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The "Grant for Fertility Innovation" program initiated by EMD Serono in 2009 supports projects in the area of fertility research with the potential to improve the chances of patients to have a healthy baby back homeStage Image

The "Grant for Fertility Innovation" program initiated by EMD Serono in 2009 supports projects in the area of fertility research with the potential to improve the chances of patients to have a healthy baby back home

© Plainpicture

More opportunities after an in vitro fertilization

Messages from the uterus

2012/8/13

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The endometrium releases biochemical signals to an embryo that it can implant itself into the uterus. A test for the presence of these signals could increase the birth rate after in vitro fertilization. EMD Serono is supporing research in this area of reproductive medicine with its “Grant for Fertility Innovation.”

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  • Carlos Simón, the Scientific Director of the Instituto Valenciano de Infertilidad (IVI), is one of the scientists whose work is being supported by EMD Serono's "Grant for Fertility Innovation"
  • Carlos Simón, the Scientific Director of the Instituto Valenciano de Infertilidad (IVI), is one of the scientists whose work is being supported by EMD Serono's "Grant for Fertility Innovation"
    © EMD Serono

    Reproductive medicine helps many couples whose attempts at having children have failed. Nevertheless, not every cycle of in vitro fertilization (IVF) is successful. This partly has to do with the fact that some of the steps involved can only be evaluated subjectively and on the basis of experience. 


    For example, there are no objective diagnostic biomarkers for proving without a doubt that an embryo is viable and that the endometrium is prepared for the embryo’s implantation. With this in mind, EMD Serono launched a “Grant for Fertility Innovation” program three years ago. The global initiative is designed to improve the chances of successful in vitro fertilization for childless couples who wish to conceive.. Perhaps biomarkers are in fact the key to success here.

    The right place and time


    Carlos Simón was among the first scientists to receive a grant in the first round of funding. Simón is a Professor of Gynecology and Obstetrics at the University of Valencia in Spain.

    “The receptivity of the endometrium is a black box.“

    Carlos Simón
    Director of Research
    Instituto Valenciano de Infertilidad (IVI)

    He is also the Scientific Director of IVI, a leading global company specializing in reproductive medicine, as well as Head of Iviomics, a facility that focuses on genetic diagnostics. Simón is particularly interested in the so-called receptivity of the endometrium. “Sixty to ninety percent of transferred embryos fail to implant and eventually die,” he explains. “The receptivity of the endometrium is a black box — we really know very little about it.”

    The endometrial epithelium is only able to receive an embryo for a few days during the menstrual cycle. This short period of time is referred to as the “implantation window.” Up until now, it has not been possible to determine the receptiveness of the endometrium to implantation — neither on the basis of the endometrial thickness nor by determining whether or not the cells that must form the maternal part of the placenta after the initiation of a pregnancy have differentiated themselves sufficiently.  


    “Previous studies did not get us any further,” Simón explains. “It was not until we analyzed all the lipids (fats) that are secreted during the implantation window that we finally got on the right track.” The researchers were then able to show that the two prostaglandins PGE2 and PGF2α appear at the right place and time, which means they might serve as messengers in the dialogue between the endometrium and the embryo.

  • At the Instituto Valenciano de Infertilidad (IVI), one of the leading companies specializing in reproductive medicine, researchers are investigating the receptivity of the endometriumEnlarge
  • At the Instituto Valenciano de Infertilidad (IVI), one of the leading companies specializing in reproductive medicine, researchers are investigating the receptivity of the endometrium
    © EMD Serono

    Old friends


    Prostaglandins are tissue hormones secreted by cells rather than glands. They only act locally and are formed from fatty acids. U.S. scientists demonstrated back in 1997 that mice missing a protein for synthesizing the prostaglandins were unable to receive an embryo in their uteruses.

    In that sense, the two tissue hormones were like old friends to the scientific community. Still, do they really represent the decisive signal for the receptiveness of the endometrium, and can they serve as a biomarker for a diagnostic test?

