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Advances in oncofertility can help preserve the fertility of many cancer patients but women who receive cancer treatment to the pelvis, including radiation and surgery, may lose the ability to carry a child to term. A few weeks ago, we also discussed how radiation to the ovaries and uterus can increase a cancer survivor’s risk for stillbirth and neonatal death. In these cases, women who preserve their fertility through egg or embryo banking may need to use surrogacy.

There are two common types of surrogacy arrangements. In traditional surrogacy, an infertile couple finds a surrogate mother to be artificially inseminated with the husband’s sperm. In this case, the surrogate is also the biological mother of the child. Traditional surrogacy was popularized in the mid-1970s in the US and was the only available type of surrogacy until the advent of in vitro fertilization (IVF) in the 1980s. The development of IVF allowed women with healthy eggs to fertilize them in a laboratory and have them implanted in another woman, called a gestational surrogate, who will not be genetically related to the child. Cancer survivors who have preserved their fertility but are unable to carry a child to term can employ this type of surrogacy.

Going through pregnancy to give someone else a child is a generous act no matter what. Some women find friends or family members who are willing to carry their child without compensation. In addition, couples can also find women who are willing to be a surrogate or gestational carrier for a fee. In the US, costs for surrogacy are high and can easily run up to $70,000.

The high costs of surrogacy in the US led to the popularization of surrogacy tourism, where couples employ surrogates and gestational carriers in other countries. Surrogacy costs in India, which run around $25,000, are considerably less than the US. In fact, the Indian Council of Medical Research predicts that surrogacy in that country may soon make $6 billion each year.

The advent of surrogacy has raised many legal issues surrounding parenthood. Some court cases received much media attention and changed state laws. Since each state has its own laws about surrogacy, it can be quite complex for a couple to determine the laws of their individual state. This complexity has led to some surrogacy scams that take advantage of needy couples. The FERTLINE (866/708-3378) has experience helping couples find local resources that can explain the laws and practices in their states.

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Update: The National Fertility Law Center blog recently posted on health insurance for surrogates in Wisconsin.

Discovery about zinc’s role may help in future fertility treatments

By Marla Paul

CHICAGO — Scientists as well as fertility doctors have long tried to figure out what makes a good egg that will produce a healthy embryo. It’s a particularly critical question for fertility doctors deciding which eggs isolated from a woman will produce the best embryos and, ultimately, babies.

New research reveals healthy eggs need a tremendous amount of zinc to reach maturity and be ready for fertilization — a finding that may ultimately help physicians assess the best eggs for fertility treatment, according to a study from Northwestern University.

“Understanding zinc’s role may eventually help us measure the quality of an egg and lead to advances in fertility treatment,” said Alison Kim, a postdoctoral fellow in obstetrics and gynecology at Northwestern University Feinberg School of Medicine. “Currently we can’t predict which eggs isolated from a woman produce the best embryos and will result in a baby. Not all eggs are capable of becoming healthy embryos.“

There’s no link yet to zinc content in the egg and the nutritional status of women, but Kim plans to research that area.

Kim is the lead author of a paper that will be published in the September issue of the journal Nature Chemical Biology. The article will be featured on the cover. Co-senior authors are Tom O’Halloran, director of the Chemistry of Life Processes Institute at Northwestern and associate director of basic sciences at the Robert H. Lurie Comprehensive Cancer Center of Northwestern University, and Teresa Woodruff, the Thomas J. Watkins Professor of Obstetrics and Gynecology and executive director of the Institute for Women’s Health Research at Feinberg. Woodruff also is a member of the Lurie Cancer Center.

Northwestern scientists, working with mice, discovered the egg becomes ravenous for zinc and acquires a 50 percent increase in the metal in order to reach full maturity before becoming fertilized. The flood of zinc appears to flip a switch so the egg can progress through the final stages of meiosis. Meiosis is when the egg sheds all but one copy of its maternal chromosomes before it can be fertilized by a sperm and become an embryo.

“Zinc helps the egg exit from a holding pattern to its final critical stage of development,” said O’Halloran, the Charles E. and Emma H. Morrison Professor of Chemistry in the Weinberg College of Arts and Sciences at Northwestern. “It’s on the knife’s edge of becoming a new life form or becoming a cell that dies. It only has 24 hours. Zinc seems to be a key switch that helps control whether the egg moves forward in its development stage. “

Kim found there were approximately 60 billion zinc atoms in a mouse egg just before the egg was ready to be fertilized. She measured the zinc content of the eggs using a technique called synchrotron-based X-ray fluorescence microscopy through collaboration with the Advanced Photon Source at Argonne National Laboratory. This method allowed detection of multiple metals in single eggs using the characteristic X-ray signature of each element.

