Autotransplantation of Menstrual Endometrial Stromal Cells as a Promising Technology in Reproductive Medicine

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Abstract
Background: Infertility represents a global medical and social problem, and endometrial dysfunction (thinning, impaired receptivity, synechiae, etc.) remains one of the key causes of implantation failure and limitation of the effectiveness of assisted reproductive technology (ART) programs. In this regard, new pathogenetic approaches are being actively investigated, among which cell technologies occupy a special place. Objective: To analyze current scientific literature data on the potential of mesenchymal stromal cells derived from menstrual blood (MenSCs) for restoring functional activity of the endometrium and improving the effectiveness of ART programs. Materials and methods: This review summarizes the results of fundamental research, preclinical trials on animal models, and early clinical studies on the isolation, cultivation, phenotyping, and transplantation of human MenSCs. The review includes data from foreign and Russian articles found in Pubmed, Elsevier, and Cochrane Library databases on this topic, published over the last 7 years. Results: Literature analysis confirms that menstrual blood is an accessible and reproducible non-invasive source of MSC cells with a phenotype and properties consistent with the criteria of the International Society for Cell Therapy (ISCT). MenSCs demonstrate high proliferative potential, multilineage differentiation capacity, and pronounced paracrine activity directed toward angiogenesis and modulation of endometrial receptivity. Based on recent studies, the safety profile of MenSCs is assessed as favorable. Conclusion: Further research in this area is needed to standardize protocols for cell isolation and transplantation, and ultimately to use optimized methods in clinical practice of ART programs to increase implantation and pregnancy rates.

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