Evaluating of Safety and Efficacy of Autologous Adipose Tissue- Derived Mesenchymal Stem Cells (AMSC) Transplantation in Women with Premature Ovarian Failure

Premature ovarian failure (POF) is a clinical syndrome defined by lossof ovarian activity before the age of 40 years. POF is characterized bymenstrual disturbance (amenorrhea or oligomenorrhea) with raisedgonadotrophins and low estradiol. The prevalence of POF is 1%.Population characteristics such as ethnicity may affect the prevalence.Primary ovarian insufficiency affects 1 in 10 000 women by age 20, 1 in1000 women by age 30, 1 in 100 by age 40. The diagnosis POF is basedon the presence of menstrual disturbance and biochemical confirmation.The diagnostic criteria are (i) oligo/amenorrhea for at least 4 months,(ii) and elevated FSH level > 25 IU/L on 2 occasions > 4 weeks apart.The causes of POF include genetic disorder (chromosomal abnormality,fragile-X permutation), autoimmune, metabolic abnormalities, infections,surgery, radiotherapy – chemotherapy and idiopathic. The side effectsof POF are: cardiovascular disease, reduce bone mineral density,negative impact on psychological well-being and quality of life, reducedlife expectancy, largely due to cardiovascular disease and Infertility.The infertility treatments of POF patients are (i) egg donation, and (ii)renewal of ovarian tissue. The survival and function of oocyte requiretheir interaction with granulosa cells, and the number or activity ofgranulosa cells. The number of newly formed adult primordial follicles isdetermined by the availability of granulosa cell nets. In ovaries with POF, degenerating intravascular oocytes and ovarian cortical granulosa cellnets are virtually absent. This indicated that the availability of transplantedgerm cells in adult human ovaries lacking granulosa cell nets may not besufficient for follicular renewal. Stem cells are the foundation cells forevery organ and can differentiate into the different type of cell. Stem cellsare self-renewable undifferentiated cells capable of differentiation anddivide into specialized cells. Ovarian stem cells are bipotent stem cellsfor the formation of ovarian germ and granulosa cells. Many researchershave reported that therapeutic stem cells derived from different sources(human endometrial stem cell, menstrual-derived stem cells, Humanplacenta-derived mesenchymal stem cells, bone marrow-derived stemcells) can generate oocytes in female rats or mice. Based on previousexperimental results in animals, we designed a study to show the safetyand efficacy of autologous adipose tissue-derived mesenchymal stemcells (AMSCs) injection into the ovary in women with POF patients. Toevaluate the safety and efficacy of autologous adipose tissue-derivedmesenchymal stem cells (AMSC) in women with POF. Nine POF patientswere scheduled for AMSC transplantation due to inclusion and exclusioncriteria. AMSC preparation from the adipose tissue-derived lowerabdominal wall, vaginally or laparoscopically injected into the ovary ofPOF patients. Safety and possible side effects, FSH and AMH levels andreturn menstrual cycle were evaluated.

کلیدواژه ها:

Efficacy ، Autologous ، Adipose tissue ، Mesenchymal stem cells ، Transplantation ، Premature Ovarian Failure