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The first two articles discussed how keys and locks work at the level of the ovary. This article will discuss newly discovered cellular pathways at the level of the ovary from a lock and key view.
The following study discusses follicular development: Notch signaling pathway in cumulus cells can be a novel marker to identify poor and normal responder IVF patients by Gamze Tanriverdi & Secnur Denir & Sule Ayla & Ayhan Bilir & Huseyin Oktar & Ismail Cepni & Tulay Irez. J Assist Reprod Genet (2013) 30:1319–1326
Let’s look at the science part first. Researchers monitored levels of two different cells: notch and cumulus cells in women undergoing IVF.
Notch cells are actively involved in cellular growth. They help other cells grow and function correctly. They are present everywhere in the body, even follicles.
Cumulus cells are found inside the follicle, coordinate follicular development and oocyte (egg) maturity including gene transcription inside the egg (ie: egg quality). The way cumulus cells signal to each other is by expanding. Bigger and fatter cumulus cells provide the best egg quality. When cumulus cells don’t expand correctly, it can indicate poor egg quality and potential for poor implantation.
It is currently not understood how notch and cumulus cells interact, but they rely on each other for proper follicular growth.
So how does this work with the car/engine scenario?
Let’s say Sally has lost her car key. Her car engine has nothing wrong with it. For Sally the best way to start the engine (ie: grow follicles) is to have a FSH key. When the FSH key interacts with the ignition lock, it can turn on the body’s ability to grow follicles. She produces many follicles and they are good quality.
Now, Joan has a different scenario, she has poorly functioning notch and cumulus cells. She lost her car key too, but unknown to her the car engine has dirty spark plugs. Her follicle engine is fine, just happens to be that the dirty spark plugs stop the gas from being ignited. Thus no running engine. Joan gets an FSH key, but the follicle engine still doesn’t turn on. No matter how much FSH she gets, the follicles will not respond until the spark plugs are cleaned. Her IVF cycle there are less follicles and egg quality is poor. She is given the poor responder diagnosis.
Going back to the research article, they used follicular fluid and cumulus cells removed from aspirated eggs from women trying to conceive with IVF. Women were divided into two groups – poor responders (less than 4 follicles retrieved) and normal. After reviewing the fluid/cells, it was found poor responders had low notch/cumulus cell count compared to “normal” women.
In simple words, poor responder group have a set of cellular signaling issues, compared to good responders. These cellular signals will not respond to FSH drugs. At this point, Western medicine does not have a drug to treat it.
The research article goes on to say:
“Currently, there is in increasing interest in signaling pathways that are important for developing oocytes. These signaling pathways and associated molecules are not yet well understood in the context.”
“Further studies on the communication between oocytes and cells are required in order to better understand the interaction between them. Such information may be beneficial for improving IVF outcomes.”
So this is my question: if cells are not functioning correctly due to signaling, is it ovarian failure when the drugs don’t treat it? If Western medicine could manipulate all cellular signaling would a women be given the “old ovaries” speech?
I believe it’s important for women and couples to understand that Western medicine doesn’t have all the answers. The car engine (ie: ovaries) are complicated and the mechanic (medicine) has a small group of tools. When the mechanic cannot fix the problem, your reproductive days are NOT OVER.
What I think is important, is to observe your own body and it’s signaling around the menstrual cycle. I believe cellular miss signaling is reflected in the natural rhythm of a women’s cycle. Acupuncture and Chinese herbs have a wonderful ability to treat, enhance the intricate reproductive messages, such as fertile cervical mucus, libido and painless cycles. Many women go on to have successful IVF after several months of treatment. The power of Chinese medicine, is to observe the individuality of the client and build the treatment to them. I don’t discount IVF – it’s a wonderful tool for couples. In fact I’m a firm believer in the best of both worlds can provide powerful results. Yet, when IVF fails, it’s not an indicator of never conceiving.
Please remember there are other choices to help with conception. Explore your options and see if an alternative could be your opportunity for conceiving.
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