Stem cell therapy
may help reverse effects of premature menopause, restore fertility
Young women with premature ovarian insufficiency (POI)
may be able to use their own bone marrow stem cells to rejuvenate their ovaries
and avoid the effects of premature menopause, new research suggests. The
preliminary results from the ongoing ROSE clinical trial were presented at ENDO
2018, the 100th annual meeting of the Endocrine Society, in Chicago, Ill.
"In the two participants who have completed the
treatment to date, serum estrogen levels have increased as soon as 3 months
after the injection of stem cells, and the effect has lasted for at least one
year. Their menopausal symptoms have been alleviated, and six months after the
injection of the stem cells into the ovaries, they have resumed menses,"
said senior author Ayman Al-Hendy, M.D., Ph.D., Professor of Gynecology and
Director of Translational Research at the University of Illinois at Chicago.
For the two patients who have undergone the procedure so
far, they collected each woman's own mesenchymal stem cells from her posterior
iliac crest bone marrow and used minimally invasive laparoscopy to inject the
cells into one ovary, keeping the second, untreated, ovary as a control. The
authors followed the patients closely with frequent blood work, imaging of the
ovaries, menopausal symptom questionnaires, and safety studies.
Now that both women's estrogen levels have increased
significantly and they have begun to menstruate, the research team looks
forward to the possibility that they may again become fertile.
"Ultrasound imaging of treated ovaries shows
significant size increase in the treated ovaries compared to the contralateral
untreated ovaries. In the cases completed so far, the patients have tolerated
the treatment very well with no complications or side effects," Al-Hendy
said.
The ovaries produce hormones and eggs typically until
menopause in the early fifties, when they stop working. About 1 percent of
women have POI, and some are as young as in their teens, the authors wrote in
their abstract.
With POI, the ovaries stop working and the women enter
early menopause. They lose the ability to menstruate, ovulate and have children
using their own eggs, and they may be at increased risk for menopausal symptoms
including hot flushes, night sweets, mood swings and vaginal dryness, and for
cardiovascular disease, osteoporosis-related fracture and earlier cognitive
function decline, Al-Hendy said.
This treatment was tested with 33 women experiencing POF.
Participants' oestrogen levels increased and, after six months, they began to
have periods again.
All of the women taking part in the study are now trying
to get pregnant.
Dr Kate Maclaran and Dr Marie Gerval of the Daisy Network
charity agree, saying: ‘This study offers hope for women with POI that in the
future, they may be able to conceive naturally or have fertility treatment
using their own eggs.’
Dr Christos Coutifaris, president of the American Society
for Reproductive Medicine (who was not involved in the study) shares the
optimism of those who were involved, saying ‘‘These preliminary findings are
exciting. If these observations are validated under further experimental
protocols, their implications for female fertility and reproductive hormonal
function may prove extremely significant.’
Through the injection of stem cells derived from bone
marrow, ovarian function can be stimulated, allowing the return of ovulation and
normal hormone levels as well as the possibility of pregnancy. All of the women
in the study are currently trying to get pregnant and, once the research has
been fully carried out, the option to use stem cell therapy as a treatment for
infertility across the board will be explored.
This isn’t the first study exploring the use of stem
cells in treating infertility. Back in 2009, scientists in China showed that it
was possible to isolate stem cells in mice, store them, and then transplant
them back into sterile females to enable them to give birth. But, in this most
recent study from US researchers, patients are able to reactivate their own
ovaries.
The scientific community and women everywhere are looking
forward to final results from the study which will show if the women will, in
fact, get pregnant as a result of stem cell injections.
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