The Role of Cell and Gene Therapies in the Treatment of Infertility in Patients with Thyroid Autoimmunity

Abstract

There is a rising incidence of infertility worldwide, and many couples experience difficulties conceiving nowadays. Thyroid autoimmunity (TAI) is recognized as one of the major female infertility causes related to a diminished ovarian reserve and potentially impaired oocyte maturation and embryo development, causing adverse pregnancy outcomes. Growing evidence has highlighted its impact on spontaneously achieved pregnancy and pregnancy achieved by in vitro fertilization. Despite the influence of thyroid hormones on the male reproductive system, there is insufficient data on the association between TAI and male infertility. In past years, significant progress has been achieved in cell and gene therapies as emerging treatment options for infertility. Cell therapies utilize living cells to restore healthy tissue microenvironment and homeostasis and usually involve platelet-rich plasma and various stem cells. Using stem cells as therapeutic agents has many advantages, including simple sampling, abundant sources, poor immunogenicity, and elimination of ethical concerns. Mesenchymal Stem Cells (MSCs) represent a heterogeneous fraction of self-renewal, multipotent non-hematopoietic stem cells that display profound immunomodulatory and immunosuppressive features and promising therapeutic effects. Infertility has a genetic component in about half of all cases, although most of its genetic causes are still unknown. Hence, it is essential to identify genes involved in meiosis, DNA repair, ovarian development, steroidogenesis, and folliculogenesis, as well as those involved in spermatogenesis in order to develop potential gene therapies for infertility. Despite advances in therapy approaches such as biological agents, autoimmune disorders remain impossible to cure. Recent research demonstrates the remarkable therapeutic effectiveness of MSCs in a wide array of autoimmune diseases. TAI is one of many autoimmune disorders that can benefit from the use of MSCs, which can be derived from bone marrow and adipose tissue. Cell and gene therapies hold great potential for treating autoimmune conditions, although further research is still needed.

Clinical Benefit of Autologous Platelet-Rich Plasma Infusion in Ovarian Function Rejuvenation: Evidence from a Before-After Prospective Pilot Study

“…In this way, and considering that female infertility is closely related to an established acute inflammatory microenvironment, as a consequence of the presence of autoimmune disorders (e.g., Thyroid autoimmunity) or idiopathic reasons, the administration of PRP may have a beneficial effect in terms of regulating acute inflammatory responses. It has been published in the literature that 5% of all spontaneous POI cases are due to autoimmunity and acute inflammatory responses [ 46 , 47 ]. In this way, one of the reasons for ovarian rejuvenation in these patients may be the mediated anti-inflammatory responses of the immunomodulatory molecules contained in PRP.…”

Which endometrial preparation protocol provides better pregnancy and perinatal outcomes for endometriosis patients in frozen-thawed embryo transfer cycles? A retrospective study on 1413 patients

“…Moreover, the importance of investigating the neonatal outcomes and long-term follow-up of children born from frozen embryos [ 32 , 38 ] and the psychological effects cannot be ignored [ 39 – 41 ]. Notably, there are other overlooked conditions that require the exploration of FET strategies other than endometriosis, such as the diagnosis of cancer [ 42 – 45 ] and thyroid autoimmunity [ 46 – 48 ]. Fertility preservation is a crucial issue to be addressed in all cancer patients of reproductive age, and the safety of different ART strategies for them warrants careful investigation.…”

Women have clinical aspects of infertility with thyroid pathology

“…Ч астота безплідного шлюбу, за даними дослідників, становить від 10 до 20 % [1][2][3][4][5][6][7]. Проблема взаємозв'язку порушень репродуктивної функції і патології щитоподібної залози (ЩЗ) активно обговорюється у науковій літературі [8][9][10][11][12][13][14]. З одного боку, це зумовлено високою поширеністю безпліддя у шлюбі (до 15-17 %), яке, незважаючи на сучасні досягнення у сфері репродукції людини, не має тенденції до зниження [15][16][17][18][19][20].…”