Fertility subject of landmark research

Polycystic ovarian syndrome, or PCOS as it's more commonly known, affects nearly one in 10 women in New Zealand. Photo / Thinkstock

Otago University looks at brainwaves to find cause of syndrome affecting one in 10 women in New Zealand.

An often heart-breaking syndrome that remains the leading cause of infertility in Kiwi women will be targeted in a landmark research project.

Polycystic ovarian syndrome, or PCOS as it's more commonly known, affects nearly one in 10 women in New Zealand and is linked to infertility and a raft of chronic health problems such as diabetes, higher blood pressure, cancer of the womb and abnormal cholesterol.

It's also often associated with irregular periods, increased hair growth or acne or raised levels of male or androgenic hormones.

While PCOS has presented a frustratingly complex puzzle to scientists, it's hoped a recent breakthrough by Otago University researchers will prove the first step to understanding its causes and ultimately finding effective treatment.

Their focus is on the neuroendocrine control of fertility, which depends on a small population of brain cells known as gonadotropin-releasing hormone (GnRH) neurons.

A recent study by a team at the university revealed a completely unexpected brain pathway within the GnRH neuronal network that might underpin the neuroendocrine abnormalities of PCOS.

Now, scientists led by Dr Rebecca Campbell will carry out a series of studies to explore the exact role of this pathway in the regulation of fertility.

"If we can look at a model where it's disrupted, then we can identify where those disruptions occur and know what's important for reproductive function," Dr Campbell told the Herald.

"And it gives us a better idea about what effect current drugs that are being used for other issues may be having on reproductive function."

She and colleagues suspect a cause of PCOS might be high levels of androgenic hormones stemming from a variety of sources, which trigger changes in the brain that result in downstream consequences for the ovary.

"If we can pin that down, then we might be able to avoid the types of scenarios that result in the syndrome - or know what the potential therapeutic targets will be to reverse the syndrome in adulthood."

While Dr Campbell acknowledged her team was still at the "basic science" stage, she believed the horizon could lie as little as five to 10 years away.

In its latest round of grants the Health Research Council awarded Dr Campbell and her team $900,000 for the project.

The council's chief executive, Professor Kathryn McPherson, said reproductive health was an important global health issue and PCOS was specifically estimated to affect more than 100 million women around the world.

Dr Stella Milsom, an endocrinologist at Fertility Associates in Auckland, was "delighted" the council was funding research into such a common and important condition.

Focus is helping others

Kelly McGillivray

Even before she was diagnosed with polycystic ovarian syndrome, Kelly McGillivray had known for a long time that something wasn't quite right with her body.

Being told, at the age of 19, how the condition would hamper her chances of having children, while also upping her risk of diabetes and heart disease, still came as a nasty shock.

"For me, it did feel like looking down the barrel of a gun - I kind of felt like, oh God, is this a foregone conclusion?"

Twenty years on, the Aucklander is helping young women deal with the syndrome through her work with the New Zealand PCOS Foundation.

Ms McGillivray hasn't had children - a choice she feels was influenced by how she felt about PCOS.

"I've kind of been a little bit on the fence all the way along, and possibly there was some undercurrent of thinking, oh well, it's probably going to be difficult anyway, so maybe I just won't bother."

She suspected the fear factor alone played its own part in women's ability to conceive - and she encouraged them to ensure their lifestyle and dieting were as healthy as could possibly be.

"The medical diagnosis itself is certainly very anxiety-producing, and that's why I think the research undertaken now is going to be really interesting, just looking at what other pathways it might be impacting.

"It would certainly be good to know what the exact causes are, but my suspicion is that, like a lot of things modulated by hormones, it's going to be way more complex than just saying, okay, it's this."

More than $34.5 million has just been awarded by the Health Research Council to 33 researchers for projects that will help our country. Here are three others:

How safe are our homes for kids?

On average, our children spend more time inside than adults - and this can put them at greater risk if their home is unhealthy.

In a series of six studies awarded a $5 million grant, Professor Philippa Howden-Chapman of Otago University will take major findings of her previous housing community trials further.

Her study team has shown links between meningococcal disease and household overcrowding, and between uninsulated houses and school attendance, sickness and hospitalisation.

The new studies will include trials to insulate and warm newborn babies' homes and provide them with feather duvets, provide wrap-around housing and welfare services for children who have been hospitalised, and examine the indoor air quality and possible health effects on children living in housing next to arterial roads.

The project ultimately aims to establish the effect of implementing a "rental warrant of fitness" on tenant health, particularly the health of children, and to determine the effect of such a measure on housing supply and affordability.

New drugs for stomach cancer

Another Otago University team, awarded a grant of more than $5 million, will focus on new drugs targeting aggressive stomach cancer.

Professor Parry Guilford, whose team previously used an HRC grant to successfully seek out the gene for diffuse gastric cancer, described stomach cancer as an aggressive cancer with a very poor prognosis.

But new drugs had the potential to benefit up to 400,000 new patients worldwide each year, including a disproportionate number of Maori and Pacific patients.

Drugs developed by Professor Guilford's team could also provide potentially huge health and economic gains to New Zealand.

The Cancer Genetic Laboratory at the University of Otago, which Professor Guilford co-leads, has already generated the NZX-listed cancer biotechnology company Pacific Edge.

Its flagstone product is CxBladder; a diagnostic test for bladder cancer that was first introduced to our market in 2011 and is now available in Singapore and the United States.

Wonder gel combats infant brain damage

A grant of more than $1 million will help an Auckland University team follow up on a remarkable oral gel that has been shown to prevent brain damage in newborn babies.

While it costs only $2 to produce the gel, treating the 2100 babies severely affected by low blood sugar levels in neonatal intensive care each year costs the nation $9.4 million.

Distinguished Professor Jane Harding, a neonatal paediatrician and Dean of Research at the University of Auckland, will check up on those infants treated with the gel, which is rubbed on the inside of the baby's cheek, two years on from when they received it.

This will ensure the safety and efficacy of the treatment before it is introduced into clinical practice.

Professor Harding and her team have already provided the first evidence-based strategy to treat low blood sugar levels that affect up to 15 per cent of otherwise healthy babies.