There is a lot of talk about Augment these days. I am being asked about it around once per week. Let's go over what this new cell science means.
Cells are full of stuff: a nucleus, mitochondria, endoplasmic reticulum, cytoplasm, and more. Mitochondria are the batteries of cells - they produce the energy the cell needs in order to grow, divide, and carry out various other functions.
As women age, the health of our cell's mitochondria declines. They output less energy and, as a result, cell health starts to fail. One measure of cell health is how well the cell separates its chromosomes. If an egg cell separates its chromosomes unequally, the resulting embryo will have an unbalanced number of chromosomes. An example of this is trisomy 21 or Down Syndrome, an extra chromosome 21.
We put our IVF patients on coenzyme Q 10 to try and support mitochondrial function but ultimately it's not always enough. If we really wanted to reverse bad mitochondria, we would replace them or increase their number. Like replacing your car's battery completely or adding a few more batteries, rather than just tuning it up.
Seems like a great idea, right? Might be.
Augment can be done in two ways:
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Replace a woman's mitochondria with mitochondria from a younger woman's eggs. Because mitochondria also contain some genetic material, this means the child has DNA from the father, mother, and the mitochondria donor. Thus far, most countries, except the UK, have objected to this being done. It is not available in Canada or the USA.
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Remove mitochondria from a woman's own eggs (this is done surgically) and put these mitochondria into her IVF-extracted egg. This is like putting a whole bunch of weaker batteries together to try and build one strong one. This is available as part of a research study at a Toronto clinic called TCART. They have just reported their first live born baby from this technique.
The cost of Augment at TCART is about $25,000 on top of the cost of an IVF cycle (about $12,000). We do not offer Augment at Olive yet. If Augment proves to be safe and effective over the next months to a year, then we plan to introduce it but not before.
We are watching this science closely. It has real potential but so have other therapies in the past which proved to be dangerous or ineffective. So for now we keenly observe the science and will decide when it's time to adopt it for our patients.
