Is there a Fountain of Youth for eggs?

Got Old Eggs? Have trouble conceiving? Thousands of women with poor-quality eggs struggle to get pregnant through in vitro fertilization or find themselves turning to egg donors. But what if those “old eggs” could take a dip in a scientific Fountain of Youth, creating an Egg Donation Alternative?

Cambridge-based fertility company OvaScience is pioneering a new in vitro fertilization technique called AUGMENT, which is poised to be the first major advance in IVF since the first “test tube baby” born in 1978. Already seeing success in chronically infertile women, many experts are saying this new egg-energizing method could dramatically raise the success rates of IVF.

For years, many reproductive endocrinologists have believed poor egg quality occurs when the mitochondria in an egg cell break down. “We believe this is an energy issue,” says Robert Casper, the Toronto reproductive endocrinologist who helped create the first baby born from AUGMENT. As he explained in detail for an article published in Fusion magazine: “All of our cells have mitochondria, which provide the energy for all the cell’s functions.”

As the mitochondria degenerate, so do a woman’s chances of getting pregnant. “Our thinking is that, as eggs age, the mitochondria get run down. They start to get mutations in their DNA”, and that lack of energy doesn’t allow embryos to sustain fertilization.

AUGMENT emerged from a 2004 breakthrough made by Harvard biologist Jonathan Tilly. The science is complex, but in essence, Dr. Tilly says he discovered the woman’s own body contains pristine egg stem cells on the surface of the ovary. These stem cells contain healthy mitochondria that get injected into the “old egg”… And just like that, the old egg acts young again.

Mitochondria equals energy. Energy equals a more viable egg. The old egg has just taken a dip in the fountain of youth.

So what exactly does that energy boost mean? OvaScience researchers say it allows the egg to reach implantation stage without developing chromosomal abnormalities along the way. And the entire process occurs before in vitro fertilization, boosting the chances for a successful IVF. In the right circumstances, it could eliminate the need to use donor eggs, if a woman is suddenly able to make her own eggs work for her.

“The technique addresses a void now in IVF,” said Dr. Tilly in a TIME magazine interview exploring the new method. “No cell culture can circumvent poor egg quality or an egg that is simply too tired. We are taking patients with a zero percent pregnancy rate, patients who have failed IVF because of poor egg quality, and getting them pregnant.”

It worked for Natasha and Omar Rajani after four years of fertility drugs, intrauterine insemination, natural therapy, and IVF. As Natasha Rajani told TIME, “I tried to remain positive, thinking there is a light at the end of the tunnel, and that a baby will be there at the end.” She had already miscarried a few weeks into her standard IVF pregnancy.

Then OvaScience doctors in Toronto tried AUGMENT on the would-be mother, using her own egg stem cells to extract their mitochondria, then adding that power blast of mitochondria into her poor-quality eggs.

Post-AUGMENT, the Rajanis’ IVF treatments produced baby Zain, the first child ever born using this method. “We see Zain as a symbol of hope for all couples struggling with infertility,” says Natasha, who froze two remaining embryos for the future. “While the process is long, emotional and physically draining, there is light at the end of the tunnel—and that light for us is Zain.”

Doctors in Canada, Turkey, the United Arab Emirates report successful pregnancies after using AUGMENT with test groups of women, all of whom previously underwent anywhere from one to seven unsuccessful cycles of IVF.

“We could be on the cusp of something incredibly important,” said Dr. Owen Davis, president of the American Society of Reproductive Medicine (ASRM), to medical reporter Alice Park, “Something that is really going to pan out to be revolutionary.”

A Revolutionary Fertility Solution? Or too good to be true?

The U.S. FDA Waits and Doesn’t Comment on AUGMENT

The United States Federal Drug Administration has yet to approve AUGMENT’s use. No formal trials have been conducted yet, and there are unanswered questions about the long-term effects of this genetic technique on the children born from it.

Because the procedure is so new, some reproductive science experts are skeptical and point to the lack of convincing evidence comparing pregnancy rates of women undergoing AUGMENT to those with similar infertility problems who did not use the technique.

As the ASRM’s Dr. Davis points out, “It’s a fascinating concept, but we just haven’t seen the studies yet.”

OvaScience plans to conduct 1000 cycles using AUGMENT this year and generate more data to help bring the procedure to the U.S. Women are signing up in droves, despite the lack of FDA approval, unanswered genetic questions, and doctors who question Dr. Tilly’s discovery and the very existence of these precursor egg stem cells in a woman’s body.

Considering the fact that Mitochondria carries DNA – which can be passed on from mother to child and generation to generation – many experts are cautioning women to hold off on embracing this technology. Genetic disease or mutation are possibilities that have not been explored or discounted.

“I think the FDA did the right thing,” said Carolyn Givens to Fusion newsmagazine. The San Francisco reproductive endocrinologist explained, “I don’t like the government coming down on the regulation of human medical treatments—but when it involves something that might affect future generations, we need to stop and pause.”

As with any artificial reproductive technique, medical questions are quickly followed by legal questions that span everything from parentage issues and support to ownership of unused embryos, and inheritance quandaries. Attorney Leslie Schreiber, a Reproductive Lawyer, always encourages prospective parents to remember the legal component as they embark on their journey to become parents “Because part of being a parent,” says Schreiber, “is taking care of both yourselves and your children’s health and future before they are even born.”