A Canadian doctor may have found a natural way to extend women’s fertility
Dr Robert Casper, gynaecologist, reproductive endocrinologist and Toronto-based fertility guru, is telling me a bunch of stuff I really don’t want to hear.
‘The ageing female reproductive system is like a forgotten flashlight on the top shelf of a closet,’ he says in his flat, matter-of-fact Canadian bedside voice; a voice, incidentally, that reminds me of my father’s. ‘When you stumble across it a few years later and try to switch it on, it won’t work, not because there’s anything wrong with the flashlight but because the batteries inside it have died.’
The ‘batteries’ he’s referring to in his miserable metaphor (I understand the need to make a scientific point, but is it really necessary to evoke the image of lonely death in the dark?) are a woman’s eggs, or ‘O-sites’ as they are called in medical reproductive lingo. His point, of course, is a well-known fact of life: that women are born with all the eggs we’ll ever have and that as we age, they age, making having babies after 40 very difficult, and in the majority of cases, impossible.
Casper assures me that at 35 I’m ‘still young’, though tellingly, he doesn’t add the caveat I’ve become accustomed to hearing (and increasingly comforted by) until now: ‘You’ve got lots of time.’ But given that he may well have figured out a way to provide me with more time — a miraculously simple and viable method of turning back the female biological clock — I’m willing to listen to anything he says.
The issue of egg viability is the single biggest hurdle facing the burgeoning contemporary fertility industry. As you may have noticed, in the past half-century or so, female life expectancy, political influence and buying power has increased in leaps and bounds. As a natural consequence, an increasing number of women are opting to put off having children in favour of, you know, making lots of money and generally taking over the world. And yet those little cells hidden deep in our ovaries have remained stubbornly backward about the whole project of female empowerment. Irritatingly, my eggs are not interested in reading Jeanette Winterson’s new memoir, infiltrating the Garrick Club or exercising their right to vote. Nope, they just sit around painting their toenails and hoping for a sperm to call. They’re not even picky about which sperm, any old deadbeat gamete will do. Girls! I’ve told them, blowing my whistle like a lesbian gym coach. Get off your sorry arses and improve yourselves! But for some reason they won’t listen to a word I say.
Anyway, it’s a conundrum for the ages, and one that’s inspired an entire generation of educated, career-oriented, urban women in their thirties to spend countless evenings at overpriced cocktail bars howling pointlessly at the sexist injustice of it all. (How come my ex can date models, while I have to go online and find a nice, solvent bald bloke to marry? Not fair!) As we said in college, it’s a harsh toke, dude, but it’s also reality.
Dr Casper plans to change all this. He and his team of University of Toronto researchers have recently come up with a groundbreaking treatment that may prove the solution to the problem of forty-something female egg viability. Its name is Co-enzyme Q10. And guess what ladies? It’s available over the counter at your local health food store.
At a conference on reproductive medicine in Toronto in September, Dr Casper unveiled the results of his study, which found that injecting retired female breeder rats (the equivalent of 40- to 45-year-old human females) with CoQ10 resulted in improved egg quality, viability and quantity — how many eggs develop in the ovaries and are released each month. Most crucially, the offspring produced by the older, CoQ10-injected rats were just as plentiful and genetically normal as those litters born to rats still in their natural reproductive prime.
The reason Dr Casper is hopeful CoQ10 treatment will work on humans is because it’s one of the vitamins that exists naturally in our body and fuels mitochondria, the spark plug and life force of all our body’s cells. Fertility declines, he explains, because after 25 or 30 our bodies begin to make less CoQ10, which in turn, depletes the function of mitochondria. ‘It’s a natural part of ageing,’ he explains, ‘and eventually a natural part of death.’
The idea to try CoQ10, a supplement that’s long been anecdotally associated with heart health and anti-ageing lotions, came to Casper after years of working with stem cell cord blood in an effort to ‘essentially put new mitochondria into the old eggs’. This course of research was abandoned after metabolic problems arose in embryos conceived with essentially ‘two sets of mitochondria’. A creepy thought.
Admittedly the idea of injecting one woman’s embryo with another’s stem cells feels slightly Frankenstein-ish, but by the same token, the notion of simply turning back the biological clock by taking a vitamin seems too good to be true. And yet, if CoQ10 does for human females what it does for rats, it makes perfect sense. Fertility declines because in her late thirties and forties, a woman’s mitochondria slows down and, as a consequence, her eggs develop mutations. These abnormalities lead to much higher rates of Down Syndrome and miscarriage. CoQ10 has been proven to improve both mitochondrial and reproductive function in older female rats — now the only thing left to do is to test it on us.
But this is proving more difficult than it sounds. While Dr Casper has hospital approval for a clinical trial and runs a fertility clinic in Toronto that gives him plenty of access to desperate, baby-mad women nearing the end of their fertile days, he has so far been unable to convince a critical mass of patients to participate — and for good reason. ‘At this stage, people don’t want to waste time. And one of the problems with the study is that is has to be randomised, so you’ll either be put on the CoQ10 or the placebo. Most women feel, why take the risk?’ The average female patient in his clinic is 38, up from 33 five years ago. Over half the women he treats are over 40. In most cases, he says he simply advises women to take a dose of 1200mg of CoQ10 a day and proceed with treatment. And the anecdotal evidence is heartening. His clinic’s IVF success rate for women over forty is currently 25 per cent, up from 10 per cent three years ago. ‘The technology has also improved so it’s hard to isolate,’ he concedes, ‘and the men are taking CoQ10 too, since it may have an impact on sperm production as well.’ Even with CoQ10, it would seem the odds of conception after 40 still aren’t great, but they’re better than those without.
Until recently, women who hoped to put off having biological children until middle age were faced with an unpleasant choice: freeze your eggs or take your chances. Every few weeks, it seems, one glossy magazine or another runs a story written by a jittery thirty-something Mary Tyler Moore-type who paid some fertility specialist to pump her full of hormones, extract her ovums, fertilise and freeze her sperm-bank-fathered embryos so she can relax — ahhh! — safe in the knowledge that her babies are cryogenically frozen in a platinum-plated vault in Beverly Hills until she carves out a window in her diary to give birth.
But common as this story is, for most women it’s largely a moot point. Not just because of expense (it costs several thousand pounds) and risks (it involves surgery) but because, as Dr Casper points out, ‘There’s a very narrow window for freezing your eggs. Before 35 is ideal, but there’s still a fair amount of time so why would you want to? And yet you don’t want to be 39 or 40 when you first start trying. So 35 to 38 is really the ideal window.’
In other words, the window I happen to be staring out of right now. Be this as it may, I have a much deeper fear than ending up as a dead flashlight on a shelf, and that’s ending up as a woman who writes wisecracking, first-person, panic-concealing magazine features about freezing her eggs. I might be a bad feminist for saying so, but it just seems undignified. That I refuse to debase myself in the face of nature’s cruelty may well come back to haunt me. But in the meantime, I’m sanguine enough to leave my biological future in the hands of fate — and, of course, Dr Casper himself. Now excuse me while I slip off to the health food store. Doctor’s orders.