with us each visit and always has a warm bedside manner. We have a beautiful son because of Dr. Ziegler and the talented staff at the Reproductive Science Center. I would recommend him to anyone!”
Thank you so much for your kind words, Tara. We really appreciate everyone who takes the time out to share their experience with us.
The first stages of placental development take place days before the embryo starts to form in human pregnancies. The finding highlights the importance of healthy placental development in pregnancy, and could lead to future improvements in fertility treatments such as IVF, and a better understanding of placental-related diseases in pregnancy.
In a study published in the journal Nature, researchers looked at the biological pathways active in human embryos during their first few days of development to understand how cells acquire different fates and functions within the early embryo.
They observed that shortly after fertilization as cells start to divide, some cells start to stick together. This triggers a cascade of molecular events that initiate placental development. A subset of cells change shape, or “polarize’” and this drives the change into a placental progenitor cell–the precursor to a specialized placenta cell–that can be distinguished by differences in genes and proteins from other cells in the embryo.
“This study highlights the critical importance of the placenta for healthy human development,” said Dr. Kathy Niakan, group leader of the Human Embryo and Stem Cell Laboratory at the Francis Crick Institute and Professor of Reproductive Physiology at the University of Cambridge, U.K., and senior author of the study. “If the molecular mechanism we discovered for this first cell decision in humans is not appropriately established, this will have significant negative consequences for the development of the embryo and its ability to successfully implant in the womb.”
Understanding the process of early human development in the womb “could provide us with insights that may lead to improvements in IVF success rates in the future. It could also allow us to understand early placental dysfunctions that can pose a risk to human health later in pregnancy,” Niakan added.
Premature ovarian insufficiency, put simply, is early menopause, according to RESOLVE: The National Infertility Association. Women typically start to enter menopause between the ages of 42 and 56. POI, however, occurs in 1 in 1,000 women between the ages of 15 and 29 and 1 in 100 women between the ages of 30 and 39. The average age is 27. A family history of POI is seen in about 4% of these women, meaning most have no family history of the condition.
Women who have POI (sometimes known as premature ovarian failure, or POF) may experience some symptoms similar to those of menopause: hot flashes, no period, vaginal dryness and others. POI may occur suddenly, over one to two months, or gradually, over several years.
You can learn more about POI at the RESOLVE web page. And be sure to listen to our recent podcast about POI, with Dr. Alan Martinez.
A drug that acts via the natural “kisspeptin” hormone system in the body has the potential to treat reproductive health problems in women, according to a new study.
Twenty-four women were injected with a drug called MVT-602 which targets the kisspeptin system to stimulate reproductive hormones that affect fertility, sexual development and menstruation. The naturally occurring form of kisspeptin, called kisspeptin-54 (KP54), has been researched for a number of years to treat reproductive disorders, but in the new study, MVT-602 induced more potent signaling of the kisspeptin system over a longer period of time than KP54.
The researchers suggest that MVT-602 may be used to effectively treat a range of reproductive conditions that affect fertility, such as polycystic ovary syndrome (PCOS). Because of MVT-602’s much longer duration of action, it can be given less frequently than the naturally occurring form of kisspeptin, whilst still being able to maintain the degree of stimulation of reproductive hormone levels required to restore reproductive health.
The study was published in the Journal of Clinical Investigation.
Using the power of single-cell analysis, researchers at the Babraham Institute in the U.K. have assessed the effects of age on egg cells (oocytes) in mice, particularly looking to identify genomic and epigenetic factors that relate to reduced developmental competence. The knowledge uncovered by this research provides new insights into the mechanisms underlying egg quality and is relevant to the development of techniques to assess the quality of human egg cells, an area of growing importance as the use of fertility treatments increases. The research is published in the journal Aging Cell.
Advancing maternal age causes a gradual reduction in fertility. “Why egg cells lose their development competence is something we don’t fully understand but it’s like to be due to a combination of factors,” says Dr. Gavin Kelsey, Head of the Epigenetics research program at the Babraham Institute, who led this work.
The research used a cutting-edge single-cell technique developed at the Institute to identify the characteristics of eggs with reduced developmental competence and distinguish eggs from older females that retained a young-like profile. In particular, eggs from older females had fewer active gene expression and showed greater variability.
