Local researchers in fertility breakthrough

MELBOURNE researchers have discovered a way to protect the fertility of women who undergo cancer treatment or suffer from early menopause.

The findings, published in the journal Molecular Cell  today  could pave the way for a course of injections or tablets able to protect women's fertility within a decade.

"This is a fundamental change in the way we can now think about infertility and menopause," said Clare Scott, who heads the ovarian research laboratory at the Walter and Eliza Hall Institute in Parkville.

Working with colleagues from Monash University and Prince Henry's Institute in Clayton, Professor Scott was among a team of eight researchers who identified two key proteins which when blocked can help recover fertility following chemotherapy or radiotherapy. The proteins, known as PUMA and NOXA, trigger death in damaged cells in the ovaries.

Researchers established a way to prevent the proteins reaching the damaged cells, thereby keeping the cells alive.

They were also able to show for the first time that the cells were able to repair the damage caused to their DNA by cancer treatment — and go on to produce healthy offspring.

"That's never been known," Professor Scott said. "We were amazed, we would never have predicted this."

The findings have broader implications for women's health because premature menopause, beginning before 40 years of age, can also bring with it other health problems such as osteoporosis and an increased risk of heart disease.

"If a woman becomes menopausal at age 42, she is really losing the benefits that estrogen provides," Professor Scott said.

Normal menopause occurs any time between age 47 and 52. Professor Scott said while she was not advocating pregnancy for women in their 40s, the breakthrough could also extend a woman's fertile years if she wanted to delay motherhood for other reasons. The discovery might also pave the way for boosting IVF success rates or extending the natural onset menopause into a woman's 60s.

The two proteins exist in nearly all cells of the body and are "the first responders" when there is cell injury or damage. Their job is to remove damaged cells.

But by intervening to block the PUMA protein about 15per cent of specialised egg cells were saved. While it might not sound like much, these egg cells are "the cream of the crop" and would be enough for normal fertility.
Professor Scott said if the second protein NOXA was also blocked, 90per cent of the cells were rescued and able to be repaired.

"For the first time we have been able to work out a mechanism for what causes infertility and it is death triggered by PUMA," she said. "But if you prevent that death by blocking PUMA then DNA repair can occur."