Retrospective analysis of autologous bone marrow mesenchymal stem cells as adjuvant therapy in recurrent intrauterine adhesions.

Abstract

Objectives: We aimed to retrospectively analyze the efficacy and safety of autologous bone marrow mesenchymal stem cells (BM-MSCs) as adjuvant therapy for intrauterine adhesion (IUA) and endometrial repair.

Methods: Patients enrolled at Shengjing Hospital Affiliated to China Medical University from January 2017 to January 2020 for the treatment of infertility who diagnosed with recurrent IUA as confirmed by hysteroscopy were included. BM-MSC was isolated from the patient's own bone marrow collected before and preserved. The patients were admitted to the hospital for hysteroscopic transcervical resection of adhesions in the early proliferative phase of the menstrual cycle, given the first intrauterine perfusion of BM-MSCs on the same day of surgery and after surgery for the second and third perfusion on the fifth day of the menstrual cycle.After the third perfusion and improvement in the menstrual cycle, the patients were followed up once a year, for up to two years.

Result: All patients had menstrual bleeding and significantly increased menstrual flow during three rounds of perfusions with MSC compared to before treatment. However, this effect was reversed and there was no significant difference between the menstrual flow 1 year after treatment vs before treatment. The IUA scores after three rounds of treatment as well as one and two years after treatments were significantly lower compared to before surgery. No IUA recurrence was observed during the 2 year follow-up. Endometrial thickness had significantly increased during treatment. During the 2 year follow-up period, one patient conceived naturally. One patient was successfully implanted after in vitro fertilization and embryo transfer.

Conclusion: Intrauterine perfusion of autologous BM-MSCs, assisted by adhesiolysis, was effective in preventing postoperative IUA recurrence and partially improved the reproductive prognosis.