The Potential of Allogeneic Sertoli Cell Transplantation in Kyrgyzstan and Low-and-Middle Income Countries - Overcoming Barriers to Fertility Care: A Narrative Review
DOI:
https://doi.org/10.52783/jns.v14.2148Keywords:
Cryptorchidism, LMICs, Allogeneic Sertoli cell transplantation, Spermatogenesis restoration, Preclinical trialsAbstract
Infertility in males associated with cryptorchidism is a relevant but under investigated problem in low-and-middle-income countries (LMICs), including Kyrgyzstan, where the availability of sophisticated fertility services is limited, which only adds more socioeconomic problems. This narrative review aims to determine the therapeutic efficacy of allogeneic transplantation of undifferentiated Sertoli cells (USCs) in the rehabilitation of spermatogenesis in experimental cryptorchidism, and assess its applicability as a non-costly and easily expandable treatment for LMICs. The search strategy employed a systematic approach to the following databases: Scopus, PubMed, Web of Science, and Google Scholar. The search strategy comprised keywords such as “Sertoli cell transplantation,” “cryptorchidism,” “spermatogenesis restoration,” “allogeneic therapy,” and “male infertility in LMICs.” Articles published between the years 2005 and 2024 were included, and the search was restricted to preclinical trials, mechanistic analyses, and reviews that focused on the biology of USC, immune tolerance, and translation. This review concludes that USCs can restore the testicular microenvironment, nurture the development of germ cells, and escape the immune response in experimental models, which could be a better option than current aggressive treatments. Nevertheless, problems including scarcity of donor cells, technical issues, and inadequate infrastructure in LMICs need innovative solutions, including simplified methods and regional capacity building. Given the current situation in the healthcare system of Kyrgyzstan, including the high incidence of cryptorchidism and lack of financial resources, the authors of this article consider it necessary to further explore the possibility of applying USC-based therapies for the treatment of male infertility in LMICs.
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