Autologous Mesenchimal Stem Cell Therapy in Patients with Unexplainable Low Ovarian Response

Abstract

Background: In Mexico there are 17% of women of reproductive age with infertility problems, equivalent to 1.4 million couples who need assisted reproductive techniques; 9 to 24% of these patients present low ovarian response, mainly in women older than 38 years, due to ovarian aging. Objective: To design a human method to administer autologous adipose tissue mesenchymal stem cells directly into the ovaries to elucidate the underlying mechanisms of ovarian rejuvenation and point the way for the development of future therapies. Method and Result: We present a case of a 39-year-old woman, classified as low or suboptimal ovarian response. included in group 2, subgroup 2a, of the Poseidon criteria; to which a human method was designed to administer autologous adipose tissue mesenchymal stem cells (AD-MSCs) directly into the ovaries prior to ovarian stimulation; under written informed consent to the patient; It was carried out in a procedure where 14 oocytes were obtained, which were fertilized with donor semen (normozoospermic) and a biopsy was performed of three blastocysts obtained, to carry out a preimplantation genetic study that reported an euploid embryo; This is placed in the mother’s uterus in order to achieve pregnancy and a healthy newborn. Once transferred to the mother, the euploid blastocyst, the human gonadotropin hormone beta subunit test was positive 6572mUI / mL and it was completed, obtaining a male newborn obtained by caesarean section at 39.2 weeks of healthy gestation with adequate evolution. Conclusions: Stem cell therapy obtained from bone marrow is an alternative for women with low ovarian response to achieve pregnancy, by improving the quality of oocytes; it is the first report in Mexico, in women with low idiopathic ovarian response.