The potential application of conditioned media-mesenchymal stem cells on human oocyte maturation in assisted reproductive technology: a quasi-experimental based-study at Dr. Sardjito General Hospital, Yogyakarta, Indonesia

Abstract

Background: PCOS typically characterized by a decreased level of GDF9 and BMP15, which contribute to follicular arrest. Recent research related to stem cells showed that conditioned media-mesenchymal stem cell (CM-MSC) might have a positive role in folliculogenesis. Therefore, this study aimed to assess the effectiveness of CM-MSC towards oocyte maturityMethod: A quasi-experimental design was used to examine the outcome of 3 different interventions, namely group A (4-hour incubation in standard media), group B (24-hour incubation in standard media), and group C (24 hours incubation in conventional media with addition of CM-MSC). Nuclear and cytoplasmic maturity, along with GDF9 and BMP15 levels were measured and analyzed.Results: Sixty-three patients at an infertility clinic, RSUP Dr. Sardjito, Yogyakarta was recruited and a total of 292 germinal vesicles were obtained to start in vitro maturation procedure. Multivariate analysis showed group C has OR 6.9 (3,3–14,41) to obtain metaphase II oocyte than group B (p <0,0001). Infertility causes, insulin resistance, and maternal age risk are other factors that significantly influence oocyte maturity outcome (p <0.001; p = 0.005; p = 0.017). For the oocyte morphology outcome, no significant effect was obtained from the intervention (p> 0.05). Group C has higher GDF9 levels (Δ mean = 3.31) and BMP15 (Δ mean = 1.52) compared with group B (p <0.001; p = 0.006).Conclusion: It can be concluded that 24-hour incubation in CM-MSC was effective to induce oocyte maturation. However, other factors, such as infertility causes, insulin resistance, and maternal age, should also be considered.