Stem Cells In IVF: Hope or Hype?

Abstract

Perhaps the most obvious link to IVF and stem cells is the development of human Embryonic Stem Cells (hESC) from the inner cell mass of human embryos [4]. Whilst hESC are pluripotent and therefore an excellent candidate for gamete production, very little progress has been made because of the legal, ethical, moral, and religious objections to creating hESC which requires the destruction of a viable human embryo [5]. Induced Pluripotent Stem Cells (iPSC) have a similar history when it comes to IVF. These are somatic cells (e.g., skin cells) which are ‘transformed’ into pluripotent stem cells by the introduction of various genes [6]. These iPSC are pluripotent and autologous, so they have the ability, in theory, to be able to carry out gametogenesis in patients undergoing fertility treatment [7]. The problems with the routine clinical use of iPSC in fertility treatment is the cost but most importantly ongoing safety concerns about iPSC because of the genes needed to be inserted to convert a somatic cell into a stem cell [8]. Mesenchymal stem cells (MSC) can be obtained from adipose tissue, bone marrow, the umbilical cord and even inside teeth [9]. These MSC stem cells can produce bone, connective tissue and adipose tissue and there are some data suggesting that MSC may be useful in premature ovarian failure [10]. The drawbacks of using MSC in the treatment of infertility are the cost and the standardization of MSC to ensure safety and efficacy [11]. All these stem cell types have their problems when considering their use in the treatment of infertility. It may be many years, if ever, before they come to routine clinical practice in the treatment of infertility.