Petric P, Vrtacnik-Bokal E, Stimpfel M
Department of Human Reproduction, Division of Gynaecology, University Medical Centre Ljubljana, Slajmerjeva 3, Ljubljana, Slovenia.
Reprod Sci. 2021 Jun;28(6):1733-1745. doi: 10.1007/s43032-021-00566-7. Epub 2021 Apr 8.
Infertility is a major health problem, and despite improved treatments over the years, there are still some conditions that cannot be treated successfully using a conventional approach. Therefore, new options are being considered and one of them is cell therapy using stem cells. Stem cell treatments for infertility can be divided into two major groups, the first one being direct transplantation of stem cells or their paracrine factors into reproductive organs and the second one being in vitro differentiation into germ cells or gametes. In animal models, all of these approaches were able to improve the reproductive potential of tested animals, although in humans there is still too little evidence to suggest successful use. The reasons for lack of evidence are unavailability of proper material, the complexity of explored biological processes, and ethical considerations. Despite all of the above-mentioned hurdles, researchers were able to show that in women, it seems to be possible to improve some conditions, but in men, no similar clinically important improvement was achieved. To conclude, the data presented in this review suggest that the treatment of infertility with stem cells seems plausible, because some types of treatments have already been tested in humans, achieving live births, while others show great potential only in animal studies, for now.
不孕症是一个重大的健康问题,尽管多年来治疗方法有所改进,但仍有一些情况无法通过传统方法成功治疗。因此,人们正在考虑新的选择,其中之一是使用干细胞的细胞疗法。用于不孕症的干细胞治疗可分为两大类,第一类是将干细胞或其旁分泌因子直接移植到生殖器官中,第二类是在体外分化为生殖细胞或配子。在动物模型中,所有这些方法都能够提高受试动物的生殖潜力,尽管在人类中,仍缺乏足够的证据表明其成功应用。缺乏证据的原因包括缺乏合适的材料、所探索的生物过程的复杂性以及伦理考量。尽管存在上述所有障碍,研究人员已经能够证明,在女性中,似乎有可能改善某些情况,但在男性中,并未取得类似的具有临床重要意义的改善。总之,本综述中呈现的数据表明,用干细胞治疗不孕症似乎是可行的,因为某些类型的治疗已经在人体中进行了测试并实现了活产,而其他一些治疗目前仅在动物研究中显示出巨大潜力。