stem cells

Can menopause be reversed with stem cells?

Restoring fertility with stem cells: Princeton IVF blog
New research suggests bone marrow stem cells could be used restore estrogen and fertility in women with early menopause.

It may become possible in the near future

Women who suffer from premature menopause, also known as primary ovarian insufficiency (POI) or primary ovarian failure (POF) have either run out of eggs or no eggs capable of being stimulated.

This can occur for a number of reasons but early menopause causes 2 major problems for women who suffer from it. One is infertility, and this type of infertility can usually only be successfully treated with donor egg IVF. The other problem is hormonal. With the depletion of ovarian follicles, levels of reproductive hormones, especially estrogen, drop dramatically. The low levels of estrogen can cause a number of problems including vaginal dryness, difficulty with intercourse, hot flushes, bone loss and loss of sleep to name a few.

So, if there was a safe way to restore eggs to an ovary that has shut down prematurely, it might be a great advance in women's health care.

With that in mind, the ROSE trial was undertaken. The researchers injected cells from the bone marrow, which is rich in stem cells into the ovaries in an attempt to help regenerate new eggs.

Obtaining cells from the bone marrow is a fairly routine medical procedure and injecting substances into the ovarian is also not a new procedure. What is new about this is combining the two and using stem cell to restore ovarian function.

The few patients in the trial had an increase in the size of their ovaries and higher estrogen levels even a year out of from the procedure.

It will still take time and more studies to determine how safe and effective stem cells from the bone marrow are at restoring functioning ovaries and fertility to women with premature menopause / POI, but the results so far are encouraging. 

 

Is it possible to stop the biological clock?

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Today, age is the most important determinant of woman's ability to conceive both naturally and with treatments such as IVF, but might it be possible to overcome the "biologic clock"? 

It is has been understood for many years that a woman is born with all the eggs she will ever produce and that she begins to lose eggs even before she is born. The eggs seem to work reasonably well into the early 30's but in the late 30's  and particularly in the 40's the number and quality of those eggs diminish considerably. We know that most if not all of that drop is the result of abnormal chromosomes in the eggs and when genetically abnormal eggs fertilize they produce genetically abnormal embryos. Most genetically abnormal embryos will not implant in the womb, and if they do, they usually miscarry.

These abnormal eggs result from errors in a process call meiosis. If this sounds familiar from high school biology, it is. Meiosis is the process by which reproductive stem cells produce eggs and sperm for reproduction. Most scientists nowadays believe that these errors result, at least in part, from a lack of the energy needed to divide the chromosomes properly, and that energy comes from cell's natural batteries, the mitochondria.

Now, a biotech company has come up with a technique to transfer fresh young, energy-rich mitochondria into a woman's eggs, and has even achieved a live birth with it. Sounds like a miracle cure? Maybe, maybe not.  If proven successful and safe, it has the potential to revolutionize IVF treatment for women over 35 and extend the age at which non-donor IVF may be successful. Still, don't expect to see it an IVF clinic near you any time soon. First, we do not know how effective this technique really is and most importantly whether it results in healthy children. The technology involves cloning technology and "3-parent IVF," and it is unlikely that will get past regulatory agencies here in the US anytime soon.