"Big News" About New Eggs Is a Big Maybe

This week, a study published in the journal Nature Medicine is promising to scramble a long-held belief about women's eggs.

Scientists at Massachusetts General Hospital have isolated egg-producing stem cells from human ovary tissue. Then, in laboratory conditions, the cells eventually resulted in new egg cells.

Image: Carlos Porto / FreeDigitalPhotos.net

It's the big health news du jour. (So I'm sure my inbox will fill with hopeful "Dr. Kristiansen, did you see the news?!")

For years now, we've all believed that females are born with the most eggs they'll ever have and that when the number dwindles down, natural infertility is the result. This new finding is exciting in terms of possibilities for related infertility treatments.

But good research takes time. Often, a very long time.

Do you recall when we started learning more than a decade ago that, contrary to long-held beliefs, human brains can generate new cells? It's very exciting to consider people with brain injury may be able to recover more fully! But now, many years of research later, experts in neuroscience are skeptical again.

There are still far more questions that must be addressed before this knowledge about "new" egg cells is usable by fertility specialists in helping women with age-related infertility or premature ovarian aging. In fact, I'd bet that the necessary details will come too late to institute a related plan for any woman who is currently considering fertility treatment. For those who want to delay conception but take advantage of their youthful fertility, the best options remain egg or embryo freezing via IVF. And my team at Houston Fertility Center will be happy to serve you with those tried-and-true techniques, today.

There's More to Healthy Babies Than Good Eggs

We tend to focus on the very key component of viable egg cells in assisted reproductive technology. There's no doubt that "good eggs" are needed to make conception and pregnancy happen. A piece of the pregnancy puzzle that doesn't usually get as much attention is the impact of uterine health.

It makes sense, of course, that once an egg is fertilized, the resulting embryo needs a healthy place to implant and grow. The lining of the uterus, known as the endometrium, is that place. In cases of women with average to good fertility levels, the endometrium is primed for implantation by a variety of hormones relaying through her body. It's all part of the menstrual cycle. [Here's an explanation of how the endometrium works.] Timing is crucial -- both in natural and assisted conception -- because the lining is re-created and either used or sloughed off through menstruation on a cyclical basis, approximately every 28 days. If a woman's hormones are imbalanced, the result is sometimes an endometrium that's not ready to receive and nourish a conceived embryo. This can be a type of infertility.

We administer endometrium-enhancing medications -- such as progesterone supplementation -- to some patients, regardless of the assisted reproductive technique they're using to conceive. Ultrasound monitoring is used to view and gauge the health of the uterine lining, just as we use ultrasound to see how well a woman's ovaries are ovulating. Still, there's more to solving the pregnancy puzzle, and researchers have recently unveiled a new potential key.

A study of mice has resulted in the newly discovered connection between a protein called Hand2 and the control of the uterine lining's proliferation. The researchers' findings could eventually lead to more ways for fertility experts to help patients who have endometriosis or previously unexplained infertility.

Answering the question, "Why can't we get pregnant?" requires attention to many variables within each patient's situation. The responsive functioning of a woman's uterus is increasingly becoming the focal point of research. After all, there's a lot more to having a baby then simply creating an embryo.

~ Sonja Kristiansen