The Kiss

by Daniel Shapiro, M.D.

On 3/16/2010, FOX news reported that British researchers were able to ‘restore fertility’ to infertile women by injecting them with the substance ‘Kisspeptin’ twice weekly.  The report was true, but as is often the case with cable news, there is more to the story than the sound bite from yesterday.

Kisspeptin was first identified in 1999 by researchers in Hershey, PA.  To honor Hershey’s biggest business, the research team named the molecule ‘Kisspeptin’ after the chocolate.  Any time you see ‘peptin’ in a name it means the thing is a protein. The ‘kiss’ part of the name was to be cute.

The original work with the molecule showed that it could suppress the spread of melanoma and breast cancer in experimental  settings, thought he clinical application for the molecule in cancer care has yet to come to fruition. Because of its role in tumor suppression, the molecule is also known as ‘metastin’.

Recent work with Kisspeptin showed a link between Kisspeptin and the onset of puberty.  The molecule induces activity in GnRH secreting neurons in the brain, which tell the pituitary gland to make FSH and LH so that a woman can ovulate and a man can make sperm.

Once puberty is complete, Kisspeptin keeps the secretion of FSH and LH going so that ovulation will continue to occur and sperm will be available on an ‘as needed’ basis.

In patients with hypothalamic hypogonadism, FSH and LH secretion are impaired. In women this leads to loss of ovulation and loss of regular menstrual cycles as a result. These patients are infertile for obvious reasons; no ovulation means no egg and no egg means no baby.

So basically what the Brits did is take a group of women with hypothalamic hypogonadism and juice them up with Kisspeptin.  Like Prince Charming kissing Snow White, the ‘kiss’ woke up the pituitary of these women and led them to secrete FSH and LH so they could ovulate.  In most folks regular ovulation leads inexorably to a baby if there is sperm around.  And they all lived happily ever after.

So FOX was right, but only for patients with this particular problem, which sadly is uncommon.  Women with depleted ovarian reserve or tubal disease or male factor who ovulate on their own already will still be laying on the bier in the Dwarves’ cottage with the woodland animals all about if they take Kisspeptin.

There may yet be other applications for Kisspeptin in fertility medicine but for now its application is limited to women with hypothalamic hypogonadism.  This is probably a superior method for ovulation induction in these patients than conventional therapy as one would assume that the multiple birth rate would be much lower with Kisspeptin than FSH injections.  We are still in the early stages of learning about Kisspeptin’s potential and we may one day be using this medicine a lot. For now though its use is limited.

 

Comments

[Camilo Buitrago]

Is there any use of the Kisspeptin for men? As you say that it also can work to generate sperm for men. Thanks