Bridging the gap of research and clinic to improve fertility treatments
In clinical practice, doctors often face patient problems without clear solutions. Dr. Malene Hviid Saxtorph is one of these doctors. Each year, thousands of blastocysts, early-stage embryos, are transferred into the uterus, yet many fail to implant, and it remains unknown why.
“When repeated embryo transfers don’t lead to pregnancy, you start to wonder – could something in the uterus, like the microbiota or other unknown aspects, be affecting implantation?,” she explains. Motivated by the need for answers, Malene returned to research again. She now graduated from BRIDGE – a translational research programme designed to bridge the gap between research and medical treatment.
How her academic journey continued
Malene’s journey took shape when Clinical Professor Henriette Svarre Nielsen, an expert in recurrent pregnancy loss, connected her with Principal Investigators Joshua Brickman and Jan Żylicz from the Novo Nordisk Foundation Center for Stem Cell Medicine, reNEW. “It felt like the perfect match,” says Dr. Hviid Saxtorph.
As part of her BRIDGE project, Malene provided the research team with real human blastocysts to benchmark against the developed embryo like models, know as blastoids. These models mimic early-stage human embryos but cannot develop into a fetus. They allow researchers to study how embryos interact with their environment, especially the culture media – the nutrient-rich solution used to culture embryos during fertility treatment – used in IVF (in vitro fertilization).
“The IVF media we use today is optimized for mouse embryos,” Malene explains, “but human embryos are different and this could be part of the reason why some high-quality embryos fail to implant in the uterus.”
Hviid Saxtorph is currently testing a novel media in the clinic using human embryos with the aim to improve IVF culture for human embryos. ‘‘It’s been challenging to get ethical committees on board,’’ she admits. ‘‘People hear ’embryo-like models’ and think of cloning. But these models are tools that help us understand. They have so many limitations—they can’t be compared to the real thing.”
In parrallel, Hviid Saxtorph is also recruiting women donating endometrial biopsies to culture cells from the lining of the womb—the endometrium—to recreate the uterine environment embryos encounter during implantation. This allows her, together with the research team, to test whether embryo-like models grown in improved media indeed do attach more effectively, which would be a promising step forward in infertility research.
Even a small improvement, like a 5–10% increase in implantation rate, could have significant societal impact. ‘‘In Denmark, we do around 40,000 IVF cycles a year. Improving outcomes means reducing emotional stress and heartbreak of failed treatments as well as financial costs,” says Malene.
Bringing two worlds together
Returning to academia brought a different pace. ‘‘Unlike in the clinic, basic research takes much longer to get results,’’ she explains. ‘‘but it’s been incredibly invaluble. I’ve seen the dedication and passion driving basic science. This has really been a great inspiration to me.’’
While scientists often focus on a very particular area, Malene has a broader perspective. ‘‘As a doctor, I know a little about many things, but after my time at reNEW and working close with basic scientist I understand why it’s important to know a disease at the molecular level in order to develop effective treatments. I’m thankful for this opportunity, as it’s gvien me a whole new perspective,’’ she says.
The exchange goes both ways. ‘‘I see patients daily. I see their challenges, what they know – or don’t know. Researchers have a responsibility to make their work accessible and relevant,” she states. ‘‘That’s why BRIDGE is so valuable. We can bridge the gap between academia and the clinic.’’
Next steps: an embryo biobank
As a result of her research, Malene is now leading the development of a biobank of surpulus embryos donated from fertility treatments. With full consent, these embryos (otherwise discarded), can be stored and used in future research.
“Many patients want to donate their surplus embryos. They know how tough IVF can be, and they want to help others, just as others once helped them by donating their embryos in the past.”
By making embryos more accessible to researchers, Malene hopes to accelerate discoveries in reproductive medicine and improve fertility treatments.