Pharmacogenomics and personalized medicine in infertility

Abstract

Around 60-80 million couples are infertile around the globe, and in a large proportion of western world, constant decline in fertility is a major cause of concern. Although infertility per se may not threaten physical health, it is a source of distress, as societal norms tend to equate infertility with failure. Given the complexity of the process of gametogenesis and the large number of genes involved, it is likely that a significant proportion of infertility phenotypes are genetic in origin. Pharmacogenomics has aggressively been studied and addressed for life-threatening illnesses like cancer, cardiovascular disorders, depression, HIV, tuberculosis, asthma, and diabetes. However, this field has not advanced sufficiently to address issues related to personalized treatment for infertility, mainly because infertility fails to fit into the definition of a major disease and is lower in order of priority than other ailments. Here, we will discuss the present status of knowledge which may be a starting point for expansion into pharmacogenomics of male and female infertility. Polymorphisms in several genes are studied in relation to controlled ovarian hyperstimulation (COH) outcome in infertile women undergoing IVF treatment in clinics, and therapies based on genetic background has just begun to emerge. Except this, no major advancement has yet occurred in this field, but a huge scope of pharmacogenomics and personalized medicine for treatment of infertility exists because several genes and their SNPs have already been proven to be associated with infertility, and they may provide strong basis for personalized therapies.