“As demonstrated by this research, single-cell techniques and epigenetic analysis could be used to indicate the quality of an egg in terms of forming a healthy embryo after fertilization.” concludes Dr. Kelsey.
Michigan State University researchers have identified a potential genetic target for treating an especially painful and invasive form of endometriosis that often leads to infertility.
Their study, published in Cell Reports, could lead to better treatments for women suffering from severe forms of endometriosis, said Mike Wilson, a postdoctoral fellow in the MSU College of Human Medicine. Wilson and Jake Reske, a graduate student in the MSU Genetics and Genome Sciences Program, are first authors of the study.
Their research focused on a type of endometriosis that occurs in women who have a mutation in a gene called ARID1A, which is linked to the more invasive and painful form of the disease. “There haven’t been many successful nonhormonal therapies for this form of endometriosis that have made it to the bedside yet,” Reske said.
In laboratory experiments, he and Wilson tested a drug that appeared to target the super-enhancers and stop the spread of endometriosis. Such a drug, part of a new type of treatment called “epigenetic therapy” that controls how genes are expressed, could be far more effective than current treatments, including surgery, hormone therapy and pain management.
A research collaboration based in Kumamoto University in Japan has clarified how homologous chromosome pairing–a process necessary for sperm and egg formation where paternally- and maternally-derived chromosomes match and exchange genetic information during meiosis–attracts factors that play a monitoring role. This research may lead to future advances in reproductive medicine, such as the identification of the causes of infertility.
Meiosis is a special type of cell division that takes place in the ovaries and testes to produce eggs and sperm. Here, maternal and paternal chromosomes of the same type are aligned in a process called “homologous chromosome pairing.” This results in the partial exchange of genetic information. Homologous chromosome pairing is an essential process for matching paternal and maternal DNA and facilitating the exchange of DNA sequences between them, but if it doesn’t work, meiotic recombination doesn’t occur normally and eggs and sperm cannot form.
Details about how the mechanism is induced on chromosomes is still unclear. Its dysfunction is an important but poorly understood problem with direct implications for reproductive medicine. If this mechanism fails, it leads to a significant decrease in sperm and egg formation resulting in infertility, the researchers said. There are many cases of human infertility where the cause is unknown, but they hope that this discovery will help to clarify the mechanism for many of the people affected.
Things are different this year because of COVID-19. The holidays, from Thanksgiving through the New Year, will be different, too. We should all refrain from large gatherings, even among family. And for those coping with infertility, that may actually be a blessing in disguise.
“Holidays can be stressful, even in the best of circumstances. Expectations are at a peak. Pressure comes, both from the outside and within, to break out of the normal routine – to celebrate, and to enjoy! But for the person experiencing infertility, holidays can add additional emotional stress to an already complicated situation,” says RESOLVE: The National Infertility Association.
Fewer gatherings may reduce that stress, but it won’t make it disappear. “But by planning in advance and acknowledging that holidays may be uncomfortable; you can prepare yourself and improve your chances of getting through them,” RESOLVE says.
And to help, here is a link to RESOLVE’s tips for handling holiday stress.
The symptoms of menopause–hot flashes, night sweats, mood swings–are common once a woman hits age 40 or so. But for about 1% of women younger than that, those and other symptoms may indicate premature ovarian insufficiency (POI). For a variety of possible reasons, these women’s ovaries stop working earlier than normal, causing their menstrual cycles to become irregular or stop, and making pregnancy difficult.
In our latest podcast, Dr. Alan Martinez discusses the causes and treatments for POI. You can listen here.
Did you know that RSCNJ now has almost 40 podcasts, featuring our two physician specialists, that cover a wealth of information important to those looking into fertility care?
Our specialists, Dr. William Ziegler and Dr. Alan Martinez, discuss everything from endometriosis and PCOS to weight control and psychosocial aspects of infertility. Listen to them at home, while driving or whenever you have the time.
You can find them on all your favorite podcast platforms, or by visiting our podcast web page.
William Ziegler, DO, FACOG
Alan Martinez, MD, FACOG