MEDVIA member Lavima Fertility has developed a new IVF technique to mature eggs in vitro, rendering burdensome hormone injections obsolete for women undergoing IVF or freezing their eggs after a cancer diagnosis.

31 July 2024

Infertility is an immense issue – one in six couples struggles to conceive, according to the World Health Organization. “Every family or circle of friends usually includes a couple that has struggled to get pregnant,” says Elien Van Hecke, co-founder and CCO of Lavima Fertility. “Many keep these struggles to themselves, suffering in silence, which makes this very common problem seem less prominent than it actually is.”

This isn’t only an issue for individual families, but for society at large. In many regions of the world, infertility rates are on the rise, exacerbated by factors such as obesity, environmental pollutants and choosing to have children later in life. “This is becoming a serious societal concern in countries already struggling with low birth rates and aging populations, including Asian countries like Japan and much of Western Europe,” Van Hecke emphasizes.

The onus of hormone injections

When couples struggle to conceive, they often turn to assisted reproductive methods such as In Vitro Fertilization (IVF). This is a relatively new technique: The world’s first baby to be conceived by IVF – Louise Brown – was born in 1978. With IVF, eggs are removed from a woman’s ovary, fertilized in a petri dish, and then the resulting embryo is transferred back into her uterus. Van Hecke: “The most common technique is to inject a single sperm directly into the egg – a method developed at UZ Brussel.”

The IVF process usually starts with 10-12 days of hormone injections to mature the eggs. Normally, a woman’s hormones lead to the maturation of a single egg per month, which is either fertilized or shed during menstruation. During IVF, hormone injections instead result in the maturation of some 10-20 eggs, which are then extracted by a doctor using a needle.

“These hormone injections are painful and burdensome,” Van Hecke explains. “They need to be administered daily, with the syringes containing the hormones kept cold in between injections, and the woman needs to have a check-up every few days throughout the process.”

The overload of hormones often leads to symptoms such as headaches, pain and abdominal bloating. The bloating happens because a mature egg follicle can grow up to one centimeter in diameter, which ordinarily isn’t an issue for a single mature egg but becomes a lot more troublesome when 10 or more eggs are matured simultaneously.

“For most women this is an uncomfortable but not dangerous. However, some women suffer an overreaction to the hormones requiring acute medical care and have to be admitted to a hospital ICU.”

What’s more: IVF generally isn’t initiated until a couple has spent several years trying to conceive, meaning that the physical toll of these hormone injections is usually exacerbated by the emotional strain of wanting desperately to have a child.

Eliminating injections with a new technology

Happily, VUB spin-off Lavima Fertility has developed a solution that eliminates the need for hormone injections for the many women undergoing IVF. Based on breakthroughs at the VUB and UZ Brussels – world renowned for their fertility research – the company has created a method of maturing eggs in vitro.

“Our technology CAPA-IVM allows us to extract immature eggs and mature them in a petri dish, bypassing the need for painful hormone injections,” Van Hecke shares.

CAPA-IVM – which stands for Capacitation-In Vitro Maturation – seems like the obvious alternative to hormone injections. So why hasn’t it been possible until now? “People tried,” says Van Hecke. “Back when IVF was first developed, IVM was trialed, but most of the eggs failed to mature properly. So clinicians decided to make hormone injections the standard practice.”

A two-step process

As it turns out, the frustrating results of early IVM came down to a lack of knowledge about the basic science of egg maturation. “Thanks to the academic research at VUB, we now know those early failures are because the egg maturation process in a woman’s body happens in two distinct stages,” Van Hecke elaborates. “Eggs consist of a nucleus and cytoplasm, and these different elements mature in two separate phases. In a woman’s body, that happens naturally, but when maturing an egg in vitro, you need to find a way to put the nucleus development ‘on hold’ while the cytoplasm matures.”

Lavima Fertility achieves this two-step maturation by submerging in vitro eggs in a medium containing a small peptide called CNP (C-type natriuretic peptide). This blocks meiosis and gives the cytoplasm the time it needs to mature.

After 30 hours, a different medium is used containing a protein called amphiregulin and a Follicle-Stimulating Hormone (FSH), which then also matures the nucleus. “We’re glad our IVM technology can help women around the world avoid a difficult – and now unnecessary – ordeal.”

A life-changing option for women with cancer

In addition to helping women undergoing IVF, Lavima Fertility’s technology can be used for women wanting to freeze their eggs. More women than ever are opting to have their eggs extracted and stored this way. “Many choose to do so for personal reasons, like prioritizing a career or not having found the right partner,” Van Hecke says. “But there are also a lot of women who have their eggs stored for medical reasons, such as cancer.”

Lavima Fertility’s technology has the potential to be particularly impactful for these women. When diagnosed with cancer, women of childbearing age are often given the choice of undergoing an emergency egg extraction. This is because cancer treatments like chemotherapy and radiation therapy usually destroy a woman’s eggs, dramatically decreasing her chances of eventual conception.

But spending several weeks on hormone injections for egg extraction can be dangerous. “It means delaying cancer treatment, giving the cancer a longer time to grow and spread,” Van Hecke cautions. “Additionally, there are certain types of cancers where the women can’t undergo the hormone injections at all, because the hormones involved in egg maturation would worsen the cancer.”

CAPA-IVM presents a dramatic improvement, as women can have plenty of immature eggs extracted and safely frozen away for eventual IVF immediately after their cancer diagnosis.

A new generation of IVF babies

Lavima Fertility has been working with fertility clinics for several years and is now in the process of gathering the data required for regulatory approval with the FDA and EU CE marking. “We hope to achieve this within the next few years,” says Van Hecke.

Meanwhile, there have already been over 800 babies born using the company’s CAPA-IVM technology. “The oldest children born using our method are now happy, healthy kids around the age of five,” Van Hecke says with a smile. “It gives us great hope for the future.”

By Amy LeBlanc