Autologous menstrual blood-derived stromal cells transplantation for severe Asherman's syndrome
Autologous menstrual blood-derived stromal cells transplantation for severe Asherman's syndrome
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DOI：
10.1093/humrep/dew235
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发表时间：
2016-12-01
影响因子：
6.1
通讯作者：
Kong, Lin
中科院分区：
文献类型：
--
作者：
Tan, Jichun;Li, Pingping;Kong, Lin
研究问题：自体移植月经血来源的基质细胞（menSC）是否能再生子宫内膜以支持重度Asherman综合征（AS）患者的妊娠？总结回答：自体干细胞移植显著增加重度AS妇女的子宫内膜厚度（ET）。已知：AS是妇女继发性不孕的主要原因。细胞移植已尝试在一些临床病例与令人鼓舞的result.Study设计，大小，持续时间：在这个实验性的，非对照和前瞻性的3年临床研究涉及7例AS患者，自体menSC分离和培养月经血的每个病人在类似的2周内，然后移植回他们的子宫。对象/材料，地点，方法：选择中国医科大学附属盛京医院经宫腔镜诊断为重度AS（Ⅲ ~ Ⅴ级）的不孕妇女，年龄20-40岁，月经量正常。进行自体造血干细胞移植，然后进行HRT。子宫内膜厚度监测与冷冻胚胎移植（FET）根据需要。主要结果和机会的作用：我们成功地培养了七名患者的menSC和转移回他们的子宫自体细胞。我们的结果表明，ET显着（P = 0.0002）增加到7毫米的5名妇女，这保证了胚胎植入。4例患者接受了FET，其中2例成功受孕。一名患者在第二次menSCs移植后自发妊娠。局限性，预防原因：样本量有限，缺乏严格的控制或对潜在机制的了解。研究结果的更广泛意义：自体menSCs移植是治疗重度AS女性的潜在选择。
STUDY QUESTION: Does autologous transplantation of menstrual blood-derived stromal cells (menSCs) regenerate endometrium to support pregnancy in patients with severe Asherman's syndrome (AS)?SUMMARY ANSWER: Autologous menSCs transplantation significantly increases endometrial thickness (ET) for women with severe AS.WHAT IS KNOWN ALREADY: AS is a major cause of secondary infertility in women. Cell transplantation has been tried in a few clinical cases with encouraging results.STUDY DESIGN, SIZE, DURATION: In this experimental, non-controlled and prospective 3-year clinical study involving seven patients with AS, autologous menSCs were isolated and cultured from menstrual blood of each patient within similar to 2 weeks and then transplanted back into their uterus. Endometrial growth and pregnancy were assessed after cell therapy.PARTICIPANTS/MATERIALS, SETTING, METHOD: Infertile women, aged 20-40 years, diagnosed with severe AS (Grade III-V) by hysteroscopy and with menstrual fluid were recruited at the Shengjing Hospital affiliated to China Medical University. Autologous menSCs transplantation was conducted followed by HRT. Endometrial thickness was monitored with frozen embryo transfer (FET) as needed.MAIN RESULTS AND THE ROLE OF CHANCE: We successfully cultured menSCs from seven patients and transferred the autologous cells back to their uterus. Our results showed that the ET was significantly (P = 0.0002) increased to 7 mm in five women, which ensured embryo implantation. Four patients underwent FET and two of them conceived successfully. One patient had spontaneous pregnancy after second menSCs transplantation.LIMITATIONS, REASONS FOR CAUTION: Limited sample size, lack of rigorous controls or knowledge of underlying mechanism.WIDER IMPLICATIONS OF THE FINDINGS: Autologous menSCs transplantation is a potential option for treating women with severe AS.