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. 2017 May;39(5):217-223.
doi: 10.1055/s-0037-1601484. Epub 2017 Apr 11.

The Effect of Mesenchymal Stem Cells on Fertility in Experimental Retrocervical Endometriosis

Affiliations

The Effect of Mesenchymal Stem Cells on Fertility in Experimental Retrocervical Endometriosis

Jaqueline Pedroso de Abreu et al. Rev Bras Ginecol Obstet. 2017 May.

Abstract

Purpose To evaluate the effect of mesenchymal stem cells (MSCs) on fertility in experimental retrocervical endometriosis. Methods A total of 27 New Zealand rabbits were divided into three groups: endometriosis, in which endometrial implants were created; mesenchymal, in which MSCs were applied in addition to the creation of endometrial implants; and control, the group without endometriosis. Fisher's exact test was performed to compare the dichotomous qualitative variables among the groups. The quantitative variables were compared by the nonparametric Mann-Whitney and Kruskal-Wallis tests. The Mann-Whitney test was used for post-hoc multiple comparison with Boniferroni correction. Results Regarding the beginning of the fertile period, the three groups had medians of 14 ± 12.7, 40 ± 5, and 33 ± 8.9 days respectively (p = 0.005). With regard to fertility (number of pregnancies), the endometriosis and control groups showed a rate of 77.78%, whereas the mesenchymal group showed a rate of 11.20% (p = 0.015). No differences in Keenan's histological classification were observed among the groups (p = 0.730). With regard to the macroscopic appearance of the lesions, the mesenchymal group showed the most pelvic adhesions. Conclusion The use of MSCs in endometriosis negatively contributed to fertility, suggesting the role of these cells in the development of this disease.

Objetivo Avaliar o efeito das células-tronco mesenquimais sobre a fertilidade na endometriose retrocervical experimental. Métodos Um total de 27 coelhas da raça Nova Zelândia foram divididas em três grupos: endometriose, em que os implantes endometriais foram criados; mesenquimal, em que as células-tronco mesenquimais foram aplicadas complementarmente à criação implantes endometriais; e controle, sem endometriose. O teste exato de Fisher foi realizado para comparar variáveis dicotômicas qualitativas entre os grupos. As variáveis quantitativas foram comparadas pelos testes não paramétricos de Mann-Whitney e Kruskal-Wallis. O teste de Mann-Whitney foi utilizado para a comparação múltipla pós-hoc com correção de Boniferroni. Resultados em relação ao início do período fértil, os grupos endometriose, mesenquimal e controle tiveram medianas de 14 ± 12,7; 40 ± 5; e 33 ± 8,9 dias, respectivamente (p = 0,005). Sobre a taxa de fertilidade (número de gravidezes), os grupos endometriose e controle mostraram uma taxa de 77,78%, enquanto o grupo mesenquimal mostrou uma taxa de 11,20% (p = 0,015). Não foram observadas diferenças na classificação histológica de Keenan entre os grupos (p = 0,730). No que diz respeito à aparência macroscópica das lesões, o grupo mesenquimal mostrou maiores adesões pélvicas. Conclusão O uso de células-tronco mesenquimais na endometriose contribuiu negativamente para a fertilidade, sugerindo o papel dessas células no desenvolvimento da doença.

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Conflict of interest statement

Declaration of Conflicting Interests: The Authors have no conflicts of interest to declare.

Figures

Fig. 1
Fig. 1
Chronology of the experiments in the study.
Fig. 2
Fig. 2
(A-F) Differentiation of mesenchymal cells. (B) The differentiation into the adipocyte lineage was demonstrated by staining with Oil Red O; (D) Alizarin Red S staining shows mineralization of the extracellular matrix in the osteogenic differentiation; and (F) toluidine blue shows the deposition of proteoglycans and lacunae in the chondrogenic differentiation. (A, C, E) Untreated control cultures without adipogenic, osteogenic or chondrogenic differentiation stimuli are shown.
Fig. 3
Fig. 3
(A) Histological image of the endometrial implant with a Keenan index of 3. (B) Histological picture of the endometrial implant with a Keenan index of 0.
Fig. 4
Fig. 4
(A) Mesenchymal group: large presence of adhesions (yellow arrows) that made it difficult for the implant to adhere (white arrows); (B) Endometriosis group: presence of a minor amount of adhesion (yellow arrow) next to the implant (white arrow).

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