Cross-linked hyaluronan gel to improve pregnancy rate of women patients with moderate to severe intrauterine adhesion treated with IVF: a randomized controlled trial

Mao, Xiaoyan; Tao, Yu; Cai, Renfei; Zhang, Jie; Gao, Hongyuan; Chen, Qiuju; Kuang, Yanping; Zhang, Shaozhen

doi:10.1007/s00404-019-05368-6

Cited by 24 publications

(11 citation statements)

References 16 publications

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“…Traditional treatment of IUAs includes hysteroscopic adhesiolysis followed by placement of an intrauterine barrier device and hormonal therapy. However, high recurrence of IUAs (33.3-45.7% [3][4][5] ) and poor reproductive outcome (pregnancy rate is 23.7-27.7% [5][6][7] ) still exist in moderate and severe cases due to the inadequate endometrial repair.…”

Section: Introductionmentioning

confidence: 99%

An Acellular Scaffold Facilitates Endometrial Regeneration and Fertility Restoration via Recruiting Endogenous Mesenchymal Stem Cells

Xin

Zheng

Chen

et al. 2022

Adv Healthcare Materials

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Severe intrauterine adhesions (IUAs), characterized by inadequate endometrial repair and fibrosis, can lead to infertility. Stem cell-based therapies, which deliver mesenchymal stem cells (MSCs) to the wound site, hold a considerable promise for endometrium regeneration. However, some notable hurdles, such as stemness loss, immunogenicity, low retention and survival rate, limit their clinical application. Evidence shows a strategy of mobilizing endogenous MSCs recruitment can overcome the traditional limitations of exogenous stem cell-based therapies. Here, an acellular biomaterial named stromal derived factor-1 alpha (SDF-1𝜶)/E7-modified collagen scaffold (CES) is explored. CES based on harnessing the innate regenerative potential of the body enables near-complete endometrium regeneration and fertility restoration both in a rat endometrium acute damage model and a rat IUA model. Mechanistically, the CES implantation promotes endogenous MSCs recruitment via a macrophage-coordinated strategy; then the homing MSCs exert the function of immunomodulation and altered local microenvironments toward regeneration. To conclude, CES, which can harness endogenous MSCs and overcome the traditional limitations of cell-based therapies, can serve as a clinically feasible and cell-free strategy with high therapeutic efficiency for IUA treatment.

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Section: Introductionmentioning

confidence: 99%

An Acellular Scaffold Facilitates Endometrial Regeneration and Fertility Restoration via Recruiting Endogenous Mesenchymal Stem Cells

Xin

Zheng

Chen

et al. 2022

Adv Healthcare Materials

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“…Furthermore, HA gel alone showed no significant effect on the postoperative pregnancy rate [ 38 , 39 ]. In a randomized controlled trial, the application of HA gel during hysteroscopy in patients with moderate to severe IUA had improved the quality of the endometrium and uterine receptivity, thereby enhancing the clinical pregnancy rate after IVF/CSI and FET [ 40 ].…”

Section: Hyaluronic Acid In Endometrial Regenerative Medicinementioning

confidence: 99%

Recent developments in bio-scaffold materials as delivery strategies for therapeutics for endometrium regeneration

Zhao

et al. 2021

Materials Today Bio

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Intrauterine adhesions (IUAs) refer to the repair disorder after endometrial injury and may lead to uterine infertility, recurrent miscarriage, abnormal menstrual bleeding, and other obstetric complications. It is a pressing public health issue among women of childbearing age. Presently, there are limited clinical treatments for IUA, and there is no sufficient evidence that these treatment modalities can effectively promote regeneration after severe endometrial injury or improve pregnancy outcome. The inhibitory pathological micro-environment is the main factor hindering the repair of endometrial damaged tissues. To address this, tissue engineering and regenerative medicine have been achieving promising developments. Particularly, biomaterials have been used to load stem cells or therapeutic factors or construct an in situ delivery system as a treatment strategy for endometrial injury repair. This article comprehensively discusses the characteristics of various bio-scaffold materials and their application as stem cell or therapeutic factor delivery systems constructed for uterine tissue regeneration.

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“…The recurrence rate of severe IUA patients even exceeds 60% after TCRA (Capella-Allouc et al, 1999). The clinical pregnancy rate of IUA patients does not exceed 20% after TCRA (20%) , transdermal estrogen treatment (16.67%) (Chi et al, 2018) and IVF (15.3%) (Mao et al, 2020).…”

Section: Introductionmentioning

confidence: 98%

Applications of Hydrogels in Premature Ovarian Failure and Intrauterine Adhesion

Zhang

Ding²,

Duan³

et al. 2022

Front. Mater.

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Premature ovarian failure (POF) and intrauterine adhesion (IUA) that easily lead to reduced fertility in premenopausal women are two difficult diseases to treat in obstetrics and gynecology. Hormone therapy, in vitro fertilization and surgical treatments do not completely restore fertility. The advent of hydrogels offers new hope for the treatment of POF and IUA. Hydrogels are noncytotoxic and biodegradable, and do not cause immune rejection or inflammatory reactions. Drug delivery and stem cell delivery are the main application forms. Hydrogels are a local drug delivery reservoir, and the control of drug release is achieved by changing the physicochemical properties. The porous properties and stable three-dimensional structure of hydrogels support stem cell growth and functions. In addition, hydrogels are promising biomaterials for increasing the success rate of ovarian tissue transplantation. Hydrogel-based in vitro three-dimensional culture of follicles drives the development of artificial ovaries. Hydrogels form a barrier at the site of injury and have antibacterial, antiadhesive and antistenosis properties for IUA treatment. In this review, we evaluate the physicochemical properties of hydrogels, and focus on the latest applications of hydrogels in POF and IUA. We also found the limitations on clinical application of hydrogel and provide future prospects. Artificial ovary as the future of hydrogel in POF is worth studying, and 3D bioprinting may help the mass production of hydrogels.

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Cross-linked hyaluronan gel to improve pregnancy rate of women patients with moderate to severe intrauterine adhesion treated with IVF: a randomized controlled trial

Cited by 24 publications

References 16 publications

An Acellular Scaffold Facilitates Endometrial Regeneration and Fertility Restoration via Recruiting Endogenous Mesenchymal Stem Cells

An Acellular Scaffold Facilitates Endometrial Regeneration and Fertility Restoration via Recruiting Endogenous Mesenchymal Stem Cells

Recent developments in bio-scaffold materials as delivery strategies for therapeutics for endometrium regeneration

Applications of Hydrogels in Premature Ovarian Failure and Intrauterine Adhesion

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