    Regardless of the answer, they do seem to have what it takes for this: For one thing, just a drop of fluid from the uterine cavity is all that is needed to detect their presence — and the suction of this fluid via a catheter poses no risks for a subsequent pregnancy. Moreover, the drop itself represents the milieu the embryo encounters when it approaches the endometrium. Simón and his colleagues were able to demonstrate that the two prostaglandins form during the implantation window in both a natural and an IVF cycle. They do not form, however, when a women uses an intrauterine device. 


    In addition, the researchers were able to show that the two tissue hormones are secreted by the endometrium’s epithelial cells and that these cells also possess the required enzymes. If the enzymes are inhibited by chemicals, the messenger will not be synthesized and the embryo will not attach itself. That is because the embryo has a type of “antenna” that enables it to detect the presence of the tissue hormones.

    In vitro fertilization: Biomarkers can help childless couples increase their chances of having their own child

    In vitro fertilization: Biomarkers can help childless couples increase their chances of having their own child

    © Getty Images

  • Diego Ezcurra is responsible at EMD Serono for contacts with medical professionals working in the area of fertility
  • Diego Ezcurra is responsible at EMD Serono for contacts with medical professionals working in the area of fertility
    © EMD Serono

    Pregnancy linked to tissue hormones


    A clinical study later attempted to find out if the presence of PGE2 and PGF2α does in fact determine whether or not a pregnancy will occur. The study was conducted with 32 childless women who were trying to conceive a child.

    A drop of fluid was taken from the women’s uterine cavities 24 hours before transfer of a three or five-day old embryo. The two tissue hormones were detected in those women who became pregnant, while no messengers were present in the fluids taken from women who failed to get pregnant.

  • Cells (sperms) in a counting chamber as seen under the microscope: Two specific tissue hormones can be utilized as objective biomarkers to define if the endometrium is ready to receive the embryos before transferEnlarge
  • Cells (sperms) in a counting chamber as seen under the microscope: Two specific tissue hormones can be utilized as objective biomarkers to define if the endometrium is ready to receive the embryos before transfer
    © EMD Serono

    The published research report has been selected by the American Society of Reproductive Medicine out of thousands of submitted articles as a potential recipient of an award at the organization’s next annual congress. 

    “We see the ‘Grant for Fertility Innovation’ as a true win-win initiative,” says Diego Ezcurra, Head of Fertility, External Scientific Affairs, at EMD Serono. 

    Ezcurra, who is from Argentina, was the one who came up with the idea for the grant, and he also manages the project. “The scientists get funding for their research, and EMD Serono can take over the development of the diagnostic procedure if the results appear promising. We already offer very effective fertility hormones, and we may soon be able to also supply reliable diagnostics for the benefit of the patients.”

    2012/8/13

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    Did you know

    • that in Germany every seventh couple that would like to have a child remains childless, and that every sixth couple worldwide has difficulties with fertility at some point?

    • that 84,493 children were born with the help of reproductive medicine in Germany between 1997 and 2010, and that the equivalent worldwide figure is more than 3.75 million since 1978?

    • that 50,583 in vitro fertilization procedures were performed in Germany in 2010, and 29% of the patients became pregnant as a result?

    • that in 2006 more than 1.4 million in vitro fertilization procedures were carried out in 32 countries of the European Union?

    • that in Germany it is more likely that a sperm cell will be injected into an egg cell (ICSI: 76%) than that traditional in vitro fertilization will be performed (IVF: 22%)?

    • that the average pregnancy rate in the EU is 32% after IVF and 33% after ICSI?

    • that the likelihood of success is better for younger women than for older women?

    • that in the U.S. and Germany a female patient seeking the help of reproductive medicine will undergo approximately 2.2 in vitro fertilization cycles on average?

    • that in Germany the average age for a woman who is seeking in vitro fertilization is 34.8 years and for a man it is 38.1?

    • that in Germany a couple who have been unsuccessful in having a child will seek out an IVF center after 3.7 years on average?

     
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