Current analyzes for fertility treatments reflect the number of eggs that can be obtained from women, but say nothing about their quality.
A blood test will show the level of fertility before undergoing the fertilization treatment and thus take the pertinent measures to solve the possible problems.
In addition, it will also work to know the possibilities that a woman has of getting pregnant Spontaneously. This is what a study says Franco-Spanish researchers and doctors, published in the Journal of Gynecology and Women's Health.
The conclusions of this research suggest that the excessive release of DNA from cells reflects an elevated level of oxidative stress in the ovaries, and therefore hinders fertility by not being able to produce eggs.
And it is that precisely, one of the indispensable conditions to be able to opt for an in vitro fertilization treatment is for the woman to be able to produce eggs, according to the assisted reproduction organization.
In addition, it is necessary that you do not have uterine problems or abnormalities that prevent the implantation of the embryo or the evolution of pregnancy.
According to Dr. Jan Tesarik, one of the authors of this work and director of the MARGen Clinic in Granada:
“The quality of the ovules, even those of young women, has dropped significantly in the last 20 years. The causes are multiple, although our results suggest a probable common denominator: an oxidative stress of the ovarian cells and the maturation of the ovules, responsible for the release of the DNA from the affected cells. ”
This proposed new blood test would evaluate the quality of those eggs.
What are these analyzes or liquid biopsies?
DNA molecules carry the genetic information of all cells, and their usual location is intracellular (within the nucleus of cells). However, a small proportion of DNA escapes the cells and appears free in the blood.
This is explained by the researcher and director of the Margen Clinic, which ensures:
"In recent years, numerous studies have evaluated the use of this free DNA, circulating in the blood, in the diagnosis and prognosis of cancer, under known liquid biopsies. They have deep sequencing of free circulating DNA to obtain information about their cellular origin and functional status of the cells in question. "
"Similar techniques are also being developed to assess the degree of cellular damage in the case of myocardial infarction or immune disorders."
Now, this recent study suggests that the analysis of free circulating DNA could also be relevant in the field of assisted reproduction.
In addition, we ask Dr. Tesarik what this test consists of, what improvements it incorporates, for what treatments it is indicated and when it will begin to be used. These are your answers.
What is the great advantage of this analysis?
There are currently other markers in blood that reflect the level of fertility related to hormone levels such as antimullerian (AMH) or gonadotropin FSH. But they only allow predicting the number of ovules that can be obtained in the fertility treatment, but they say nothing of their quality.
The analysis we are launching will complement the other analyzes. We know that the quality of the ovules is related to the age of the woman, but each woman is different and no generalized conclusions can be made. The analysis of the free DNA will tell us if the quality of the ovules is equal, better or worse than it would correspond to the age of the ID of each woman. That is to say:
It will allow to determine more precisely the origin of the problem in each individual clinical case and choose an appropriate therapeutic strategy ”For which fertility treatments would it be suitable?
For any treatment for assisted reproduction, including IVF, ICSI or artificial insemination.
But also to predict the woman's probability of becoming pregnant spontaneously.
Are there already reliable results?
We have conducted the first clinical trials in France, Tunisia and Algeria. The observations, disclosed in the article published in the 'Journal of Gynecology and Women's Health', are those that point to this causal relationship between the results of the analysis and the fertility of women.
Although from the technical point of view the analysis is ready for immediate implementation in Spain, there is still no date or valuation of the price of the test.
What does seem clear, according to the expert, is that in the very near future:
"The development of techniques based on circulating free DNA, as a marker of the reproductive function of women (and probably also of men), will go through a qualitative analysis of the samples obtained, including also the evaluation of genetic information."
What is in vitro fertilization?
There are several steps that must be taken to achieve the final success of the treatment.
Ovarian stimulation controlled. The woman receives hormonal medication for approximately 10 days to stimulate the production of eggs and thus obtain a greater number of them. In addition, this medication allows you to control the time of ovulation, thus increasing the chances that the ovules obtained are mature and suitable for fertilization.
Ovarian or follicular puncture. It is the surgical intervention in which mature ovules are removed from the ovary. It is performed by aspiration, lasts about 20-30 minutes and requires anesthesia.
The analysis of the free DNA would allow to know if 'the ovules are going to work' before the puncture, avoiding the test until they are of quality.
- Collection and preparation of semen. The male sample is collected (usually by masturbation, although it can also be obtained by epididymal aspiration or testicular biopsy).
Next, the sperm goes through a training process that will make the sperm capable of fertilizing and giving rise to the embryo.
- Fertilization of the ovules. It can be done by the conventional in vitro fertilization technique (placing an egg cell surrounded by sperm cells on the culture plate), or by the ICSI technique, which consists of 'injecting' the sperm into the egg.
Of the resulting embryos, the best ones are chosen to transfer to the uterus and wait until they are implanted and pregnancy is achieved.
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