Researching better ways to help the involuntary childless
A molecular dialogue between embryo and uterus is critical to pregnancy. Andres Salumets is researching this interaction to understand infertility and develop improved treatments for involuntary childlessness.
What are you researching?
“I’m researching reproduction and infertility. A relatively large proportion of the population of all societies, around 10 to 15 per cent, have dif- ficulties reproducing without medical help. Assisted conception, or IVF, has been an established technique for decades, but it is still a flawed procedure in dire need of improvement. Only 25 to 30 per cent of all IVF attempts are successful, which makes the treatment expensive, time- consuming and distressing for the patient.”
How are you going about this?
“Our main focus of research is on eggs, embryos and samples of uterine mucosa. We often study healthy physiological mechanisms in tandem with the problems that can arise and result in infertility. We are particularly interested in the first weeks of pregnancy and the interaction between the embryo and uterus. A fascinating molecular dialogue goes on between them that we have only just begun to understand and that is essential for pregnancy to start. If something goes wrong in this communication, the embryo won’t attach to the uterus and start to grow. One interesting aspect of this is timing – embryo and mucosa can each be healthy, yet still fail to bond if they are out of step in their communication.”
How can this knowledge be used clinically?
“My research group at Competence Centre on Health Technologies (CCHT) and University of Tartu in Estonia has developed a clinical test that is now used in a dozen countries, in part to determine at what point in time an IVF-fertilised egg should be returned to the uterus for the timing to be right. The research can also lead to improved methods for choosing embryos in the IVF procedure and eventually to the development of infertility drugs. Since it has become more common for couples to start a family later in life, I also hope that we’ll one day be able to give young women information about their chances of becoming pregnant and a forecast of how slowly or quickly these chances will decline with age.”
Professor of Reproductive Medicine at the Department of Clinical Science, Intervention and Technology
Andres Salumets was born 1971 in Jõhvi, Estonia, and studied biochemistry at the University of Tartu, earning his master’s degree in 1995. That same year, he became an embryologist at the Nova Vita Clinic, Estonia’s first private IVF provider. Salumets obtained his PhD in 2003 at Helsinki University, Finland, and conducted research at the Estonian Biocentre between 2004 and 2007.
In 2008 he took up a position at the University of Tartu, becoming professor there two years later. Alongside his research he has partially continued his work at the biotech company CCHT, where he has also been director and consultant of research.
Andres Salumets was appointed Professor of Reproductive Medicine at Karolinska Institutet on 1 September 2020.
Text: Anders Nilsson
First published in the booklet From Cell to Society 2021