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8 October 2019

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The future of fertility

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Thanks to science, it’s becoming easier to overcome some of the hurdles to parenthood.

At a glance
●    Developments in fertility are helping more people become parents despite challenges
●    Grafting ovarian tissue may help people with cancer to conceive post treatment
●    Freezing eggs can help increase a woman’s chances of conceiving in the future 

Future of Fertility

If you’re planning on starting a family in the near future, it’s reassuring to know that the constant evolution of science means you can have the best chance of overcoming fertility challenges. One such development in the pipeline is an artificial uterus. Japanese scientists have successfully grown human embryos to 10 days in artificial wombs, with the intention of eventually being able to implant the whole structure back into women who have struggled to conceive. 

But as fertility specialist Associate Professor Kate Stern explains, that breakthrough isn’t likely to be available to couples anytime soon.

“There’s no well-developed artificial womb yet,” she says. “But we have some alternatives, such as surrogacy.”

So what IS available, and what’s on the horizon? 

There are a lot of other exciting advances in fertility science available right now, and likely to emerge in the near future. The Melbourne IVF scientific team is actively engaged in research to produce viable mature eggs (oocytes) from tiny follicles in ovarian tissue. This has enormous potential to help many cancer patients whose ovarian function may be permanently damaged by chemotherapy. This exciting research also has implications for optimising fertility for other women who have difficulties conceiving. 

“One of the most exciting aspects of working in fertility and fertility research is trying to help patients who have cancer be able to have a baby later on,” adds Stern. “Cancer treatment often destroys fertility, or makes it much, much weaker, so we’re working on strategies to provide hope for these women to have a baby. 

“One of the things that we do is freezing ovarian tissue before chemotherapy and then we can put the tissue back afterwards and – still, to me, miraculously – we can develop eggs and help these women have a baby with the grafted ovarian tissue. Other options include egg freezing and other hormones to protect the ovaries.”

But, Stern points out that results aren’t always straight forward.

“One of my dearest patients, we grafted tissue and everything looked like it should work but it didn’t,” she says. “We thought about it and tried to work out some new strategies, did it again, and it worked! We’re so happy – she’s pregnant now.”

Eggs… on ice

As Professor Stern mentioned, freezing eggs can be an option for women with cancer but it’s also an increasingly appealing option for healthy women, too, who want to maximise the opportunity for future fertility.  As we get older, the quality and number of a woman’s eggs deteriorates. For many women, life doesn’t pan out as they hope, and egg freezing can help reduce the risk of missing out on having a baby because of a lack of a partner or job security. Although egg freezing was first done successfully in 1986, significant advancements have been made over the years, making this now a realistic proposition for women from many walks of life.  

Nikki’s story

Sexologist and relationship expert Dr Nikki Goldstein took up the opportunity to help future-proof her fertility, freezing her eggs at age 29. 
“Many people told me I was too young, but after looking at some of the statistics, I felt that it was the right time for me,” she says. “I was single, and having a great time dating, and didn’t want to be finding someone for the sake of just having a family. Even though it was a difficult experience at times, it was something that I was doing for my future self.”

Dr Goldstein is keen to share her experience to encourage others to start thinking about preserving their fertility long before they are ready to start having children. 

“There is nothing shameful or taboo about egg freezing, or even having these discussions,” she says. “It’s really important to speak to friends that might have been through the egg-freezing process before, but also speaking to your doctor. Arm yourself with as much information as possible so you can make the right decision for you.”


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