An epigenetic study opens the door to halting the transmission of diseases such as diabetes and obesity

• More than 1000 experts from as many as 54 countries are coming together at this flagship forum to address all-round patient care and achieving better pregnancy rates
• Uterus transplants are put forward as a relatively effective method of treating uterine factor infertility, following the birth of three babies since September 2014

ALICANTE, 24 APRIL 2015

The genetics of reproduction and regenerative medicine, as solutions to the transmission of diseases and to infertility, are two of the pivotal themes that experts in reproductive medicine from all over the world will be discussing at the 6th International IVI Congress which is taking place at the moment in Alicante.

“Assisted reproduction is not just a field of medicine that deals with achieving pregnancy in patients who cannot conceive naturally; it is also concerned with eradicating genetic diseases and other disorders that these cause, from repeated miscarriage to babies born with problems, some of which are more common than we think, such as diabetes or obesity,” emphasised Antonio Requena, Medical Director of Grupo IVI, during the press conference. “Regenerative medicine in assisted reproduction has also made giant leaps forward with the birth last September of the first baby following a uterus transplant. Since then we have seen three pregnancies carried to term and one that is still ongoing using this technique,” he added.

The maternal origins of adult diseases

A study entitled The maternal origins of adult disease. The womb may be more important than the home, carried out by Fundación IVI researcher Felip Vilella, will be presented at this Congress and will highlight how the endometrium is capable of secreting molecules that modify the embryo transcriptomically, giving rise to an epigenetic modification.

“These findings demonstrate that there is an exchange between the endometrium and the embryo, in which the endometrium can contribute new expressions or block others, an epigenetic modification that shows us the transmission process for diseases such as diabetes and obesity,” explained Dr Requena at the press conference introducing the Congress. “This research opens the door to being able to prevent these types of diseases when their cause is epigenetic. Knowing that such transmission exists, in the future we will be able to discover how to stop it, putting an end to the pattern of obese mothers having obese children,” he continued.

The epigenetic exchange revealed by Vilella’s research also occurs in pregnancies using donated ova, since it is a dialogue established by the maternal endometrium with the embryo at the implantation stage, regardless of the genetic origin of the embryo. “This is further proof that there is an exchange between mothers and their children in the uterus, irrespective of where the egg has come from,” concluded Requena regarding this study, which has won the Society for Reproductive Investigation’s Science Award.

Uterine transplant

Uterine factor infertility affects 200,000 women in Europe. The absence of a uterus from birth, the loss of the uterus following a hysterectomy or non-functionality of the uterus in reproductive terms are the causes of infertility in this case. A uterus transplant is a solution that is still in the experimental phase, but that has already shown positive results in terms of births.

Doctor Mats Brännström, who achieved the first birth in the world following a uterus transplant last year, appeared at the press conference representing the block of communications on regenerative medicine, and he highlighted “the importance of continuing research into this relatively effective method of putting an end to uterine factor infertility.”

“In 2013 we extracted nine uteri from live donors for transplant into eight women who had been born without a uterus and one woman whose uterus had been removed following cervical cancer,” explained Brännström. “Two of the patients experienced problems during the first few months and had hysterectomies. The other seven underwent embryo transfer, after presenting regular menstruation two months after transplant. The first birth took place in September 2014: a male baby who was born at week 31+5 due to a problem with maternal preeclampsia. Following that birth there were two more births without any maternal problems, and two miscarriages, and there is currently one other ongoing pregnancy. Implantation failure occurred in just one patient after four embryo transfers,” the doctor concluded.