The use of autologous mesenchymal stem cells for endometrial repair in patients with lower fertility

Objective: Evaluation of the effectiveness of mesenchymal stem cells (MSC) in patients with lower fertility associated with Asherman’s syndrome and an extremely thin endometrium. Patients and methods: A pilot study was conducted with participation of 11 women aged 25-43 years. The endometrium was evaluated by dynamic transvaginal ultrasound (US) with Doppler imaging, outpatient hysteroscopy on the 7-9th day of the menstrual cycle (m.c.). Autologous MSC were collected from adipose tissue or menstrual blood. Intravenous and intrauterine injection of autologous MSC was performed on the 3-4th m.c. The effect of therapy was assessed by the occurrence of pregnancy and also by echographic characteristics of the endometrium. Results: The use of MSC was attended by a significant (р < 0.003) increase of endometrial thickness according to US findings and a decrease of the resistivity index of basal arteries in all patients, restoration of normal endometrial thickness and structure in 8 patients. Control outpatient hysteroscopy did not reveal any recurrence of intrauterine synechiae. Clinical pregnancy was recorded in 6 cases. Conclusion: The use of autologous MSC is a promising method of overcoming infertility in patients with Asherman’s syndrome and an extremely thin endometrium not responding to standard therapy. © 2019, Dynasty Publishing House. All rights reserved.