Regenerative therapy by endometrial mesenchymal stem cells in thin endometrium with repeated implantation failure. A novel strategy

Abstract

Objective: Our primary objective was to evaluate the endometrial changes before and after the transfer of endometrial mesenchymal stem cells (enMSCs) in a population of thinned endometrium women, with absence or hypo-responsiveness to estrogen and repeated implantation failure (RIF). The secondary objective was to evaluate the clinical outcomes of the intervention in terms of clinical pregnancy (CP), early abortions, ongoing pregnancy and live birth delivery rate (LBDR) per in vitro fertilization (IVF) cycle.Methods: A longitudinal and experimental study. The intervention was defined as "subendometrial inoculation of enMSCs," and the post-intervention changes were evaluated by the following variables: endometrial thickness (Eth), endometrial flow cytometry (enFC), endometrial histopathology (enHP) and endometrial immunohistochemistry (enIHQ). The variables were analyzed after the intervention (Post-treatment) regarding previous values (Pretreatment).Results: Eth values before and after treatment with enMSCs were 5.24±1.24 mm vs. 9.93±0.77 (p=0.000), respectively. Endometrial Flow Cytometry showed significant differences in favor of Normalized variables in the post-treatment assessment, associated with the pretreatment, LT/Li, LB/Li, NK/Li, CD8/CD3 + and CD4/CD8 (p≤0.015), respectively. Only two variables Li/PC and CD4/ CD3 had NS (p=0.167 and 0.118). A similar analysis was performed on enHP with an HP increase post-treatment (p=0.007). The CP rate was 79.31% (23/29), a live birth delivery rate per embryo transfer was 45.45% (10/22) and ongoing pregnancy 7/29 (24.14%).Conclusion: Subendometrial enMSCs inoculation produces a significant increase in endometrial thickness; normalize the enHP, enIHQ and enFC. As a result, IVF after treatment with enMSCs yields a higher rate of CP and LBDR.

Normalization of endometrial histopathology and endometrial NK cells concentration predict successful pregnancy in repeated implantation failure

“…On the other hand, a higher frequency of premature births in oocyte donation has been published, suggesting a different modulated immune activity at the maternal-fetal interface of egg-donor pregnancies ( Gundogan et al, 2010 ) . Probably the advent of the endometrium regenerative cell therapy appears to be an efficient tool in endometrial immunology therapy ( Tersoglio et al, 2020 ) . The strength of this research is based on the strict follow-up in enHP, enIHQ and the immunological shifts before/after treatment.…”

Chronic endometritis: pathogenesis, diagnosis, management and associated infertility

“…В результате указанной терапии эти женщины забеременели и родили живых детей. Среди оставшихся четырех пациенток с хроническим эндометритом у троих имела место повторная потеря беременности [48]. Существуют отдельные работы по использованию богатой тромбоцитами плазмы (БТП) для лечения различных заболеваний, ОБЗОРЫ ЛИТЕРАТУРЫ в том числе ПНИ на фоне ХЭ.…”

Management of Resistant Endometrium in Cases of Recurrent Implantation Failure Using Endometrial Mesenchymal Stem Cells as an Innovative Regenerative Therapy-A Short Communication

“…Hence IVF following treatment with enMSC's gives a very good rate of CP as well as LPDR ( Fig. 1 and 2) [42]. Further Esmailzadeh et al, tried with the aim that that endometrial mesenchymal stem cells (eMSC) have a vital role in regeneration of endometrium during menstrual cycles.…”