Menopausal women become pregnant with their own eggs
Two women thought to be infertile have become pregnant using a technique that seems to rejuvenate ovaries, New Scientist can reveal. It is the first time such a treatment has enabled menopausal women to get pregnant using their own eggs.
“I had given up hope on trying to get pregnant,” says one of the women, WS, who is now six months pregnant. “To me, it’s a miracle.”
The approach is based on the apparent healing properties of blood. Kostantinos Sfakianoudis and his colleagues at the Genesis Athens Clinic in Greece draw blood from their patients and spin it in a centrifuge to isolate platelet-rich plasma. This has a high concentration of the cell fragments usually involved in blood clotting, and is already used to speed the healing of sports injuries, although its effectiveness for this purpose is unclear.
The clinic is attempting to use this plasma to repair women’s reproductive systems, injecting it directly into the ovaries and uterus. So far, the team has given this experimental treatment to more than 180 women, many of whom sought treatment because they have a disorder that damages the lining of the uterus.
But the team has also used the treatment in an effort to rejuvenate the organs of 27 menopausal and peri-menopausal women, between the ages of 34 and 51.
“We’ve had people come from as far as Mongolia,” says Sfakianoudis. While most want to get pregnant, some of these women just wanted to stop the symptoms of menopause, which can include hot flushes, night sweats and thinning hair.
Those wanting to get pregnant then went back to their home countries to try IVF. Sfakianoudis doesn’t know how many have attempted this so far, but says that he knows two women have managed to get pregnant.
Six months pregnant
WS, is a 40-year-old from Germany. She had been trying to get pregnant to have a second child for more than six years, and had experienced six unsuccessful IVF attempts. “After the sixth IVF, the doctor said we should stop there, and consider egg donation,” she says.
Instead, WS received treatment at the Genesis Athens Clinic, returning to Germany to have standard IVF treatment. The stimulation hormones prompted her to release three eggs, and the highest quality egg was fertilised. An embryo was implanted in her uterus and she is now six months pregnant. “Everything is going well,” she says. “It’s a girl”.
The other woman, a 39-year-old from the Netherlands, had previously not had a period for four years, and had been showing other signs of menopause. Because she wanted to start a family, she went to Greece to receive treatment in December 2016. A month later, she began menstruating again, says Sfakianoudis.
Within a few months of treatment, the woman underwent a form of IVF treatment in the Netherlands. She had “natural” IVF, which avoids using hormones to stimulate the ovaries to produce extra eggs, as is done in standard IVF procedures. Instead, doctors collect the one egg that is released during ovulation, fertilise it outside of the body, and later reimplant the embryo.
The woman successfully became pregnant, but unfortunately miscarried last week, a few months into her pregnancy. Women between the ages of 35 and 39 are thought to have a one in five chance of miscarriage during the first 12 weeks of pregnancy. “Even with the miscarriage it’s extremely encouraging,” says Sfakianoudis. He hopes that the woman will try again.
Doctors say the results so far are promising, but that rigorous trials are needed before firm conclusions can be drawn. “Anything that might help ovaries regain function would be fabulous,” says John Randolph at the University of Michigan in Ann Arbor. “A lot of people have high hopes of doing something like this.”
The team isn’t sure how the treatment might be working. One theory is that the plasma wakes up stem cells in the ovary, encouraging them to produce more eggs. But scientists are currently debating whether such stem cells even exist. Alternatively, the treatment itself might contain stem cells, suggests Randolph. “We need to figure out how this works and how safe it is,” he says.
Simply sticking a needle into an ovary might have an effect, says Claus Yding Andersen at Copenhagen University Hospital in Denmark. Damaging an ovary can change the shape of the blood vessels that support it, which may cause isolated egg follicles to be provided with a blood supply for the first time, enabling them to release eggs.
Sfakianoudis is planning a clinical trial of the treatment, which will compare the effects of platelet-rich plasma with a placebo injection. Until then, it is impossible to say how well, if at all, the treatment is working, says Kutluk Oktay at New York Medical College. Even once menopause starts, there are still some egg follicles left, so there is a small chance that women can still get pregnant at this stage without any treatment, he says.
If it works, the treatment could be used to enable older women to get pregnant. The menopause usually occurs around the age of 50, and so far, Sfakianoudis’s has not treated anyone over 52. But he says that it is not his place to judge how old is too old for a woman to start a family. “Some people might not meet their partners until later in life,” he says. “If there is a treatment that will help them, then why not use it?”
But pregnancy is riskier in older age, says Andersen. “I do think it’s questionable whether we should allow women in their 60s and 70s to get pregnant,” he says.
The treatment isn’t just desirable for women looking to extend the average reproductive window. While most women undergo the menopause at around the age of 50, about one per cent of women experience premature menopause, before the age of 40. Women who undergo chemotherapy cancer treatment can experience early menopause too, although freezing ovaries or eggs before treatment offers them a chance to reverse this once their chemotherapy is over. If rejuvenation with platelet-rich plasma works, it would offer the same opportunity to women who didn’t get a chance to freeze any tissue before treatment.
Sfakianoudis plans to trial his treatment in Greece and the US, but will continue offering it at his clinic in the meantime. Others are likely to follow suit, says Randolph. “Most people in the field will wait for more information before offering this to their patients, but there will be a few people who will jump on it,” he says.