Offering hope to women in a fertile field of growing importance

As more women delay having children, the importance of Associate Professor Beverley Vollenhoven's work grows. This Monash researcher and IVF clinician is improving the rate of successful pregnancies in older women and seeking new treatments for fibroids - a common condition, often treated by removing the womb.

Beverley is part of the only team in Australia researching fibroids - growths in the uterus that up to half of all women may get, especially as they age.

When the size or number of these often-painful growths becomes too great, the typical response is to remove the womb - not a favourable option if you want children but are yet to have them.

"There are a lot of women in their 30s with fibroids, who haven't had a child yet," Beverley says. "They might or might not have their fibroids removed, but if they need to, it affects their ability to reproduce, so you get into a bit of a bind over what's best for the patient."

Temporary treatments for fibroids are available but bring on menopause, with all its complications, if used for too long.

Beverley believes some kind of hormonal treatment is likely to offer the best hope of treating fibroids permanently without affecting a woman's ability to reproduce.

"We know there must be some hormonal control involved because fibroids only grow in the reproductive years," she says."Girls don't have them in childhood, nor do post-menopausal women."

Reproductive hormones are Beverley's speciality, incorporated within an area of medicine known as reproductive endocrinology. After years of successfully combining research and practice, she is an expert on menopause, contraception and infertility, not just fibroids.

As a researcher, Beverley is investigating potential fibroid treatments in the laboratory, using molecular biology techniques, with the help of research students and long-time collaborator Professor Peter Rogers of the Royal Women's Hospital.

Her team is not looking for a magic bullet to treat fibroids but the pathway along which such a treatment might be applied most effectively.

As a busy practitioner, Beverley treats women who are infertile, menopausal, have hormone-related conditions or require contraception. She is the Head of Gynaecology at Southern Health, a clinician at Monash IVF and has her own private practice.

Her research into in-vitro fertilisation at Monash IVF has shown that the rate of miscarriages among older IVF patients can decrease substantially - from one in two to one in five, the same rate as in younger women - if embryos are transferred to the womb at a later stage of development.

She says improved IVF techniques in recent years, using single rather than multiple embryo transfers, have also cut the incidence of multiple births among IVF patients. But the challenge now is to reduce the risk of a single embryo splitting to form identical twins - a risk that's three times higher in IVF pregnancies than in natural pregnancies.

Beverley is also investigating the contraceptive drug Depo-Provera, which gives up to three months of protection against pregnancy from a single injection but at the risk of potentially lower bone density over time.

Another of her studies is assessing the impact of early menopause on women under 40, especially on women yet to have children.

With the trend to delayed childbirth continuing - the median age of all women who registered a birth was 29.7 years in 1999 and 30.6 in 2009 - Beverly expects research in her field to pay more attention to the uterus in the future.

"It's the uncontrolled factor in what we do," she says. "We can control the environment in which an embryo grows, and its development to some extent, but when it goes into the uterus, god knows what happens. Why doesn't it stick? Why does it stick? We need to find out."