According to the World Health Organization (WHO), 1 in 6 adults worldwide experience infertility, or approximately 17.5% of the adult population.
This stark statistic underscores the impact fertility challenges have on countless lives around the world.
In this article, we study the history, current landscape, and future direction of fertility treatment, exploring the basic science and recent advances.
We’ll also get some insights from one of the leading experts in the field, Dr. Piraye Yurttas Beim, founder and CEO of Celmatix, a women’s health biotech company focused on ovarian biology.
What is fertility treatments?
Fertility treatments are medical procedures or interventions aimed at helping individuals or couples achieve pregnancy when they are experiencing difficulties conceiving naturally. These treatments can include various methods such as in vitro fertilization (IVF), fertility medications, surgical procedures, and assisted reproductive technologies to address infertility issues.
Fertility Treatment Advancements Over Decades
Once filled with uncertainty, fertility treatments have evolved significantly over the past decades. From the early days of in vitro fertilization (IVF) to the most recent breakthroughs, the field of reproductive medicine has evolved tremendously.
The invention of IVF offers a revolutionary leap for those facing infertility challenges. Louise Brown, the world’s first test-tube baby, was born in 1978, marking a historic moment in fertility research.
They recently unveiled an innovative program that not only aims to eliminate the need for follicle-stimulating hormone (FSH) injections during IVF and egg freezing, but also to treat male infertility. Also has the ability to change by increasing the number and performance.
What is IVF?
IVF stands for “In Vitro Fertilization.” It is a fertility treatment technique where an egg and sperm are combined outside the body in a laboratory dish, and once fertilized, the resulting embryo is implanted into the woman’s uterus to achieve pregnancy.
A brief history of IVF
Infertility is not a recent problem nor is it exclusive to humans. Several plant and animal species also have infertility problems. Over the centuries, different cultures have developed their own rituals, beliefs, and remedies to address infertility.
The concept of artificial insemination was known as early as 3500 BC, as evidenced by Vedic literature in India. During this period, traditions such as Niyoga pratha sometimes enabled people who did not have children with their spouse to conceive a child with another man or woman in a socially acceptable way.
Modern IVF (as well as modern birth control) got its breakthrough in the 1920s, when medical researchers identified the female fertility hormones estrogen and progesterone. Hormone supplements were developed in 1943. These fertility supplements and medications allowed doctors to increase the chances of pregnancy in patients, as well as the ability to control and time egg development and ovulation, which are the keys to IVF success.
IVF was first experimented with in mice and rabbits in the 1950s, and by the early 1970s researchers felt confident enough about the techniques to focus on replicating the IVF treatment process in humans.
At the same time, the idea of sperm preservation and banking emerged, which led to the development of cryopreservation techniques. This advance not only facilitated artificial insemination but also contributed to the development of the IVF procedure, where stored sperm can be thawed and used to fertilize eggs outside the human body.
During the middle of the 20th century, artificial insemination techniques set the stage for advances in IVF. Dr. Patrick Steptoe and Sir Robert Edwards emerged as the pioneers of IVF, with the birth of the first test-tube baby in 1978 marking an important milestone in the field.
Since that time, IVF has become relatively common to solve fertility problems. The procedure involves using hormone therapy to stimulate the ovaries to produce multiple eggs, which are then retrieved and fertilized with sperm in the laboratory.
Advancements in fertility treatments
Cryopreservation was an important development in fertility treatment to allow women to preserve their fertility for later stages of life. Oocyte cryopreservation, also known as egg freezing, involves removing and freezing unfertilized eggs from a woman’s ovaries.
This method can offer women the opportunity to delay pregnancy without worrying about the decline in egg quality associated with maternal age. It can also preserve eggs in ovarian cancer, when eggs can be destroyed by radiation therapy.
Cryopreserved eggs can be thawed and fertilized later through IVF.
Sperm cryopreservation is also used for fertility treatment. This includes freezing and storing sperm samples for later use. This process is especially beneficial for men who are facing problems like infertility due to medical treatment, surgery or other factors.
Intracytoplasmic sperm injection (ICSI)
ICSI represents another important advance in fertility treatment, especially in cases of male infertility. It involves the injection of a single sperm into an egg to assist in fertilization.
The technique has been used in the treatment of severe cases of male infertility, such as non-obstructive azoospermia (NOA), where there are no sperm in the semen.
Recent advances in ICSI include the use of artificial intelligence (AI) to assist in selecting the best sperm for injection, improving the chances of successful fertilization and healthy embryo development.
