Title : The influence of autologous in vitro activation of ovaries by stem cells and growth factors on endocrine and reproductive function of patients with ovarian insufficiency
Abstract:
Introduction: Premature ovarian failure (POF) occurs in 1% of women, in age 35-40, mostly of unknown cause, and leads to reduction or loss of female reproductive function. Many factors cause the interruption of the Hippo signaling pathway and the termination of follicular growth resulting in the onset of amenorrhea and menopause. The pathway of phosphatidylinositol-3-kinase / protein kinase B (PI3K-Akt) plays a key role in cellular responses to cell proliferation. PI3K-Akt signaling is associated with ovarian function, growth of primordial follicles, yellow body survival and oocyte maturation.
Materials and methods: The SEGOVA method (therapy with autologous concentrated growth factors and autologous stem cells and in vitro activation of the tissue of the ovaries) acts on the described intracellular signaling system. The study included 50 patients, 30 to 50 years of age, with a diagnosis of POF and infertility.The study was performed at Jevremova Special Hospital in Belgrade, Saint James Hospital in Malta, and RemedicaSkoplje Hospital, between 2015-2018.
Aim: The goals of longitudinal prospective observational study were:
1. To investigate the blood levels of FSH, LH, progesterone and estradiol before and 3, 6, and 12 months after the procedure of in vitro activated ovarian tissue.
2. To investigate if the volume of retransplanted activated ovarian tissue affected the levels of FSH, LH, progesterone, and estradiol hormones.
3. To investigate if the volume of the bone marrow and total nucleated cell count taken before the treatment correlated with hormone level at 3, 6, and 12 months after the treatment.
4. To investigate the effects of in vitro ovarian activation on reproductive function, follicle count, number and quality of aspirated cells, and number of embryos.
Results: The sample of 50 patients monitored over 12 months exhibited that SEGOVA has a positive effect on the endocrine status and the reproductive outcome of patients. Out of all patients, 64% (32 of 50) had follicles present.Out of 32 patients who had follicles, 25% had oocytes (8 of 32). The fertilization rate of the aspirated oocytes was 75%(6 of 8), resulting in embryos. Embryo transfers were performed in 66,67% embryo positive women (4 of 6), while 50% of embryo positive women (3 of 6) had vitrified embryos. Out of all patients who had embryo transfer, 75% (3 of 4) resulted in successful pregnancies, which is 6% of total number of patients (3 of 50). Two patients spontaneously conceived after transplantation and one pregnancy was conceived with IVF. Three pregnancies resulted in the successful birth of 4 newborns (one twin pregnancy). Therearestill 10 vitrified embryos left. The levels of FSH, LH, and Progesterone show significant decrease, and estradiol increase, 12 months after the procedure.
Conclusion: The application of the SEGOVA method in the future could solve many problems in human reproduction due to a large number of patients diagnosed with POF, as well as the possibility of delaying menopause, thus improving the quality of life and general health.
