Sonia Herraiz1, Mónica Romeu2, Anna Buigues3, Susana Martínez4, César Díaz-García5, Inés Gómez-Seguí6, José Martínez7, Nuria Pellicer4, Antonio Pellicer8. 1. Fundación IVI, La Fe University Hospital, Valencia, Spain; IVI-RMA Valencia, La Fe University Hospital, Valencia, Spain; Reproductive Medicine Research Group, IIS La Fe, La Fe University Hospital, Valencia, Spain. Electronic address: Sonia.Herraiz@ivi.es. 2. Reproductive Medicine Research Group, IIS La Fe, La Fe University Hospital, Valencia, Spain; Women's Health Area, La Fe University Hospital, Valencia, Spain. 3. Fundación IVI, La Fe University Hospital, Valencia, Spain; Reproductive Medicine Research Group, IIS La Fe, La Fe University Hospital, Valencia, Spain; Department of Pediatrics, Obstetrics and Gynecology, University of Valencia, Valencia, Spain. 4. Women's Health Area, La Fe University Hospital, Valencia, Spain. 5. IVI-RMA London, London, UK. 6. Hematology Department, La Fe University Hospital, Valencia, Spain. 7. Radiology Department, La Fe University Hospital, Valencia, Spain. 8. Fundación IVI, La Fe University Hospital, Valencia, Spain; Reproductive Medicine Research Group, IIS La Fe, La Fe University Hospital, Valencia, Spain; IVI-RMA Rome, Rome, Italy.
Abstract
OBJECTIVE: To evaluate effects of autologous stem cell ovarian transplant (ASCOT) on ovarian reserve and IVF outcomes of women who are poor responders with very poor prognosis. DESIGN: Prospective observational pilot study. SETTING: University hospital. PATIENT(S): Seventeen women who are poor responders. INTERVENTION(S): Ovarian infusion of bone marrow-derived stem cells. MAIN OUTCOME MEASURE(S): Serum antimüllerian hormone levels and antral follicular count (AFC), punctured follicles, and oocytes retrieved after stimulation (controlled ovarian stimulation) were measred. Apheresis was analyzed for growth factor concentrations. RESULT(S): The ASCOT resulted in a significant improvement in AFC 2 weeks after treatment. With an increase in AFC of three or more follicles and/or two consecutive increases in antimüllerian hormone levels as success criteria, ovarian function improved in 81.3% of women. These positive effects were associated with the presence of fibroblast growth factor-2 and thrombospondin. During controlled ovarian stimulation, ASCOT increased the number of stimulable antral follicles and oocytes, but the embryo euploidy rate was low (16.1%). Five pregnancies were achieved: two after ET, three by natural conception. CONCLUSION(S): Our results suggest that ASCOT optimized the mobilization and growth of existing follicles, possibly related to fibroblast growth factor-2 and thrombospondin-1 within apheresis. The ASCOT improved follicle and oocyte quantity enabling pregnancy in women who are poor responders previously limited to oocyte donation. CLINICAL TRIAL REGISTRATION NUMBER: NCT02240342.
OBJECTIVE: To evaluate effects of autologous stem cell ovarian transplant (ASCOT) on ovarian reserve and IVF outcomes of women who are poor responders with very poor prognosis. DESIGN: Prospective observational pilot study. SETTING: University hospital. PATIENT(S): Seventeen women who are poor responders. INTERVENTION(S): Ovarian infusion of bone marrow-derived stem cells. MAIN OUTCOME MEASURE(S): Serum antimüllerian hormone levels and antral follicular count (AFC), punctured follicles, and oocytes retrieved after stimulation (controlled ovarian stimulation) were measred. Apheresis was analyzed for growth factor concentrations. RESULT(S): The ASCOT resulted in a significant improvement in AFC 2 weeks after treatment. With an increase in AFC of three or more follicles and/or two consecutive increases in antimüllerian hormone levels as success criteria, ovarian function improved in 81.3% of women. These positive effects were associated with the presence of fibroblast growth factor-2 and thrombospondin. During controlled ovarian stimulation, ASCOT increased the number of stimulable antral follicles and oocytes, but the embryo euploidy rate was low (16.1%). Five pregnancies were achieved: two after ET, three by natural conception. CONCLUSION(S): Our results suggest that ASCOT optimized the mobilization and growth of existing follicles, possibly related to fibroblast growth factor-2 and thrombospondin-1 within apheresis. The ASCOT improved follicle and oocyte quantity enabling pregnancy in women who are poor responders previously limited to oocyte donation. CLINICAL TRIAL REGISTRATION NUMBER: NCT02240342.
Authors: Sicilia T Grady; Ashlee E Watts; James A Thompson; M Cecilia T Penedo; Kranti Konganti; Katrin Hinrichs Journal: J Assist Reprod Genet Date: 2018-11-23 Impact factor: 3.412
Authors: Duc M Hoang; Phuong T Pham; Trung Q Bach; Anh T L Ngo; Quyen T Nguyen; Trang T K Phan; Giang H Nguyen; Phuong T T Le; Van T Hoang; Nicholas R Forsyth; Michael Heke; Liem Thanh Nguyen Journal: Signal Transduct Target Ther Date: 2022-08-06