Mesenchymal stem cells as an adjuvant for the treatment of poi, and as a support in expectant management of placental hematomas and premature rupture of membranes: case report

Abstract

In Mexico, 17% of women of childbearing age have infertility problems, this alteration may be associated to Premature Ovarian Insufficiency (POI). On the other hand, Premature Rupture of Membranes (PROM) is defined as the rupture of ovular membranes before labor begins. The application of Mesenchymal Stem Cells (MSCs) has been proposed for the treatment of POI, placental abruption and PROM. Objective: Describe a case report of a patient that received MSCs by intravenous injection as an adjuvant for the treatment of POI, and as an aid to reduce placental hematomas that appeared during pregnancy, which resulted in PROM (preterm, and previable), and a preterm baby delivery (alive). Clinical case presentation: A 30-year-old woman with history of primary infertility of 2 years; Anti-Müllerian Hormone (AMH) of 0.2 ng/mL; laparoscopic Bilateral Tubal Obstruction (BTO), endometriosis, diagnostic and surgical laparoscopy for myomatosis, and Factor VII deficiency; as well as 3 IVF, 4 embryo transfers, and 1 IUI unsuccessful. With confirmed POI diagnosis, the application of several doses at different times of MSCS is decided, resulting in pregnancy. Sometime later during pregnancy, placental hematomas and PROM are observed and decided to apply MSCs at different stages of pregnancy, resulting in the live birth of a baby (29.3 Weeks of Gestation) Conclusion: The application of multiple doses of MSCs turns more efficient the placental tissue restoration, allowing hematomas to disappear, and delaying a possible PROM.