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.

Background Women play an important role in the work setting. This leads them to put off their motherhood, sometimes preventing them from getting pregnant. Delaying pregnancy face women with low ovarian response, such as in Premature Ovarian Insufficiency (POI) or Ovarian Aging (OA). There is no current treatment, although there is evidence of improving ovarian function by inyecting mesenchymal stem cells (MSC). Materials and Methods Prospective, observational study of 17 women who attended Pronatal Clinic from 2019 to 2020. Each patient was registered in Assisted Reproductive Treatment (ART) and was enrolled in ovarian treatment with an autologous adipose tissue Mesenchymal Stem Cell (AD-MSCs) protocol. Three groups were assembled: 1) Control: AMH >1.2 ng/mL, without AD-MSCs, 2) POI/OA: female infertility due to POI/OA with AMH <1.2 ng/mL and 3) Amenorrhea: female infertility due to POI/OA with amenorrhea and AMH <1.2 ng/mL. Variables: Age, weight, height, serum AMH, endometrial thickness, follicular size and number on day 2 and 11 of the menstrual cycle, oocyte number, number of blastocysts and pregnancy rate. Results Between month 2 and 5, after AD-MSCs inyection, POI/OA group showed an increase in follicle number (2 to 9) and size (13.5 to 15.5 mm) on day 11 of the menstrual cycle, which resulted in a higher number of MII oocytes (2.6 to 4.2), and an increase in number of blastocysts (0 to 3) and endometrial thickness (8.6 to 9.4). Regarding the Amenorrhea group, a reboot in menstrual cycle was observed, although no further development of blastocyst was found. Conclusion The AD-MSCs inyection directly in the ovary allowed an increase in number of blastocysts and improved pregnancy rates in POI/OA patients.

In Mexico, 17% of women of childbearing age have infertility problems, this alteration may be associated to Premature Ovarian Insufficiency (POI). On the other hand, Premature Rupture of Membranes (PROM) is defined as the rupture of ovular membranes before labor begins. The application of Mesenchymal Stem Cells (MSCs) has been proposed for the treatment of POI, placental abruption and PROM. Objective: Describe a case report of a patient that received MSCs by intravenous injection as an adjuvant for the treatment of POI, and as an aid to reduce placental hematomas that appeared during pregnancy, which resulted in PROM (preterm, and previable), and a preterm baby delivery (alive). Clinical case presentation: A 30-year-old woman with history of primary infertility of 2 years; Anti-Müllerian Hormone (AMH) of 0.2 ng/mL; laparoscopic Bilateral Tubal Obstruction (BTO), endometriosis, diagnostic and surgical laparoscopy for myomatosis, and Factor VII deficiency; as well as 3 IVF, 4 embryo transfers, and 1 IUI unsuccessful. With confirmed POI diagnosis, the application of several doses at different times of MSCS is decided, resulting in pregnancy. Sometime later during pregnancy, placental hematomas and PROM are observed and decided to apply MSCs at different stages of pregnancy, resulting in the live birth of a baby (29.3 Weeks of Gestation) Conclusion: The application of multiple doses of MSCs turns more efficient the placental tissue restoration, allowing hematomas to disappear, and delaying a possible PROM.

Objective: To report the incidence of thrombophilias and importance in the development of thrombotic events in a population of Mexican women. Methods: Is a retrospective, observational and cross-sectional study of 184 women of reproductive age, where the age, weight, height and study of hereditary thrombophilias of FVL-G1691A, PT-G20210A, MTHFR-C677T and PAI-1 4G/5G were studied. Four groups were formed: 1) FVL-G1691A, 2) PT-G20210A, 3) MTHFR-C677T and 4) PAI-1 4G/5G, each group was separated by homozygous and heterozygous mutation. Results: MTHFR-C677T and PAI-1 4G/5G present higher incidence (48.9 and 64%), when comparing with FVL-G1691A and PT-G20210A (3.8 and 0.5%) (p<0.05), higher incidence of PAI-1 4G/5G was observed, when compared to MTHFR-C677T (64.6 vs. 48.9%, p<0.05), difference that was not observed when comparing FVL-G1691A with PT-G20210A (3.8 vs. 0.5%, p>0.05). When patients presented only one thrombophilia, the highest incidence is of MTHFR-C677T and PAI-1 4G>5G (16.5 and 35.2%). Patients with multiple thrombophilias had an incidence of MTHFR-C677T with PAI-1 4G/5G of 30.2%. Conclusion: Our results in the population of Mexican women, we report a high incidence of the MTHFR-C677T and PAI-1 4G / 5G mutation, which makes them susceptible to the development of thrombotic events.

Background: Childbirth is a physiological event for the expulsion of the fetus. It has a low maternal morbidity or mortality, does not present problems in subsequent pregnancies and it has a lower risk of fetal death and neonatal morbidity. Despite this, there are circumstances where cesarean section is the best option. Objective: To determine the prevalence of delivery and cesarean section, and identify whether maternal age is an influencing factor when choosing the route of birth. Methods: Retrospective, observational and cross-sectional study, carried out in Mexican women in private institutions during the period from 2015 to 2019. Inclusion criteria: women who attended the private hospital and had a medical history including maternal age, gestational age, number of deliveries and cesarean sections (emergency and elective) were included. Exclusion criteria were twin pregnancies and preterm births. Three age study groups were formed for deliveries and caesarean section A) 18 to 29years of age, B) 30 to 39 years of age and C) 40 to 45years of age and differences between deliveries and caesarean sections were compared. The SPSS Statistics package, version 25, was used; Descriptive statistics were performed including mean (±) standard deviation or percentage and comparison of groups by Chi-squared test. Results: The decrease in childbirth is directly proportional to the increase in maternal age, with a higher prevalence of childbirth in women between 18 and 29years of age (Group A=60.79%) and a higher prevalence of cesarean delivery in women between 40 and 45years of age, age (Group C=48.19%). A statistically significant difference was found only in Groups A vs B, when comparing the prevalence of deliveries (60.79 vs 51.81%, p=0.05) and cesarean sections (29.21 vs 48.19%, p=0.05). Conclusions: physiological delivery is preferred in our private institution; although, complications during pregnancy and childbirth associated with maternal ageing influence the higher rate of cesarean section.