Vakili Sina, Jafarinia Morteza
Infertility Research Centre, Shiraz University of Medical Sciences, Shiraz, Iran.
Shiraz Neuroscience Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Galen Med J. 2024 Oct 8;13:e3632. doi: 10.31661/gmj.v13i.3632. eCollection 2024.
Infertility affects approximately 15-20% of couples globally, with female factors contributing to nearly half of cases. Conditions such as polycystic ovary syndrome, endometriosis, tubal damage and premature ovarian failure are leading causes of female infertility. Current treatments like in vitro fertilization (IVF) have limitations and risks. Mesenchymal stem cells (MSCs) have shown therapeutic potential due to their ability to differentiate, secrete trophic factors, and exhibit immunomodulatory and anti-inflammatory properties. They have been demonstrated to repair and regenerate reproductive organs in various preclinical models of infertility related conditions. MSCs have reduced endometriotic lesions, regenerated lost follicles in premature ovarian failure (POF) models, and promoted tubal repair in damage models. Some clinical and preclinical studies have reported improved outcomes with MSC therapy in endometriosis and premature ovarian failure patients. This review discusses the properties and sources of MSCs, their mechanisms of action, preclinical evidence for applications in conditions like POF, polycystic ovary syndrome (PCOS), endometriosis, Asherman syndrome, and preeclampsia, and preliminary clinical data on MSC therapy for female infertility management.
全球约15%-20%的夫妇受不孕症影响，其中女性因素导致的病例近占一半。多囊卵巢综合征、子宫内膜异位症、输卵管损伤和卵巢早衰等病症是女性不孕的主要原因。目前的治疗方法，如体外受精（IVF）存在局限性和风险。间充质干细胞（MSCs）因其具有分化能力、分泌营养因子以及表现出免疫调节和抗炎特性而显示出治疗潜力。在各种不孕症相关病症的临床前模型中，已证明它们可修复和再生生殖器官。间充质干细胞减少了子宫内膜异位症病变，在卵巢早衰（POF）模型中再生了丢失的卵泡，并在损伤模型中促进了输卵管修复。一些临床和临床前研究报告称，间充质干细胞疗法可改善子宫内膜异位症和卵巢早衰患者的治疗效果。本综述讨论了间充质干细胞的特性和来源、其作用机制、在卵巢早衰、多囊卵巢综合征（PCOS）、子宫内膜异位症、阿谢曼综合征和子痫前期等病症中的应用的临床前证据，以及间充质干细胞疗法治疗女性不孕症的初步临床数据。
