A recent study has found that women with premature ovarian insufficiency (POI), can use their own bone marrow stem cells to rejuvenate their ovaries and avoid the effects of premature menopause. The preliminary results are from the ongoing ROSE clinical trial.
Premature ovarian insufficiency (POI) is a loss of normal function of your ovaries before age 40. If your ovaries fail, they don't produce normal amounts of the hormone estrogen or release eggs regularly. Infertility is a common result. POI is sometimes referred to as premature menopause, but the two conditions aren't exactly the same. Women with POI can still have irregular periods for years may possibly even get pregnant. Women with premature menopause stop having periods and can't become pregnant. Restoring estrogen levels in women with POI helps prevent some complications, such as osteoporosis, that occur as a result of low estrogen.
Cause of POI
There are several possible causes for POI
If you’re diagnosed with POI there are several different things that may have caused it:
Toxins. The most common causes of toxin-induced POI is chemotherapy and radiation therapy. These therapies can damage the genetic material in cells. Other toxins such as cigarette smoke, chemicals, pesticides and viruses might accelerate ovarian failure.
Chromosomal defects. There are some genetic disorders associated with POI, including mosaic Turner's syndrome, where a woman only has one normal X chromosome and an altered second X chromosome, and fragile X syndrome.
An immune system response to ovarian tissue (autoimmune disease). In this rare form, a woman’s immune system produces antibodies against her ovarian tissue, harming the egg-containing follicles and damaging the egg. What triggers the immune response is unclear, but exposure to a virus is one possibility.
Unknown factors. It's possible to develop POI, but have no known chromosomal defects, toxin exposure or autoimmune disease. In that case the doctor might recommend further testing to find the cause, but in most cases, the cause remains unknown (idiopathic).
Hope for Women with POI
Stem cell research may help reverse POI
For women who are experiencing POI, or early menopause, there is new hope for reversing the process and even restoring fertility. "In the two participants who have completed the treatment to date, serum estrogen levels have increased as soon as 3 months after the injection of stem cells, and the effect has lasted for at least one year. Their menopausal symptoms have been alleviated, and six months after the injection of the stem cells into the ovaries, they have resumed menses," said senior author Ayman Al-Hendy, M.D., Ph.D.
After this initial treatments, 33 more participants are entered into a clinical trial. In the treatment for the first two participants, they collected each woman's own mesenchymal stem cells from her posterior iliac crest bone marrow. They then used minimally invasive laparoscopy to inject the cells into one ovary, keeping the second, untreated, ovary as a control. The patients were followed closely with frequent blood work, imaging of the ovaries, menopausal symptom questionnaires, and safety studies.
There is hope the first two participants may become fertile again, now that both women's estrogen levels have increased significantly and they have begun to menstruate.
"Ultrasound imaging of treated ovaries shows significant size increase in the treated ovaries compared to the contralateral untreated ovaries. In the cases completed so far, the patients have tolerated the treatment very well with no complications or side effects," Al-Hendy said.
Healthy ovaries produce hormones and eggs typically until menopause begins in the early fifties, when they stop working. Approximately 1 percent of women have POI, some are even as young as in their teens. With such young onset, finding fertility solutions will be a great triumph.
Beyond the loss of fertility there are other side effects to POI or early menopause. In addition to losing the ability to menstruate, ovulate and have children using their own eggs, and they may be at increased risk for menopausal symptoms including hot flushes, night sweets, mood swings and vaginal dryness, and for cardiovascular disease, osteoporosis-related fracture and earlier cognitive function decline. The ability to reverse all of this will be very rewarding for women dealing with these issues.
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