Stem Cell Treatment is a new approach to fertility challenges. The evolution of In Vitro Fertilization (IVF) technology has provided new possibilities for achieving pregnancy. Over the past 25 years, IVF success rates have nearly doubled, with an 80-90% success rate often achieved after three cycles. It’s important not to lose hope if the first cycle is unsuccessful, as subsequent cycles can lead to success. However, a specific group of patients known as poor responders remains a significant challenge for clinicians.

As women age, the likelihood of chromosomal abnormalities and cytoplasmic dysfunction in embryos increases, and the number of chromosomally normal eggs decreases. Consequently, both the quality and quantity of embryos are reduced, particularly affecting IVF success rates after the age of 38-40. The primary reason for lower pregnancy rates is the increased rate of chromosomal abnormalities in embryos from older patients. For instance, while younger women may need only a few eggs to produce a normal blastocyst, women around 40 may require over 10-15 eggs, necessitating more cycles to achieve a viable pregnancy.

The Role of Stem Cells

Recent research suggests that stem cell treatments could offer promising solutions. Specifically, Mesenchymal Stem Cells (MSC) have shown potential in improving ovarian function and enhancing fertility outcomes. These stem cells have been found to restore ovarian function in animal models and have shown similar potential in human studies.

Mesenchymal Stem Cells (MSC)

For over a decade, studies on rodents have demonstrated that injecting stem cells into the ovarian niche can restore ovarian function even after significant damage. Healthy eggs can be retrieved post-treatment, fertilized through IVF, and lead to healthy offspring. Different sources of MSCs, such as amniotic fluid, menstrual blood, placental tissue, umbilical cord, bone marrow, and adipose tissue, have been explored, with the best results often derived from connective tissue MSCs.

In humans, there have been reports of women regaining fertility after undergoing chemotherapy or radiation treatments followed by bone marrow transplants. This phenomenon is believed to be due to stem cell factors that reach the ovaries and repair damaged egg cells, restoring their function.

Premature Ovarian Failure (POF)

Exciting animal and human studies led to trials where MSCs were injected into the ovaries of infertile patients. In 2016, a study by Edessy et al. reported that 2 out of 10 patients with premature ovarian failure (POF) resumed menstruation, and one patient successfully gave birth after autologous bone marrow-derived MSC injections. Although the initial pregnancy rates were low (0-10%), recent advancements combining MSC injections with more aggressive gonadotropin stimulation and IVF have achieved a 57% pregnancy rate. This is particularly significant for POF patients who otherwise have minimal chances of conceiving.

Poor IVF Responders

Applying MSC injections to patients with poor IVF responses has shown impressive improvements in egg numbers and embryo quality, with success rates ranging from 30-60%. This increase in the quality and quantity of embryos significantly enhances the chances of achieving a biological pregnancy before resorting to donor eggs or embryos. Notably, some pregnancies have occurred with minimal stimulation, underscoring the potential of MSC therapy in boosting fertility.

How MSCs Work

MSCs help restore damaged ovarian tissue through their ability to differentiate into various ovarian cell lines and produce growth factors that inhibit cell death (apoptosis) and stimulate growth. These stem cells have a unique “homing” ability, allowing them to migrate to areas of damage and release reparative factors, thereby restoring normal ovarian function.

Exosomes

The secretome of MSCs, or exosomes, consists of tiny particles that facilitate cell signaling and tissue repair. These exosomes contain growth factors and cytokines crucial for anti-inflammatory effects, immune regulation, and cell growth. Exosomes derived from MSCs enhance the reparative functions of stem cells, making them essential in fertility treatments.

Platelet-Rich Plasma (PRP)

PRP, prepared from the patient’s blood, concentrates growth factors and cytokines that aid in tissue regeneration. Initially used to improve vascularization in cryopreserved ovarian tissue, PRP has demonstrated potential in inducing menstrual cycles and improving ovarian response in fertility treatments. Combining PRP with MSCs has shown to significantly enhance treatment outcomes.

Dr. Invitro Clinic’s Approach

At Dr. Invitro Clinic, we have been pioneering the use of stem cell injections into the ovaries since 2018, achieving notable success. Despite a temporary pause during the COVID-19 pandemic, our program resumed in 2021 with promising results. Our approach aims to improve embryo quality and quantity in IVF cycles, providing a viable option for patients before considering egg or embryo donation.

With a pregnancy rate close to 40% and ongoing pregnancies among treated patients, our clinic is at the forefront of utilizing MSCs, exosomes, and PRP in fertility treatments. This innovative approach offers hope and new possibilities for patients struggling with infertility.