Intrauterine transplantation of autologous menstrual blood stem cells increases endometrial thickness and pregnancy potential in patients with refractory intrauterine adhesion

Abstract

Aim: This study was designed to evaluate the effects of intrauterine transplantation of menstrual blood stem cells (MenSCs) on endometrial thickness and pregnancy outcomes in patients with refractory intrauterine adhesion (IUA). Methods: This study included a group of infertile women (n = 12, age 22-40 years), with refractory IUA. Autologous MenSCs isolated from the women's menstrual blood were expanded in vitro and transplanted into their uteruses, followed by hormone replacement therapy. Transvaginal ultrasound examination was performed to assess the endometrial thickness. Transabdominal ultrasound was conducted to detect pregnancy outcome. Results: Autologous MenSCs were successfully isolated and expanded from menstrual blood and transplanted into the uterus of each patient. A significant improvement of the endometrial thickness was observed from 3.9 ± 0.9 to 7.5 ± 0.6 mm (P < 0.001). No adverse reaction was observed. The duration of menstruation was increased from 2.4 ± 0.7 to 5.3 ± 0.6 days (P < 0.001). Five out of 12 patients achieved clinical pregnancy and the pregnancy rate was 41.7%. Conclusions: Intrauterine transplantation of autologous MenSCs results in regeneration of endometrium, a prolongation of menstrual duration and an increase rate of pregnancy in patients with refractory IUA.

Therapeutic Potential of Menstrual Blood-Derived Stem Cell Transplantation for Intrauterine Adhesions

“…by MenSCs transplantation, and some of them achieved clinical pregnancy (9). In that study, five out of 12 patients got pregnant, and in other words, there was a pregnancy rate of 41.7% (9).…”

“…Autologous MenSCs have been transplanted to patients with refractory IUA for clinical therapy. The results revealed that patients with refractory IUA had thicker endometrium and prolonged menstrual duration managed by MenSCs transplantation, and some of them achieved clinical pregnancy ( 9 ). In that study, five out of 12 patients got pregnant, and in other words, there was a pregnancy rate of 41.7% ( 9 ).…”

“…The results revealed that patients with refractory IUA had thicker endometrium and prolonged menstrual duration managed by MenSCs transplantation, and some of them achieved clinical pregnancy ( 9 ). In that study, five out of 12 patients got pregnant, and in other words, there was a pregnancy rate of 41.7% ( 9 ). Another study also showed women with IUA had thicker significantly endometrium after autologous MenSCs transplantation ( 10 ).…”

Human amniotic mesenchymal stem cells combined with PPCNg facilitate injured endometrial regeneration

“…Salama et al [86] found that BM-MSCs up-regulated the expression of PCNA and VEGF, down-regulated the expression of NF-κB and effectively repaired the injured endometrium in the rat IUA model. Ma et al [87] reported that Men-SCs transplantation could promote endometrial repair in patients with refractory IUA, which showed increased endometrial thickness, prolonged menstrual duration, and increased pregnancy rate. In a current clinical study, patients with unresponsive thin endometrium caused by IUA received UC-MSCs therapy.…”

The Top 100 Most Cited Articles on Intrauterine Adhesion: a Bibliometric Analysis

“…Nevertheless, more importance was attached to biotherapy, especially in the field of stem cell therapy. Bone marrow mesenchymal stem cells (BMSCs) [59], umbilical cord mesenchymal stem cells (UCMSCs) [60], and menstrual blood mesenchymal stem cells (MbMSCs) [61,62] have been used clinically in patients with IUA, resulting in an improvement in reproductive outcome. Furthermore, researchers reported that stem cells could not only promote endometrial cell proliferation, but also inhibit the process of fibrosis [63].…”