By age 35, women are warned by their doctors that aging can have detrimental effects on their ability to carry a healthy pregnancy.
For women who wish to have children but first want to build a reliable career to support a family, this creates tight deadlines, especially for those who wish to have more than one child and space them a few years apart. This means that many women face a conundrum.
A clinical study is underway to confirm that the compound rapamycin, already used for other medical purposes, can slow ovarian aging, resulting in longer fertility and other benefits.
Rapamycin Could Slow Ovarian Aging
Rapamycin is currently used in contexts such as preventing organ transplant rejection and coating cardiac stents, but has also been studied for slowing several age-related effects, according to The Lancet. A collection of studies so far has shown that the drug can slow some age-related deterioration in some body systems.
In animal studies, rapamycin has been shown to slow ovarian aging. With age, the supply of immature eggs that can mature and be released begins to dwindle more quickly; the quality of eggs can decline; and hormonal production becomes less steady and predictable. All these processes can make fertility decline and affect the outcome of a pregnancy.
Dr. Zev Williams of Columbia University is seeking evidence to confirm whether the drug can also provide this service in humans, and he was willing to answer some questions for Parenting Patch.
Decreasing Ovarian Aging In Numbers
How does one measure ovarian aging in a concrete way that allows us to understand how much difference rapamycin might make?
Initial data indicate that it could reduce aging by up to 20%, so we asked Dr. Williams what that would mean for a patient.
“Based on pre-clinical work, initial findings suggest that it is possible for rapamycin to decrease ovarian aging by 20%. While a woman typically loses around 50 eggs each month, weekly doses of rapamycin can slow this rate, leading the ovaries to release only 15 eggs a month. Further evaluation needs to be done and we are already planning a second study with a larger group of women.”
Note that IVF patients have as many eggs as possible harvested at once to increase the chance that one or some are viable, so decreasing the rate that immature eggs are lost can mean more are available to mature when follicle stimulation is done ahead of egg harvesting.
Extending Fertility Could Be A Significant Benefit To Women
Women who will be 35 before their due date may be shocked to learn that their pregnancy is labeled with “advanced maternal age.”
However, this is based on the way that ovaries age, the hormonal changes, and the other bodily changes that can, even that early, affect the outcome of a pregnancy. It unfortunately also means that a woman who waits a few more years to start a family may find that becoming pregnant is somewhat more difficult.
Dr. Williams is looking forward to a treatment that might make this easier.
“Fertility naturally declines as a woman’s ovarian reserve diminishes with age. Slowing this process could extend the window of natural fertility and improve outcomes for assisted reproductive technologies like IVF. This is particularly meaningful as more women are delaying childbearing for personal, educational, or professional reasons.”
Bonus: Slowing Ovarian Aging Could Delay Or Decrease Menopause Symptoms
When hormones begin to change, women start to experience symptoms of menopause, which go beyond mere loss of fertility. While it varies for every individual, this can include struggles with emotional fluctuations, hot flashes, and night sweats, among others.
Dr. Williams reported that using rapamycin to slow ovarian aging may help with these symptoms as well.
“This research also has the potential to fundamentally change the experience and timing of menopause. By delaying menopause, women could avoid or reduce the severity of symptoms like hot flashes, sleep disturbances, and mood changes, and decrease their risk of postmenopausal conditions like osteoporosis. This research opens the door to reimagining menopause not as an inevitable decline but as a phase that can be managed and perhaps delayed for better health outcomes. Our work at Columbia University Fertility Center is at the forefront of this transformative field.”
It Could Work Wonders For Women’s Health Overall
Hormones flood the body, setting off an array of effects, which explains why a hormonal shift can throw us so off-balance. In fact, when we asked whether this would be of interest to a woman who was not planning to have more children, Dr. Williams explained that even for women who are not seeking to extend their fertility, there may be potential benefits to a drug that can slow ovarian aging.
“Slowing ovarian aging has profound implications for women’s health beyond fertility. The ovaries are central to reproduction, but they also play a critical role in overall health, producing hormones that regulate numerous systems, including the heart, bones, and brain. The decline in ovarian function impacts many aspects of a woman’s health beyond fertility. Estrogen and other ovarian hormones protect against conditions like osteoporosis, heart disease, and cognitive decline. By preserving ovarian function for longer, we hope to delay the onset of these age-related conditions. This approach could redefine how we think about women’s health and aging, providing a new paradigm for preventive care. At Columbia University Fertility Center, we are committed to understanding how treatments like rapamycin can benefit women holistically, not just reproductively. If a woman is solely interested in fertility, we have more effective strategies we can use.”
What Should We Take From This Information?
The studies are still underway, so it’s not time to ask your doctor about using rapamycin to delay ovarian aging yet.
However, if Dr. Williams’ research is as successful as we hope, in the coming years, we could see this emerge in ways that significantly change fertility and women’s health.
The possibilities include slowing the rate at which the ovaries shed immature oocytes, thereby extending the fertility window and improving the health of the ovaries and oocytes. This means a greater likelihood of a healthy and successful pregnancy.
But that’s just a beginning. Further rapamycin trials could prove the drug’s ability to delay or decrease menopause symptoms, and to keep hormones balanced in a way that could have positive outcomes for women’s health overall.