Do adipose-derived mesenchymal stem cells improve reproductive potential in patientswith inadequate ovarian response?

To evaluate whether intraovarian infusion of autologous adipose-derived mesenchymal stem cells (MSCs) improves ovarian reserve parameters and oocyte retrieval outcomes in women with poor ovarian response.

This retrospective pre-post cohort study included 29 women aged 25-40 years who met the European Society of Human Reproduction and Embryology (ESHRE) criteria for poor ovarian response and had experienced at least one previous Assisted Reproductive Technology (ART) cycle without oocyte retrieval. A total of 1 × 10⁶ autologous adipose-derived MSCs were laparoscopically infused into four cortical quadrants of each ovary. Serum anti-Müllerian hormone (AMH) levels were measured at baseline and 2 months after treatment. Controlled ovarian stimulation using a gonadotropin-releasing hormone (GnRH) antagonist protocol was initiated two months post-infusion, followed by oocyte retrieval. Paired comparisons were performed using the Wilcoxon signed-rank test. Multivariable linear regression evaluated factors associated with change in AMH (DAMH), and binomial logistic regression assessed predictors of successful oocyte retrieval.

Serum AMH levels increased significantly following MSC therapy. Median AMH rose from 0.01 ng/mL (0.01-0.02) to 0.02 ng/mL (0.01-0.04) (P = 0.001). No baseline demographic or clinical variables were independently associated with DAMH (all P > 0.05). DAMH was the only variable significantly associated with successful oocyte retrieval (likelihood ratio c² = 6.54, P = 0.011). Higher DAMH values corresponded to progressively increased predicted probabilities of oocyte retrieval.

Intraovarian administration of autologous adipose-derived MSCs was associated with modest but significant improvements in AMH levels and oocyte retrieval probability. These exploratory findings warrant confirmation in larger prospective controlled studies with definitive reproductive endpoints.