Reproductive health problems are of major concern in the modern world. The reasons for
these reproductive health problems are related to changes in our lifestyles In the past,
most women had their first child at about 21. Today, that age is closer to 26 or 27. Couples
are also waiting longer to start their families as they want to establish a career first. Thus,
with these delays, the reproductive organs are exposed to environmental toxins and
sexually transmitted diseases for longer. The older couples are, the more likely they are to
have developed health problems, and to get treated for them.

Reproductive health problems globally affect approximately 10–15% of couples. Physical
and mental health issues and hormonal imbalances are associated with problems related
to reproductive health. The global increased rate of reproductive health problems is due
to various reasons. Refractory reproductive health diseases, bring great distress to both
doctors and patients. However, there has been an increased focus on treatment over the
last few years. The so-called “Assisted Reproductive Technology” (ART) can only solve
about 50% of the cases and in certain instances, it carries significant risks and does not
solve the fundamental problems. The current IVF’s success rate is about 80 – 90 % (often
after 3 cycles) (1, 2).

Currently, some of the reproductive health treatment options include hormonal stimulation,
intrauterine insemination, In Vitro Fertilisation (IVF) or Intracytoplasmic Sperm Injection
(ICSI), gamete donation, and uterine surrogacy. In both sexes that experience reproductive
health problems, treatment options depend on the assertion that both partners produce
functional gametes. In couples where one partner is unable to produce functional gametes,
no treatment possibilities are currently available other than the use of donor sperm or
eggs. Genetic syndromes and medical treatments such as chemo- or radiotherapy
and immunosuppressive treatments are the most common reasons for the absence of
functional gametes. Many couples struggle with this since there is no full genetic link with
the child. Various alternatives to produce functional gametes have been suggested by
using germline progenitors, or patient-specific or umbilical cord tissue pluripotent stem
cell-derived gametes (3, 4).

Research in stem cells and regenerative medicine is on the increase with promising clinical trials in the initial stages. The specific potency, self-renewal, and tissue repair features of stem cells have great possibilities for the treatment of male and female reproductive health problems and have been used in research and treatment of various of these diseases. Various types of stem cells, including adipose stem cells, bone marrow stem cells, and umbilical cord stem cells are being tested in clinical trials for the treatment of reproductive health problems. These stem cells have shown positive results in improving the “microenvironment”, repairing the function of reproductive organs, forming germline stem cells,
and thereby improving reproductive capacity directly.

For stem cell therapy to progress, there needs to be further long-term planning, strict evaluation, and supervision to ensure the accuracy, quality, and safety of the use of stem cells in this field. Since the patient’s own stem cells and recently the use of umbilical-derived stem cells are more ethical, safe, and non-immune, the use of these types of stem cells will more likely be used in the future treatment of reproductive health problems.

There is however a cautionary note to couples: There are untested therapies where stem cells are used to treat reproductive health problems. Therefore, please consult with your reproductive physician to understand both the challenges and possibilities of solving reproductive health problems in the future.

References

1. Wu JX, Xia T, She LP, Lin S, Luo XM. Stem Cell Therapies for Human Reproductive health: Advantages and Challenges. Cell Transplant. 2022 Jan-Dec;31:9636897221083252. doi: 10.1177/09636897221083252. PMID: 35348026; PMCID: PMC8969497.
2. Figure: https://www.fribergfertility.com/stem-cells-to-stimulate-fertility-in-patients-with-ovarian failure-and- or-poor-response-in-ivf/
3. Garg K, Zilate S. Umbilical Cord-Derived Mesenchymal Stem Cells for the Treatment of Infertility Due to Premature Ovarian Failure. Cureus. 2022 Oct 20;14(10):e30529. doi: 10.7759/cureus.30529. PMID: 36415442; PMCID: PMC9674197.
4. Rosner, M., Horer, S., Feichtinger, M. et al. Multipotent fetal stem cells in reproductive biology research. Stem Cell Res Ther 14, 157 (2023). https://doi.org/10.1186/s13287-023-03379-4