Dynamic Iron, Copper, and Zinc Distribution in Eggs and Early Embryos

Zinc levels were significantly higher in eggs than other important metals such as iron and copper. Zinc was the only metal to change significantly in concentration during the maturation process.

Northwestern scientists also used small molecules to block the accumulation of zinc by the maturing egg. They found an insufficient accumulation of zinc caused all the eggs to pause prematurely at the beginning stage of meiosis. The progression of meiosis was restored by returning zinc to the eggs.

Research on the role of zinc was funded by a W.M. Keck Foundation Medical Research Award, the Center for Reproductive Science through the NIH/National Institute of Child Health and Human Development and the Chemistry of Life Processes Institute at Northwestern University through NIH/National Institute of General Medicine. Use of the Advanced Photon Source at Argonne National Laboratory was supported by the Office of Basic Energy Sciences in the Office of Science of the U.S. Department of Energy.

Marla Paul is the Senior Health Sciences Editor at Northwestern University. Contact her at marla-paul@northwestern.edu

The H Foundation is a non-profit organization that raises money to further the fight against cancer. According to Director Julie Jandris, the foundation was started when two Chicago-based entrepreneurs both had “employees pass away from cancer within one month of each other.” A group of community leaders then decided to “celebrate the loved ones who have passed away from cancer,” by hosting a party to raise money for cancer research, says Jandris. But this wasn’t going to be a stuffy, formal fundraising event. Instead the group decided to hold a Caribbean-themed party inspired by a cocktail called the Goombay Smash and call it the Goombay Bash.

That first party was so successful that the Goombay Bash became an annual event. This weekend is the tenth anniversary of the Goombay Bash, which is held at Navy Pier in Chicago, IL. To keep with the fun theme, the Bash includes an outdoor band, fireworks, and live auction in the Grand Ballroom at Navy Pier. According to Jandris, the party will include “new touch pad technology for the auction so everything is really state of the art.”

The Bash will also highlight the work of Dr. Teresa Woodruff and the Oncofertility Consortium with a short movie. Years ago, the H Foundation gave a $20,000 grant for Dr. Woodruff to research new fertility options for cancer patients. The video is “an example of how our money gets parlayed and matched into larger grants,” such as the $21 million that Dr. Woodruff received from the NIH to establish the Oncofertility Consortium.

The fun event occurs from 5pm to midnight on Saturday, August 7 and standing room tickets are still available. Throughout all the festivities, participants can also appreciate the work that they are doing to raise money for cancer research. Jandris reminds up, “Cancer is such a personal disease that no matter who you are and what your background is it somehow affects you.”

The Oncofertility Saturday Academy is an educational program for young high school women to learn about the science behind cancer and fertility. After beginning in Chicago in 2007, educators at the Better Education for Women in Science and Engineering (BE WiSE) program started a San Diego-based Oncofertility Academy in 2008.

In San Diego, the Oncofertility Academy is a summer program works that works with high school girls to teach many facets of science including cancer and reproductive biology, clinical applications, and bioethics. These diverse subjects are then combined to incorporate the emerging field of oncofertility. The lead instructor of the program, Dr. Ericka Senegar-Mitchell, is also a full-time teacher at “a public school in San Diego and hosts an after school program called Science in the City,” says Patricia Winter, the founder of BE WiSE.

The young women in the program also perform experiments in scientific laboratories at research institutes across San Diego, including the lab of Oncofertility Consortium member Dr. Jeffrey Chang at the University of California San Diego, and Scripps Institution of Oceanography. According to Winter, “We wanted this to be a, hopefully, life-changing experience for the kids.”

The students in the 2010 Oncofertility Academy are comprised of 10^th, 11^th, and 12^th grades. Winter stressed, ““Our 12 girls are from 10 different schools so we have this very broad mix” of participants.  This year’s students will have their closing ceremonies on August 14^th, where they will present and defend posters about their summer activities. According to Winter, “Parents, teachers, board members, and donors,” participate in this event to celebrate the accomplishments of each young woman and encourage future learning in the sciences.