Regeneration of fertility in ovarian dysfunction: clinical study of IVA (In Vitro Activation) and its development for organ culture of ovary

Abstract

Ovary is an organ which produces eggs as gonads. However, its ability declines with age due to decreases in ovarian follicles. The number of ovarian follicles is fixed at birth and do not increase during postnatal stages. In addition to aging, follicular numbers decline by some pathophysiological reasons. When the number of residual follicles reaches to 1,000, follicular development and subsequent ovulation is arrested, thus resulting in menopause. Although the most effective infertility treatment for these women is egg donation followed by in vitro fertilization and embryo transfer, majority of women desire to conceive using their own eggs. We developed a new infertility treatment (IVA, in vitro activation) to allow these women become pregnant by regenerate reproductive functions through in vitro ovarian cultures. We succeeded the first live birth in a patient with primary ovarian insufficiency after IVA in 2013 and IVA was successfully repeated in other countries under our guidances. In this lecture, I introduce the IVA and then suggest an ovarian prefusion culture to improve the IVA approach.