Stem cell therapy
The emergence of stem cell therapies is another new development in the fertility field. Stem cell therapies have the potential to repair damaged tissues and cells, offering new hope for treating infertility caused by various medical conditions.
Artificial intelligence (AI)
AI has introduced sophisticated algorithms that can help select embryos with a higher probability of successful implantation. This approach uses AI to make more accurate predictions and streamline processes, such as identifying sperm quickly and accurately in severely infertile men.
Cellmatics has successfully used AI in its drug discovery efforts, according to Dr. Beim, Celmatix. “Our pipeline of drugs is the result of leveraging data to highlight the most promising opportunities,” Dr. Beam said, citing AI’s key role in driving its oral gonadotropin program.
The burden on women
Despite advances in fertility treatments, it’s clear that fertility continues to be a significant burden on women. Cultural norms and social pressures often equate womanhood with motherhood, which exacerbates the emotional toll experienced by infertility.
Even today, when many people argue about the need to slow down population growth, many women still expect to have children.
Dr. Beim addresses this problem by explaining that studying infertility involves extensive treatment protocols. “This increases the cost of drug development through lengthy clinical trials and also the timeline of live birth outcomes for those experiencing infertility,” he noted.
It further highlights the considerable market potential to address male infertility. “We believe that many men would welcome the reduction of treatment burden on their partners.”
“Improving their sperm parameters may also have positive health effects and may be a by-product of the treatment, which is beneficial for women using IVF because of their partner’s infertility,” he explained.
The availability of an oral therapy that is safe and effective for treating male infertility caused by low sperm count may help change the burden of medical care, as well as hope.
A recent article in The Lancet Global Health highlights the prevalence of partner violence among infertile women in low- and middle-income countries, illustrating the complex relationship between reproductive health, social dynamics, and gender-based violence.
While advances in fertility treatments have opened up new possibilities for conceiving, it is important to address the underlying gender aspects that perpetuate unequal expectations and pressures.
This brings us to Celmatix and their recent announcement that may help ease the burden on women.
FSH is an important hormone that regulates the growth and development of ovarian follicles in women, which in turn lead to the release of mature eggs during ovulation. In men, FSH stimulates the production of sperm within the testes. In simple terms, FSHRs are detectors in the reproductive system that respond to the FSH hormone to help with reproduction.
As a result, FSH receptors (FSHR) play an important role in the reproductive system, responding to follicle-stimulating hormone (FSH). Manipulation of FSHRs can have a profound effect on fertility outcomes, making them an important target for fertility treatments.
Celmatix is working on the first oral FSHR agonist drug. This medication aims to stimulate FSHRs in a controlled manner and in doing so mimic the effects of the follicle-stimulating hormone FSH, which occurs naturally in the body.
Their program hopes to achieve two major goals: First, to eliminate the need for injections during ovarian stimulation for IVF and egg freezing. and reducing the need for IVF treatment by improving ovulation induction and addressing male infertility directly.
“Injectable fertility drugs impose burdens on patients and providers during IVF, in terms of consultation and financial costs. Celmatix’s oral drugs can significantly transform fertility treatments,” said Dr. Beim, addressing their goals.”
Explaining the advantages over traditional fertility drugs, Dr. Beim explained, “Women prefer injection-free treatment if safety is not compromised. Animal studies show that oral gonadotropins, such as FSH , may offer similar results and better safety due to a wider therapeutic window.”
Celmatix is aiming to start clinical studies by 2025. To that end, the company is working closely with contract research organizations (CROs) and academic partners to accelerate the FDA trials necessary for regulatory approval.
The future also looks promising for some other fertility treatments, as new avenues open up.
“The complexity and risks of current oral gonadotropin protocols call for specialized reproductive endocrinology expertise for IVF-related egg maturation. Safer oral medications with standardized protocols, reducing IVF dependency, allow for greater access to providers.” explained Dr. Beim.
Dr. Beim emphasized the need to shift the burden of infertility treatment from women alone in a more balanced way. “The availability of an orally active therapy that is safe and effective for the treatment of male infertility due to low sperm count will always change rather than put the onus on the female partner,” he explained. “
Considering these factors is very important for future research.
A study led by J.M.N Duffy from University College London emphasized the importance of prioritizing areas such as the impact of male reproductive health on fertility, finding preventive measures for age-related infertility, assisted reproduction improving techniques, and coping with the emotional toll of treatment failures.
Furthermore, ethical concerns regarding affordability and access to fertility treatment also warrant significant attention.
Additionally, scientists are actively developing techniques that help make the process easier for those involved, with ongoing research into safer oral fertility drugs, improved access to treatment, and fertility treatments throughout the world. The focus is on emotional well-being during the journey.