提高生育能力的策略:保存、再生和干细胞

Carmen Acosta-Bueno, Antonio Cejudo-Román, Anabel Salazar-Vera, Rocío Quiroga-Gil
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摘要

目前,许多妇女认为她们的生育潜力降低了。一方面,社会文化的变化导致生育推迟,随之而来的是高龄对卵巢储备的负面影响。另一方面,癌症发病率的增加以及抗肿瘤治疗的众多进步使许多肿瘤患者得以生存。因此,许多妇女在执行其生育计划方面表现出困难。除了这个比例的女性人口,还有一些人,由于各种原因,经历了提前绝经。通过这种方式,建立了一个新的临床重点,其共同点在于卵巢储备减少的存在,因此,不能充分响应激素刺激。由于这个原因,在证明了残留卵巢储备可以恢复的存在之后,新的卵巢再生方案正在开发,重点是恢复那些睡眠卵泡。由于卵巢功能的改变和这些患者的低卵泡储备,目前用于保留生育能力的策略的应用效率不高。因此,体外卵泡激活技术和骨髓干细胞输注已成为改善这类患者卵泡发育的新选择。
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Estrategias de mejora de la fertilidad: preservación, rejuvenecimiento y células madre

Currently, many women see their reproductive potential reduced. On the one hand, socio-cultural changes have led to the postponement of motherhood with the consequent negative effects that advanced age has on the ovarian reserve. On the other hand, the increase in the incidence of cancer together with the numerous advances made in antineoplastic therapies have allowed many of the oncological patients to survive. As a result, many women show difficulties in carrying out their reproductive plans. In addition to this percentage of the female population, there are those who, for various reasons, experience early menopause. In this way, a new clinical focus is established whose common point lies in the presence of a diminished ovarian reserve which, therefore, does not respond adequately to hormonal stimulation. For this reason, and after demonstrating the existence of a residual ovarian reserve that can be recovered, new ovarian rejuvenation protocols are being developed that focus on the recovery of those sleeping follicles. Due to this alteration in ovarian function and the low follicular reserve of these patients, the application of current strategies for the preservation of fertility is not efficient. Therefore, in vitro follicular activation techniques and infusion of bone marrow-derived stem cells have been developed as new alternatives to improve follicular development in this type of patient.

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