About 15 percent of all reproductive couples have no children. An important reason why so many need assisted reproduction is that today more and more people are postponing to start a family.
“This is a global trend that is expected to increase in the coming years. Only in Europe, one million treatments of IVF are carried out every year; in Sweden, the corresponding number is 25,000,” says Yvonne Lundberg Giwercman, professor at the Lund University who directed the research. She has been investigating fertility in both men and women for many years.
FIV treatment involves stimulating women’s ovaries to mature many eggs, which then recover and fertilize sperm in the laboratory before being returned to the uterus. There are two different types of hormonal treatments to choose for the ripening of the egg: biological or synthetic. But the powerful hormonal therapy also involves the risk of severe side effects, sometimes they require women to enter intensive care, and many IVFR attempts fail. In Sweden, the government subsidizes up to three IVF cycles.
“There is excessive dependence on IVF treatments. About 75 percent of all attempts fail and up to 20 percent of women experience side effects, some serious enough to require emergency treatment. The choice of hormonal therapy is a factor that contributes, and an important challenge is that medical attention today has to guess what treatment is better for women,” says Ida Hjel. PHD, the University of Lund and the first author.
To find out who best responds to which hormonal treatment, researchers turned to genetics. The study included a total of 1,466 women under treatment with IVF at the Center for Reproductive Medicine at the Skåne University Hospital in Malmö, Sweden. Women with endometriosis or polycystic ovary syndrome (pcos) were excluded. Of the 1,466 women, 475 were randomized to two different hormonal treatments, while the rest were controls. A candidate gene that is involved in fertilization by mediating the action of the follicle stimulating hormone (FSH), which is known to play an important role in the ripening of eggs, was of particular interest and mapped by the sequencing of genes.
The study identified that women with a particular variant of the FSH (FSHR) receptor gene, which mediates the hormone’s action better responded to biological hormonal treatment, while others benefited from receiving the type of synthetic hormone. Knowing the genetic profile of women in advance, we can increase the number of successful pregnancies, says Yvonne Lundberg Giwercman.
“We see an increase in the number of pregnancies and a relative number of 38% more babies born among women who received hormonal therapy that coincided with their genetic variation compared to those who did not do it. This means that for every 1,000 women who undergo treatment with IVF, the equivalent of four more school classes was born: 110 more babies,” says Yvonne Lundberg Giwer.
But the gene mapping is expensive and takes time. That is why researchers have developed a simple oral swab test, which in an hour shows which hormonal therapy is more appropriate. The result can be seen with the naked eye as a pink or yellow coulour.
The researchers have requested a patent for the test, establish the company DX4Life AB and are supported by the process by Lu Innovation, Lu Ventures and the incubator SMILE in order to market the product.
“Our hope is that this reduces the risk of suffering for women, increase the number of successful treatments and reduce costs for taxpayers. Our goal is that the test is available at the beginning of 2026,” says Yvonne Lundberg Giwercman, who is also the CEO of the company that developed the Oral Swab test.