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Autologous stem cell transplantation in refractory Asherman's syndrome: A novel cell based therapy.

Singh N, Mohanty S, Seth T, Shankar M, Bhaskaran S, Dharmendra S - J Hum Reprod Sci (2014)

Bottom Line: Six cases of refractory AS with failed standard treatment option of hysteroscopic adhesiolysis in the past were included.The mean MNC count was 103.3 × 106 (±20.45) with mean CD34+ count being 203,642 (±269,274).Mean of ET (mm) at 3 months (4.05 ± 1.40), 6 months (5.46 ± 1.36) and 9 months (5.48 ± 1.14) were significantly (P < 0.05) increased from pretreatment level (1.38 ± 0.39).

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynaecology and Stem Cell Facility, All India Institute of Medical Sciences, New Delhi, India.

ABSTRACT

Background: There is substantial evidence that adult stem cell populations exist in human endometrium, and hence it is suggested that either endogenous endometrial stem/progenitor cells can be activated or bone marrow derived stem cells can be transplanted in the uterine cavity for endometrial regeneration in Asherman's syndrome (AS).

Aims and objectives: The objective was to evaluate the role of sub-endometrial autologous stem cell implantation in women with refractory AS in attaining menstruation and fertility.

Setting: Tertiary care referral center.

Design: Prospective case series.

Materials and methods: Six cases of refractory AS with failed standard treatment option of hysteroscopic adhesiolysis in the past were included. Mononuclear stem cells (MNCs) were implanted in sub-endometrial zone followed by exogenous oral estrogen therapy. Endometrial thickness (ET) was assessed at 3, 6, and 9 months.

Results: Descriptive statistics and statistical analysis of study variables was carried out using STATA version 9.0. The mean MNC count was 103.3 × 106 (±20.45) with mean CD34+ count being 203,642 (±269,274). Mean of ET (mm) at 3 months (4.05 ± 1.40), 6 months (5.46 ± 1.36) and 9 months (5.48 ± 1.14) were significantly (P < 0.05) increased from pretreatment level (1.38 ± 0.39). Five out of six patients resumed menstruation.

Conclusion: The autologous stem cell implantation leads to endometrial regeneration reflected by restoration of menstruation in five out of six cases. Autologous stem cell implantation is a promising novel cell based therapy for refractory AS.

No MeSH data available.


Related in: MedlinePlus

Posttransplant endometrial thickness of the same patient
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Figure 3: Posttransplant endometrial thickness of the same patient

Mentions: The mean preimplantation ET (mm) was 1.38 ± 0.39 and there was a statistically significant increase (t = 4.28, P = 0.008) in the growth of the endometrium to 4.05 ± 1.40 mm at 3 months [Figures 1-3]. Although the maximum ET attained by any patient was 6.7 mm, the growth of endometrium was found to be static during 6 months (5.46 ± 1.36; t = 8.15; P = 0.001) and 9 months (5.48 ± 1.14; t = 7.40; P = 0.002) follow-up [Table 2].


Autologous stem cell transplantation in refractory Asherman's syndrome: A novel cell based therapy.

Singh N, Mohanty S, Seth T, Shankar M, Bhaskaran S, Dharmendra S - J Hum Reprod Sci (2014)

Posttransplant endometrial thickness of the same patient
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4150149&req=5

Figure 3: Posttransplant endometrial thickness of the same patient
Mentions: The mean preimplantation ET (mm) was 1.38 ± 0.39 and there was a statistically significant increase (t = 4.28, P = 0.008) in the growth of the endometrium to 4.05 ± 1.40 mm at 3 months [Figures 1-3]. Although the maximum ET attained by any patient was 6.7 mm, the growth of endometrium was found to be static during 6 months (5.46 ± 1.36; t = 8.15; P = 0.001) and 9 months (5.48 ± 1.14; t = 7.40; P = 0.002) follow-up [Table 2].

Bottom Line: Six cases of refractory AS with failed standard treatment option of hysteroscopic adhesiolysis in the past were included.The mean MNC count was 103.3 × 106 (±20.45) with mean CD34+ count being 203,642 (±269,274).Mean of ET (mm) at 3 months (4.05 ± 1.40), 6 months (5.46 ± 1.36) and 9 months (5.48 ± 1.14) were significantly (P < 0.05) increased from pretreatment level (1.38 ± 0.39).

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynaecology and Stem Cell Facility, All India Institute of Medical Sciences, New Delhi, India.

ABSTRACT

Background: There is substantial evidence that adult stem cell populations exist in human endometrium, and hence it is suggested that either endogenous endometrial stem/progenitor cells can be activated or bone marrow derived stem cells can be transplanted in the uterine cavity for endometrial regeneration in Asherman's syndrome (AS).

Aims and objectives: The objective was to evaluate the role of sub-endometrial autologous stem cell implantation in women with refractory AS in attaining menstruation and fertility.

Setting: Tertiary care referral center.

Design: Prospective case series.

Materials and methods: Six cases of refractory AS with failed standard treatment option of hysteroscopic adhesiolysis in the past were included. Mononuclear stem cells (MNCs) were implanted in sub-endometrial zone followed by exogenous oral estrogen therapy. Endometrial thickness (ET) was assessed at 3, 6, and 9 months.

Results: Descriptive statistics and statistical analysis of study variables was carried out using STATA version 9.0. The mean MNC count was 103.3 × 106 (±20.45) with mean CD34+ count being 203,642 (±269,274). Mean of ET (mm) at 3 months (4.05 ± 1.40), 6 months (5.46 ± 1.36) and 9 months (5.48 ± 1.14) were significantly (P < 0.05) increased from pretreatment level (1.38 ± 0.39). Five out of six patients resumed menstruation.

Conclusion: The autologous stem cell implantation leads to endometrial regeneration reflected by restoration of menstruation in five out of six cases. Autologous stem cell implantation is a promising novel cell based therapy for refractory AS.

No MeSH data available.


Related in: MedlinePlus