Autologous menstrual blood-derived stromal cells transplantation for severe Asherman's syndrome

Does autologous transplantation of menstrual blood-derived stromal cells (menSCs) regenerate endometrium to support pregnancy in patients with severe Asherman's syndrome (AS)?

Autologous menSCs transplantation significantly increases endometrial thickness (ET) for women with severe AS.

AS is a major cause of secondary infertility in women. Cell transplantation has been tried in a few clinical cases with encouraging results.

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 ~2 weeks and then transplanted back into their uterus. Endometrial growth and pregnancy were assessed after cell therapy.

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.

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.

Limited sample size, lack of rigorous controls or knowledge of underlying mechanism.

Autologous menSCs transplantation is a potential option for treating women with severe AS.

This study was supported by Liaoning Provincial Science and Technology Program. The sponsor and authors declare no conflicts of interest.

Registered in the Chinese Clinical Trial Registry (ChiCTR-ONB-15007464).