Umer Amna, Ahmad Khalil, Khan Nasar, Greene David Lawrence, Shamim Sabiha, Habiba Umm E
R3 Medical Research LLC, 10045 East Dynamite Boulevard Suite 260, Scottsdale, AZ 85262, United States.
Pak-American Hospital, Jahangir Multiplex, Sector H-13, Islamabad 44000, Pakistan.
Regen Ther. 2024 Jul 17;26:478-488. doi: 10.1016/j.reth.2024.07.001. eCollection 2024 Jun.
Stem cell (SC) transplantation has shown potential as a therapeutic approach for premature ovarian failure (POF). Despite this, no quantitative analysis has been conducted on the efficacy of SC therapy for POF in humans. To address this gap, the present study conducted a meta-analysis to evaluate the effectiveness of the transplantation of SC in improving ovarian function among POF patients. A systematic review in this regard by searching PubMed, ScienceDirect, clinicalTrial.gov, and Cochrane's library databases was conducted to identify relevant studies, while associated reviews were also considered. The extracted data included parameters such as estradiol (E2), follicle-stimulating hormone (FSH), follicle count (FC), ovarian weight (OW), number of pregnancies, and live birth. As per the combined effect taking the last follow-up time, the level of FSH and AMH for the SC group was lower than these were at the baseline as (SMD: 1.58, 95% CI: 0.76 to 3.92, P-value: 0.185 > 0.05, I: 94.03%) and (SMD: 1.34, 95% CI: 0.77 to 1.92, P-value: 0.001 < 0.05, I: 0%) respectively. While the means of E2 and OW for the SC group was higher than these were at the baseline as (SMD: -0.47, 95% CI: -0.73 to -0.21, P-value: 0.001 < 0.01, I: 38.23%) and (SMD: -1.18, 95% CI: -2.62 to 0.26, P-value: 0.108 > 0.05, I: 76.68%) respectively. The overall effect size measured with proportion of pregnancy and live birth at a 5% level of significance expected SC transplantation results were as (combined proportion: 0.09, 95% CI: 0.03 to 0.15, P-value: 0.002 < 0.05, I: 46.29%) and (SMD: 0.09, 95% CI: 0.03 to 0.15, P-value: 0.003 < 0.05, I: 1.76%) respectively. Based on the fixed-effects model, the estimated average log odds ratio of Follicles count was 1.0234 (95% CI: 0.1252 to 1.9216). Therefore, the average outcome differed significantly from zero (P-value: 0.0255 < 0.05) due to SC transplantation. These results suggest that using SCs to restore ovarian function may be viable for treating POF. However, larger and better-quality investigations would need to be conducted in the future due to the heterogeneity of the examined studies.
干细胞（SC）移植已显示出作为治疗卵巢早衰（POF）的一种治疗方法的潜力。尽管如此，尚未对SC治疗人类POF的疗效进行定量分析。为了填补这一空白，本研究进行了一项荟萃分析，以评估SC移植在改善POF患者卵巢功能方面的有效性。通过检索PubMed、ScienceDirect、clinicalTrial.gov和Cochrane图书馆数据库进行了这方面的系统综述，以确定相关研究，同时也考虑了相关综述。提取的数据包括雌二醇（E2）、促卵泡激素（FSH）、卵泡计数（FC）、卵巢重量（OW）、妊娠次数和活产等参数。根据末次随访时间的合并效应，SC组的FSH水平和抗苗勒管激素（AMH）低于基线水平，分别为（标准化均数差：1.58，95%可信区间：0.76至3.92，P值：0.185>0.05，I²：94.03%）和（标准化均数差：1.34，95%可信区间：0.77至1.92，P值：0.001<0.05，I²：0%）。而SC组的E2均值和OW高于基线水平，分别为（标准化均数差：-0.47，95%可信区间：-0.73至-0.21，P值：0.001<0.01，I²：38.23%）和（标准化均数差：-1.18，95%可信区间：-2.62至0.26，P值：0.108>0.05，I²：76.68%）。以妊娠和活产比例在5%显著性水平衡量的总体效应大小，预期SC移植结果分别为（合并比例：0.09，95%可信区间：0.03至0.15，P值：0.002<0.05，I²：46.29%）和（标准化均数差：0.09，95%可信区间：0.03至0.15，P值：0.003<0.05，I²：1.76%）。基于固定效应模型，卵泡计数的估计平均对数优势比为1.0234（95%可信区间：0.1252至1.9216）。因此，由于SC移植，平均结果与零有显著差异（P值：0.0255<0.05）。这些结果表明，使用SCs恢复卵巢功能可能是治疗POF的可行方法。然而，由于所检查研究的异质性，未来需要进行更大规模和更高质量的研究。
