The University of New South Wales has successfully developed a cheaper and less invasive alternative to IVF treatments called CAPA in vitro maturation.
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The Royal Hospital for Women in Sydney now offers a less invasive and more affordable alternative to conventional reproductive treatments developed by experts at the University of New South Wales (UNSW).
IVF, often known as in vitro fertilization, has long been the standard treatment for infertility. This approach, however, is expensive, and it calls for patients to administer follicle-stimulating hormones (FSH), which can be quite uncomfortable and lead to some medical issues, in order to promote egg growth prior to extraction.
CAPA in vitro maturation (CAPA-IVM), a recently developed IVF alternative from UNSW, involves removing immature eggs from the ovaries and developing them outside the body, requiring fewer hormone injections and being less expensive. Prof. Robert Gilchrist of UNSW Medicine & Health in Sydney and Prof. Johan Smitz of Vrije Universiteit Brussel (VUB) in Brussels, Belgium, developed the technique.
“The IVM fertility technique originates from UNSW laboratory research, so this is a wonderful example of the lifecycle of research and the huge difference it can make in people’s lives,” said Gilchrist in a UNSW news release.
“It is proof that ‘bench-to-bedside’ research is alive and well in Australia,” he continued.
“I’ve worked for many years on this technique with my research partners, and having it translated into a fertility treatment offered to patients in Australia is very rewarding.”
How Do CAPA-IVM Treatments Work
The in vitro maturation method was not the suggested method of fertility treatment before to the discovery of CAPA-IVM because the pregnancy rates following IVM were lower than those after IVF.
“IVM has been around for years, but it’s never been very successful because it’s hard to replicate what the ovary does in a laboratory,” said UNSW Professor Bill Ledger from the Royal Hospital for Women.
“The problem has been when you take an egg out of the human body, it matures very quickly, even when it may not be ready to, but this new method called CAPA switches off the progression of the egg for 24 hours,” Ledger said. “So it grows more slowly, and it matures more healthily. And it’s more fertile when you introduce it to the sperm. It’s giving us a longer window of time to work with the egg.”
According to Prof. Gilchrist, the CAPA-IVM treatments consist of two phases that have been created to mimic the normal development and maturation of eggs that take place in the ovaries. Cumulin, a growth factor discovered by Gilchrist, and cAMP modulators, small signaling molecules that sustain normal egg processes, are added to the egg cells by CAPA-IVM to regulate egg maturation in cell cultures.
”We have demonstrated that it is possible to improve egg quality and embryo yield with next to no drugs, using potent growth factors produced by the egg,” Gilchrist said in the earlier UNSW release that circulated CAPA-IVM.
Preclinical trials on human eggs were started after the treatment’s effectiveness in improving egg quality and doubling embryo production compared to other IVM treatments were first tested on pigs. The preclinical tests were carried out by Prof. Smitz from the VUB’s Follicle Biology Laboratory in Brussels, and they produced 50% more embryos and had similar outcomes to the pig trials in terms of egg improving quality.
Future of CAPA-IVM
The CAPA-IVM procedure, according to Prof. Jeremy Thompson of the University of Adelaide’s Robinson Research Institute, represents a substantial development in the field of fertility research.
“It will remove the need for a woman to inject herself with high doses of hormones for up to 12 days,” Thompson said. “Most importantly, it could give a woman almost the same chance of becoming pregnant as with hormone-stimulated IVF.”
“A recent randomised trial in Vietnam found pregnancy rates were the same with CAPA-IVM as they are in regular IVF, although IVF patients had more embryos to freeze,” Gilchrist said.
IVM treatments, however, are not suitable for everybody. Only about 15% of infertile women are estimated to be eligible for CAPA-IVM.
Women with polycystic ovarian syndrome (PCOS) and those who need to act fast to preserve their fertility due to a diagnosis of cancer are the most suitable candidates for this treatment. According to Fertility Specialists of WA, the hormone injections used in IVF can promote cancer cells and lead to ovarian hyperstimulation syndrome, which causes swelling and pain in the ovaries in women with PCOS.
According to an earlier press release from Professor Michel De Vos at UZ Brussels, the new treatment would completely eliminate the risk of ovarian hyperstimulation syndrome.
“Young women facing cancer treatment, who wish to preserve their fertility but often don’t have time to freeze their eggs, will also benefit from this breakthrough,” Prof. De Vos said.
One of the first five locations to offer CAPA-IVM treatment will be The Royal Hospital for Women in 2021, according to the Therapeutic Goods Administration. Additionally, this is the first hospital in Australia to provide IVM treatments outside of Perth.
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