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.