A Potential Cure for Endometriosis-Related Infertility Everyday Health MenuNewslettersSearch Endometriosis News Could This Breakthrough Be the First Step Toward an Endometriosis Infertilty Cure Stem cell research opens door to bioengineering human uterus and future endometriosis-related fertility treatments. By Beth LevineMedically Reviewed by Kacy Church, MDJanuary 8, 2019Everyday Health ArchiveMedically ReviewedExperts are excited about this endometriosis research.iStockThere’s a buzz among endometriosis experts. Researchers at Northwestern Medicine have announced an exciting study result, published November 13, 2018, in the journal Stem Cell Reports: The team has been able to reprogram human bone marrow cells to develop into disease-free endometrial cells. The hope is that sometime in the future, technology will advance to the point that doctors will be able to insert these cells into the endometrium of patients with endometriosis, where they will regenerate and eradicate the disease. This research could also lead to a treatment for endometriosis-related infertility. Understanding Endometriosis Causes and Symptoms Endometriosis is a chronic disease in which endometrium-like tissue grows on organs outside the uterus, causing severe pain and sometimes infertility. Related: These Stars Are Transcending the Pain of Endometriosis We talked with one of the lead authors, Serdar E. Bulun, MD, of the department of obstetrics and gynecology at the Feinberg School of Medicine at Northwestern University and Prentice Women’s Hospital in Chicago, about this breakthrough study and the impact and implications of this paradigm-shifting result: EverydayHealth: Your work was an extension of Shinya Yamanaka’s Nobel Prize–winning work on stem cells, correct? Dr. Serdar Bulun: Correct. Yamanaka took human adult fibroblasts, such as skin cells, and made them go back in development until they are what we call pluripotent, meaning get them to an earlier stage of development so they become stem cells — they are capable of differentiating into any human organ. These stem cells have a specialized program, so they can be programmed to differentiate to make any of these specialized organ types. Before Yamanaka, stem cells could only be made from embryo cells. Yamanaka was able to put four proteins into any human cell, such as the skin cell, which basically erased that specialized programming and made that cell open to differentiating into any organ. Self-care strategies don t end here Go to Tippi to find out how other women with endo put themselves first EH: Your breakthrough was to take a human adult bone marrow cell and develop it into a healthy endometrial cell? SB: In its current form, endometriosis is a very complex, chronic disease. There is no known cure. Ovulation and repeated episodes of menstruation are significant risk factors and therefore bad for endometriosis. They actually can induce it. The treatment today is to give hormones to suppress ovulation and menstruation. If these endometriotic lesions are deposited in various locations in the lower abdomen, we can also perform laparoscopy or surgery to remove them. But this is not a cure because these lesions can come back through additional episodes of retrograde menstruation. In these women, these cells in the retrograde menstrual tissue are originally inappropriately programmed so that they are able to survive and cause inflammation in the pelvis. It makes sense to attempt to replace these intrauterine endometrial cells with appropriately programmed cells so that they would be a cell-based cure for endometriosis. Related: FDA Approves New Endometriosis Treatment Drug Thus, we can take a skin biopsy or isolate blood cells from a woman, erase the DNA program of these cells via the Yamanaka factors, and then reprogram these so-called induced pluripotent stem (iPS) cells. We were able to treat these iPS cells with a series of hormones to turn them into an endometrial cell. They look like mature endometrial cells that have receptors for progesterone, which is key, so they can act like normal endometrial cells. EH: How can this discovery be taken further in terms of endometriosis? SB: These inappropriately programmed cells in patients with endometriosis are resistant to the progesterone hormone. Our simple concept is to do a skin biopsy in a patient with endometriosis, and create a pluripotent cell out of the patient’s own cell. Now the cell is appropriately responsive to progesterone. Then, through advanced technology not yet created, we hope to replace the cell back into the endometrial cavity, so that it would naturally replace the diseased cells with healthy cells. Related: Should You Opt for Natural Progesterone Treatments for Endometriosis? EH: How else can this knowledge be used? SB: This technology might be applied to other critical problems, such as infertility, which occurs in some women with endometriosis. The diseased cells do no respond appropriately to progesterone, the implantation hormone, but these reprogrammed cells would respond. Another possible use might be in patients with Asherman’s syndrome, where intrauterine adhesions wiped out portions of the endometrium, and the endometrium could not regenerate. Finally, the same technology could be modified to make other cell types in the uterus, like the uterine muscle cells, or be combined with uterine vascular stem cells to engineer a full uterus, which could be transplanted. Since the uterus would have been created with her own cells, there would be a smaller risk of rejection than with a donated uterus. Related: Progesterone Receptor Levels Can Show Which Women Respond to First-Line Endometriosis Treatment EH: How long have you been working on this? SB: We worked on this phase for four years. Scientists around the world have been working on the same idea with different approaches. We chose a very simple approach. We simply tried different external hormonal treatments, but we had to find the right treatment, the right dose, and the right amount of treatment time. We had to demonstrate that these cells were molecularly fit. In the end, we were able to differentiate these cells into an endometrial stromal cell type over a time period of 14 days. EH: Do you see it happening any time soon? SB: Every possible therapeutic application that I have been describing right now is really futuristic. We need lots of new technology to make these things happen because it is a very complex process. But this is a good step towards these goals. It opens the door. NEWSLETTERS Sign up for our Women' s Health Newsletter SubscribeBy subscribing you agree to the Terms of Use and Privacy Policy. The Latest in Endometriosis FDA Approves Myfembree for Endometriosis Pain in Premenopausal Women Doctors were already prescribing the drug to manage uterine fibroid–related heavy menstrual bleeding, and now the medicine will be immediately available...By Lisa RapaportAugust 9, 2022 Endometriosis May Raise Risk of Stroke Study FindsWhile the overall risk is low, the link between endometriosis and cardiovascular disease is worth paying attention to.By Kaitlin SullivanJuly 25, 2022 New Study Finds Link Between Endometriosis and Early MenopauseWomen with endometriosis may have fewer reproductive years than those without the condition, especially if they’ve never had children or taken the pill...By Becky UphamJanuary 28, 2022 Does Low Testosterone Cause Endometriosis A new theory may change diagnosis and treatment of the disease.By Beth LevineMay 28, 2021 Everyday Health s Endometriosis Twitter Chat Here s What You MissedAdvocates and experts took to Twitter to discuss challenges, tips, awareness, and more in honor of Endometriosis Awareness Month.By Brianna MajsiakApril 13, 2021 Does Endometriosis Up Your Risk for Developing Rheumatoid Arthritis There’s a connection between endo and RA, according to a large study.By Beth LevineJanuary 19, 2021 Managing Endometriosis During the Coronavirus Crisis FAQsAn expert answers frequently asked questions from women with endo By Beth LevineApril 2, 2020 Model and Advocate Alaia Baldwin Aronow Opens Up About Her EndometriosisThrough advocacy and sharing vulnerable images of her ‘endo belly,’ Aronow wants other women to feel less alone.By Brianna MajsiakMarch 31, 2020 Together Against Endo Kari and Ryan Anderson Help Raise Endometriosis AwarenessFacing the disease as a couple helped Kari and Ryan Anderson persevere and start a family.By Michael DolanMarch 26, 2020 Experiences With EndometriosisAn open, honest, and raw conversation about what life with endo is really likeBy Kerry WeissMarch 19, 2020 MORE IN What Is Merkel Cell Carcinoma Symptoms Causes Diagnosis Treatment and Prevention How Is Non-Hodgkin Lymphoma Treated Leukemia Treatments Chemotherapy Targeted Therapy Radiation and More