Hormone that support early pregnancy

Scientists have discovered a fertility hormone that prepares the womb's lining for pregnancy. The discovery made by testing tissue from women aged in their forties could help scientists develop ways to improve fertility. Each month, as part of the menstrual cycle, hormones send chemical signals to cells in the womb lining to create conditions to support pregnancy.

Fertilised eggs are extremely sensitive to changes in the womb lining, but the exact environment needed for healthy implantation is unknown. The hormone helps prime cells for implantation, a vital stage in early pregnancy when a fertilised egg attaches to the womb lining. Researchers at the University of Edinburgh tested the effects of a hormone known as DHEA on healthy tissue donated by women undergoing unrelated surgery.

 DHEA may boost pregnancy, rates in women trying to conceive naturally or through IVF. They found that treating womb lining cells with DHEA in a dish doubled the level of key proteins associated with healthy implantation in the tissue. DHEA treatment also increased the production of active androgens hormones found in high levels in men.

The study also suggests that levels of DHEA-which are known to decline significantly with age could play a role in infertility in later life. A fertilised egg will implant only if the conditions are just right and DHEA and androgens might improve this environment in cells.
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Mediterranean diet may increase the success rate of IVF

New research has found that women who follow a "Mediterranean" diet in the six months before assisted reproductive treatment have a significantly better chance of becoming pregnant and giving birth to a live baby than women who did not.

Researchers asked women about their diet before in vitro fertilisation (IVF) treatment and found that those who ate more fresh vegetables, fruit, whole grains, legumes, fish and olive oil, and less red meat, had a 65-68% greater likelihood of achieving a successful pregnancy and birth compared to women with the lowest adherence to the Mediterranean-style diet.

Researchers assessed the diet of different women through a food frequency questionnaire when they enrolled at an Assisted Conception Unity in Athens, Greece, for their first IVF treatment. The questionnaire asked them about how often they ate certain groups of food in the preceding six months; the results gave the women a MedDiet Score, which ranged from 0-55 with higher scores indicating greater adherence to the Mediterranean diet. The women were aged between 22-41 and were non-obese (body mass index of less than 30 kg/m 2 ).

Researchers, led by Associate Professor Nikos Yiannakouris at the Department of Nutrition and Dietetics at Harokopio University of Athens, divided the women into three groups depending on their MedDiet Score: the first group had scores between 18 to 30, the second scored between 31-35 and the third group scored between 36 to 47.

They found that compared to the 86 women in the highest scoring group, the 79 women in the lowest scoring group had significantly lower rates of pregnancies (29% versus 50%) and live births (26.6% versus 48.8%). When the researchers looked at women younger than 35 years old, they found that every five-point improvement in the MedDiet Score was linked with an approximately 2.7 times higher likelihood of achieving a successful pregnancy and live birth.

Overall, 229 women (93.9%) had at least one embryo transferred to their wombs; 138 (56%) had a successful implantation; 104 (42.6%) achieved a clinical pregnancy (one that can be confirmed by ultrasound); and 99 (40.5%) gave birth to a live baby. Women attempting fertility should be encouraged to eat a healthy diet, such as the Mediterranean diet, because greater adherence to this healthy dietary pattern may increase the chances of successful pregnancy and delivering healthy baby.

Adherence to the Mediterranean diet may also help improve semen quality. Taken together, these findings highlight the importance of dietary influences and diet quality on fertility, and support a favourable role for the Mediterranean diet on assisted reproduction performance. The researchers did not find any association between diet and the chances of successful pregnancies and live births among women aged 35 and older. However, they believe this is because hormonal changes, fewer available eggs and other changes that women experience as they get older could mask the influences of environmental factors such as diet.
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Causes of infertility in older women

Female fertility declines rapidly after the age of 37 -- with women over 42 having only a five per cent chance of having a baby without fertility treatment.

As a woman ages, her eggs also age, this increase the chances of chromosomal abnormalities. This leads to an increase in conditions such as Down's syndrome, where the egg has three copies of chromosome 21.

A woman in her 20s has only a 12-15 per cent chance of having a miscarriage each time she becomes pregnant. On the other hand, a woman in her 40s faces on average a 50 per cent risk of miscarriage.

However most chromosomal abnormalities in eggs lead to embryos that either fail to implant in the womb, or miscarry soon after implantation. In women over 40 most miscarriages are caused by the wrong number of chromosomes being present in the egg.

In the final stages of egg development just before ovulation, it undergoes two specialised cell divisions known as meiosis I and meiosis II. Securin is important for both divisions but in old eggs, it appears that there is insufficient securin remaining to ensure meiosis II takes place normally.

The discovery opens the way to improving an older woman's chances of having eggs with fewer chromosomal abnormalities through regulating the processes that control securin levels in the two divisions of the egg or controlling the protein that securin regulates.

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