Fat is a readily accessible source of mesenchymal stem cells (MSCs). When fat is extracted by liposuction, the result is a so-called stromal vascular fraction (SVF) that contains a mishmash of mast cells (important in allergies), blood vessel-making cells, blood vessel-associated cells, fibroblasts, and MSCs. These adipose-derived stem cells (ASCs) as they are called, can be relatively easily prepared once the SVF is digested by enzymes, and centrifuges. The living adult MSCs are then rather easily identified because they adhere to plastic tissue culture plates.
Fat-based MSCs have been used in clinical studies to help heal patients with Crohn’s disease who have “fistulas.” For a picture of a fistula, see here. Crohn’s disease (CD) is one of a group of gastrointestinal diseases known as IBDs or inflammatory bowel diseases. CD features inflammation of any part of the GI tract, and this inflammation can affect multiple layers of the GI tract. Fistulas form when a hole is eroded through the GI tract and into another organ system. For example, in women, the rectum and erode and form an opening in the vagina. Alternatively, an opening can appear in some place other than the anus. Because of the repeated irritation and extensive inflammation of these lesions, they tend to not heal.
Beginning in 2003, Damián García-Olmo and his team at the Jiménez Diaz Foundation University Hospital in Madrid, Spain have tested the efficacy of fat-based stem cells in treating patients with CD-based fistulas. The results have been encouraging and highly positive, since ASCs promote healing of the fistulas and decrease recovery time (see de la Portilla F, et al. (2013) Int J Colorectal Dis 28:313–323; García-Olmo D, et al. (2003) Int J Colorectal Dis 18:451–454; García-Olmo D, et al. (2005) Dis Colon Rectum 48:1416–1423; Garcia-Olmo D, et al. (2009) Dis Colon Rectum 52:79–86).
Recently, Garcia-Olmo and his colleagues examined data from several their patients who went on to become pregnant after their treatment with fat-based stem cells and even given birth. This study, which was published in the June 2015 edition of Stem Cells Translational Medicine, examined six patients from these previous clinical trials who were successfully treated with fat-based stem cells, had satisfactory resolution and healing of their lesions, and then went on to become pregnant and give birth.
Of the five women examined in this study, one was treated for rectovaginal and perinatal fistulas, two for rectovaginal fistulas only, and two others for perianal fistulas only. All women received 2 doses of 20 million and 40 million stem cells at three-four-month intervals. One patient, however, received 2 doses of 6.6 million and 20 million stem cells nine months apart.
The fertility of these women and their pregnancies were unaffected by their previous cell therapies. There were no signs of treatment-related malformations in the babies they delivered, and their bodies did not show any identifiable signs of structural abnormalities as a result of the stem cell treatments. It must be said, that all four women who delivered healthy babies (one of them even had twins) elected for Caesarian sections. The fifth woman, unfortunately, miscarried twice, both times during the first trimester.
However, even though this represents a small data set, this study does strongly suggest that injection of a patient’s own fat-based stem cells does not negatively affect a woman’s ability to conceive, the course of her pregnancy, or the health of her baby.