Stem cells in reproductive medicine: ready for the patient?

Abstract

Study question: Are there effective and clinically validated stem cell-based therapies for reproductive diseases?

Summary answer: At the moment, clinically validated stem cell treatments for reproductive diseases and alterations are not available.

What is known already: Research in stem cells and regenerative medicine is growing in scope, and its translation to the clinic is heralded by the recent initiation of controlled clinical trials with pluripotent derived cells. Unfortunately, stem cell 'treatments' are currently offered to patients outside of the controlled framework of scientifically sound research and regulated clinical trials. Both physicians and patients in reproductive medicine are often unsure about stem cells therapeutic options.

Study design, size, duration: An international working group was assembled to review critically the available scientific literature in both the human species and animal models.

Participants/materials, setting, methods: This review includes work published in English until December 2014, and available through Pubmed.

Main results and the role of chance: A few areas of research in stem cell and reproductive medicine were identified: in vitro gamete production, endometrial regeneration, erectile dysfunction amelioration, vaginal reconstruction. The stem cells studied range from pluripotent (embryonic stem cells and induced pluripotent stem cells) to monopotent stem cells, such as spermatogonial stem cells or mesenchymal stem cells. The vast majority of studies have been carried out in animal models, with data that are preliminary at best.

Limitations, reasons for caution: This review was not conducted in a systematic fashion, and reports in publications not indexed in Pubmed were not analyzed.

Wider implications of the findings: A much broader clinical knowledge will have to be acquired before translation to the clinic of stem cell therapies in reproductive medicine; patients and physicians should be wary of unfounded claims of improvement of existing medical conditions; at the moment, effective stem cell treatment for reproductive diseases and alterations is not available.

Study funding/competing interests: None.

Trial registration number: NA.

Keywords: artificial gametes; assisted reproduction; regenerative medicine; stem cells.