Fundación IVI.
Reproductive Medicine Research Group, IIS La Fe.
Curr Opin Obstet Gynecol. 2019 Jun;31(3):156-162. doi: 10.1097/GCO.0000000000000531.
We review the techniques recently tested in both animal models and humans to provide a state-of-the-art on adult stem cell ovarian transplant to achieve ovarian rejuvenation in patients with diminished ovarian reserves.
As the firsts reports of spontaneous pregnancies achieved after bone marrow transplantation in oncologic women with primary ovarian insufficiency, increasing evidence supports the regenerative effects of stem cell-based therapies in the ovarian niche. Adult stem cells from several origins promote follicular development, increase ovarian local vascularization, increase follicle and stromal cell proliferation and reduce cell apoptosis and follicular atresia, although they do not modify embryo quality. Therefore, residual quiescent follicles of aged or damaged ovaries might produce competent oocytes in an adequate ovarian environment. Nevertheless, further research is needed to properly evaluate underlying mechanisms, identify best cell sources and design less invasive infusion techniques.
Stem cells may be a relevant therapeutic alternative for ovary regeneration and follicular development in patients with impaired ovaries, such as poor ovarian responders or women diagnosed with primary ovarian insufficiency.
我们回顾了最近在动物模型和人类中测试的技术,以提供关于成年干细胞卵巢移植的最新技术,以实现卵巢储备减少患者的卵巢年轻化。
随着骨髓移植在患有原发性卵巢功能不全的肿瘤女性中首次报告自发妊娠,越来越多的证据支持基于干细胞的疗法在卵巢巢中的再生作用。来自多种来源的成体干细胞促进卵泡发育,增加卵巢局部血管生成,增加卵泡和基质细胞增殖,减少细胞凋亡和卵泡闭锁,尽管它们不改变胚胎质量。因此,年龄较大或受损卵巢的休眠卵泡可能在合适的卵巢环境中产生有能力的卵子。然而,需要进一步的研究来正确评估潜在的机制,确定最佳的细胞来源,并设计侵入性较小的输注技术。
干细胞可能是改善卵巢功能不全患者(如卵巢反应不良者或原发性卵巢功能不全患者)卵巢再生和卵泡发育的一种有前途的治疗选择。