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Advances in research & development

Advances in research & development bring a deeper understanding of infertility:

The problem of the aging egg:

The aging egg remains a very basic problem in fertility. As a woman ages, her eggs do not work as well, resulting in embryos that do not develop or implant. Mistakes in early cell division, chromosomes, and development become common. With an aging egg, pregnancy rates are lower and miscarriage risk higher.

Finding that healthy egg can be a problem. For a twenty year old, roughly 1 in 3 of her eggs will be healthy. For a woman over forty, less than 1 in 20. This continues to be a real and ongoing challenge for our patients.

One way to work around this problem is to increase the number of eggs. Starting with more eggs gives a better chance of finding at least one that is healthy. Once we have a batch of eggs, the problem emerges of trying to choose the best out of the group. Which egg is most likely to achieve pregnancy?

R**esearch of early egg and embryo development**:

We are excited to share that we are currently working with a privately held medical technology company, along with several other centers in the Bay Area, on a new investigational imaging device in the early stages of development. We can now observe, using a video microscope, the early stages of embryo development.

Knowledge of the way an embryo develops, the early cell division, when and how, promises to improve selection of embryos. Over a several year period at Stanford Institute for Stem Cell Biology & Regenerative Medicine, Dr. Renee Pera, in collaboration with Stanford colleagues, Dr. Barry Behr (Associate Professor and IVF Lab Director), Dr. Thomas Baer (Executive Director of the Stanford Photonics Research Center), and post-doctoral fellows Dr. Connie Wong and Dr. Kevin Loewke, conducted ground-breaking research into early human embryo development. Looking at embryos in their first few days of development, the team identified an elegant set of imaging parameters by day 2 that accurately identified embryos that develop to the blastocyst stage.

Through the use of precision imaging technology coupled with novel measurements, embryologists may be able to choose the best embryos more accurately and consistently. Published last year in Nature Biotechnology, Time magazine named the discovery one of the 10 medical breakthroughs of 2010.

Dr. Renee Reijo Pera, Ph.D.

Dr. Renee Reijo Pera, a leader of the team that published this study, understands these problems, working with them in a research lab for the last twenty years. She is now bringing that knowledge to clinical medicine.

Dr. Pera received her PhD from Cornell University, and later worked in David Page’s lab at the Whitehead Institute. While working with Dr. Page, she discovered a gene on the Y chromosome that was involved in male fertility called the DAZ (Deleted in AZospermia) gene. As it turns out, the gene accounts for a significant proportion of male infertility and tests for this gene are now routine for men with low sperm counts.

Now, as Director of Stanford University’s Center for Human Embryonic Stem Cell Research and Education, Dr. Pera’s focus is on understanding issues related to human reproductive failure. The questions she and her team are addressing encompass issues such as Egg formation and development, as well as what triggers cell division and formation of a healthy embryo.

Fertility care will change based on Dr. Pera’s research on early development of eggs and embryos. This work has vast implications for the future of treatment and prevention of infertility. In her exploration, she is finding new ways of thinking about old fertility problems. Dr. Pera’s work will strongly influence medicine and clinical realm for years to come.

At Pacific Fertility Center we are committed to bringing advanced science to the clinic. We are finding major changes in our understanding of early egg and embryo development and anticipate continuing to lead the way in bringing these advances to help our patients have one healthy baby at a time.

-Philip Chenette, M.D.

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