Mesenchymal stem cells in the treatment of female infertility

The article was written by Dr. Dam Thi Minh Phuong – Medical Specialist - Stem Cells and Immune Cells at Research Department, Vinmec Institute of Stem Cell and Gene Technology.

Infertility is defined as the absence of pregnancy (including miscarriage) for at least 12 months. Infertility affects not only the quality of life but also the happiness of individuals as well as couples.

Causes of infertility can be divided into three main categories: female causes account for 33% to 41%, male causes account for 25% to 39%, and causes on both sides are 9% to 39%.
Causes of female infertility are mainly due to diseases related to the reproductive system such as ovulation disorders (polycystic ovary syndrome, hypothalamic dysfunction and primary ovarian failure), Fallopian tube infertility, endometriosis, and uterine and cervical causes (cervical stenosis, polyps, and tumors).

Current assisted reproductive methods such as hormone therapy, ovulation induction or assisted reproductive technology can help treat infertility, increase pregnancy rates, but also have many limitations such as increasing rates. breast cancer or multiple pregnancy. Therefore, in recent years, clinical researchers are focusing on the treatment of female infertility with new methods, one of which is using mesenchymal stem cells (MSCs).
Mesenchymal stem cells are a group of non-hematopoietic adult stem cells derived from the dermis. They are capable of self-renewal and differentiation into many cell lines such as chondrocytes, bone cells and adipocytes, in addition to dermal and endocrine cells. Mesenchymal stem cells can be harvested from several adult tissues such as bone marrow, menstrual blood, adipose tissue, umbilical cord and placenta. Current research or clinical trials are using either mesenchymal stem cells, or mesenchymal stem cells in combination with other drugs to treat ovarian and endometrial dysfunction. uterus.

In humans, bone marrow mesenchymal stem cells have been identified in the endometrium and are involved in the regeneration of endometrial tissue. Author Singh et al conducted mesenchymal stem cell transplant from autologous bone marrow to treat damaged endometrium and resulted in menstrual recovery in five out of six cases.
Author Tan et al used mesenchymal stem cells from transplanted menstrual blood for seven patients with severe Asherman's syndrome in combination with hormone therapy, the results showed that the thickness of the endometrium increased increased in five women reaching 7mm, one patient became pregnant spontaneously and two out of four patients successfully transferred embryos and became pregnant.
In addition, collagen-bound UC-MSC was used in a phase I clinical trial to treat patients with recurrent uterine adhesions. The results suggest that they can improve endometrial proliferation, differentiation, and angiogenesis through upregulation of estrogen receptor α, vimentin, Ki67 and von Willebrand levels and modulation of expression present ΔNP63. The above clinical trials have shown that MSCs are a readily available source of stem cells and have great potential in the treatment of female infertility.