In order to reach the miracle of life, several actors interplay. Sometimes, when everything is not going smoothly, the advancement of medicine can be beneficial.
The thematic of Human Reproduction encompasses all the actors involved in research on female and male fertility at different levels.
The different research fields involved are:
- Preserving fertility before anti-cancer treatment for men and women
- Fertility restoration after cancer treatment in men and women
- Hormonal disorders disturbing ovulation
- Endometriosis
- Fibroids
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This research involves collaborations between research groups in gynecology, andrology and endocrinology.
Ovarian tissue freezing
Chemo and / or radiotherapeutic treatments may cause early ovarian failure and irreversible loss of fertility. Our goal is to offer young patients the best option to preserve their fertility according to their age, type of cancer and treatment. For prepuberal patients and those needing to start chemotherapy without delay, ovarian tissue freezing is the only option to preserve their fertility.
Two lines of research are developed at the gynecology laboratory:
1) For patients who can safely benefit from a re-implantation of their ovarian tissue, we study the survival of ovarian follicles within the graft. In this goal, we prepare a graft with adipose stem cells differentiating into vessels (neovascularization) providing so the necessary oxygen necessary for the follicles after transplantation.
2) For patients susceptible to have malignant cells in their ovaries (e.g. in case of leukemia), transplantation of frozen ovarian tissue is not recommended. To restore their fertility, we develop a transplantable artificial ovary. Our goal is to mimic the natural ovary by placing the patient's isolated ovarian follicles in a matrix that will support the growth of the follicles after transplantation.
Freezing testicular tissue
The chemo and / or radiotherapeutic treatments have well known deleterious effects on the testicles. For boys, since spermatogenesis has not yet started, freezing immature testicular tissue containing stem spermatogonia is currently the only strategy to avoid their sterility. This is available in clinic. Then, different approaches, studied by the andrology research group, are theoretically possible for obtaining spermatozoa from frozen immature testicular tissue:
- Transplantation of the tissue to the patient
- Transplantation of a purified cell suspension into stem spermatogonia
- In vitro culture of spermatogonia to obtain cell maturation.
Endocrinology
Clinical studies (collaboration between the department of endocrinology, nutrition and gynecology) aim to determine on one hand the frequency of hyperprolactinemia when a hormonal assessment is performed before assisted procreation and on the other hand the potential influence of this hyperprolactinemia on the success rate of in vitro fertilization.
Endometriosis
Nodular deep endometriosis is a complex and frequent pathology (7-10% of women of childbearing age). Clinical experience reports symptoms of severe pain (especially during menstruation and during sex). Presently, the origin and progression of deep endometriosis lesions have not yet been elucidated. We study the invasive process of this disease and its progression. This answer may help to find new drugs to reduce the pain of patients and so improve their quality of life.
Uterine fibroids
Uterine fibroids are very common benign tumor masses causing many symptoms such as bleeding, pain, and infertility. Until recently, their treatment was mainly surgical. Fibroids develop in the uterus under the control of sexual hormones (estrogen and progesterone). New drugs that specifically act on progesterone receptors such as ulipristal acetate (Esmya庐) can treat these tumors. The laboratory of gynecology tries to elucidate the mechanisms of action of ulipristal acetate on the decrease of fibroids.
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