First baby born from recharged egg arrives

Young cells used to rejuvenate poor-quality eggs

The baby, a boy named Zain, was born to 34-year-old Natasha Rajani of Toronto on April 13. The fact that he’s here makes a lot of medical experts nervous.

In what is being described as a milestone achievement in assisted-reproduction, Rajani is the first woman in the world to give birth after undergoing an experimental fertility treatment that recharges poor quality eggs using young, energy-producing cells taken from a woman’s own ovaries.

“We’re totally satisfied this is a safe procedure, but it’s always nice to see the first baby born, and see that it’s normal,” said Dr. Robert Casper, medical director of the Toronto Centre for Advanced Reproductive Technology, (TCART), where the procedure took place.

There are eight more pregnancies that, by ultrasound, “look perfect,” Casper said. The next baby is due in another week or so, he said.

The technique, known as Augment, involves rejuvenating a woman’s eggs using energy-producing cells harvested from tiny pieces of tissue taken from the outer edges of her ovaries.

It is aimed at women with poor quality eggs — including older women — who long to carry their own biological babies and who don’t want to use healthy eggs from a donor.

The Toronto clinic is one of only four fertility clinics in the world offering the procedure, which was developed by Massachusetts-based OvaScience. It has not been approved for use in the U.S.

The first “Augment baby” is being greeted with caution.

Some worry doctors are crossing the line into germ-line engineering — altering something that will be transmitted to future generations.

“It’s still highly experimental, and I worry that we’re treating it like some kind of miracle cure already when it hasn’t been tried enough in humans to merit that kind of description,” said Dr. Arthur Caplan, head of the division of medical ethics at New York University Langone Medical Centre.

“I think we should have had — and need — more discussion about who should do this and why they should do this,” Caplan said. “It should not just be a cash business resolution of some pretty thorny ethical questions.”

The experiments and baby’s birth — announced by OvaScience Thursday — are also happening outside the usual academic system of controlled medical studies, others say.

“I think it could be everything people are hoping it will be, it could be a breakthrough,” said Dr. Neal Mahutte, president of the Canadian Fertility and Andrology Society.

However, “In the absence of a properly designed, scientific trial, you’re not going to get the answer as to whether it adds value or not.”

The energy in eggs is produced by mitochondria, little power packs that weaken with age. The idea behind Augment is to increase the energy by adding younger mitochondria taken from stem cells in the lining of the ovaries that are precursors to eggs.

The mitochondrial preparation is injected, along with sperm, into eggs retrieved from the woman. The fertilized eggs are grown to the “blastocyst” stage — about five days after fertilization — and the resulting embryos transferred back to the woman’s uterus.

Embryos that reach the blastocyst stage have a far better chance of implanting and leading to a successful pregnancy.

Augment is pricey: it is being offered to women commercially for $23,500, on top of the cost of IVF, which runs about $8,000.

All pregnancies achieved so far by Casper’s group are in women under 40.

“We have a group of patients over 40 going through it at the moment,” he said. “But we really think the Augment procedure is probably going to be ideal for younger patients who have poorer embryo development.”