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Baby Breakthrough: Infertile Woman Gives Birth
A 30-year-old infertile woman has given birth to a baby in Japan after doctors used a new technique to "reawaken" her ovaries into producing eggs again.
The experimental technique, developed by researchers at Stanford University School of Medicine in California, is in its early stage and was only tried on a small group of Japanese women with a specific kind of infertility problem.
The condition, known as primary ovarian insufficiency, affects about 1% of women and causes the ovaries to stop working before the age of 40.
Egg donation is the only option for women who enter menopause at a young age if they want to attempt to carry a pregnancy.
However, scientists now hope the breakthrough can also help women in their early 40s who have trouble becoming pregnant because of their age.
Medics at the St Marianna University School of Medicine in Kawasaki, Japan, used the technique in an experiment on 27 women who had an average age of 37.
The women stopped menstruating nearly seven years earlier on average and agreed to have both ovaries removed, according to a report published online by the Proceedings of the National Academy of Sciences.
Of this group, 13 women were found to still have residual follicles, which typically contain one immature egg.
Human females are born with about 800,000 of these follicles. Most will remain dormant, but normally one follicle develops to maturity each month and releases an egg.
"Our treatment was able to awaken some of the remaining primordial follicles and cause them to release eggs," said Aaron Hsueh, senior author of the report and professor of obstetrics and gynecology at Stanford University.
The ovaries were dissected and treated with stimulant drugs to block a certain growth pathway that causes the follicles to stay dormant.
Small pieces of the ovaries were then transplanted back into the women, near their fallopian tubes.
Eight of the 13 women showed signs of follicle growth, and were treated with hormones to stimulate ovulation.
From that group, five developed mature eggs, which the researchers harvested for in vitro fertilisation using the sperm of the women's partners.
One woman received two embryos and carried a single pregnancy to term and gave birth to a son in Tokyo last December.
The child was delivered by C-section - because the foetus was in a breech position at 37 weeks - by the report's lead author Kazuhiro Kawamura, associate professor of obstetrics and gynaecology at the St Marianna University.
"Although I believed, based on our previous research, that this in vitro activation (IVA) approach would work, I monitored the pregnancy closely and, when the baby was in a breech presentation, I performed the Caesarean section myself," said Mr Kawamura.
"I could not sleep the night before the operation, but when I saw the healthy baby, my anxiety turned to delight.
"The couple and I hugged each other in tears. I hope that IVA will be able to help patients with primary ovarian insufficiency throughout the world."
He said the mother hoped to have another child with one of the frozen embryos in storage from her treatment.
Of the other four women who also developed mature eggs, one is pregnant, two are preparing for embryo transfer or are undergoing additional egg collection and one woman was implanted with an embryo, but failed to become pregnant.
The researchers are now planning to investigate whether the technique could help counteract other causes of infertility, such as cancer treatment.
Alan Copperman, director of the division of reproductive endocrinology at Mt Sinai Medical Center in New York, said he applauded the US-Japanese team's "novel approach to an age-old problem", but added that it was "extremely premature to comment on the widespread potential for this procedure to help women with ovarian failure to achieve reproductive success".
Other experts expressed caution at the results.
"It shows a lot of promise (but) I don't think it's even close to being ready (for routine use)," said Dr Mark Sauer, of the Columbia University Medical Center in New York.
Dr Amber Cooper, of Washington University, St Louis, said the technique was "very much an experimental method".