Journal of Human Reproductive Science
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ORIGINAL ARTICLE Table of Contents   
Year : 2014  |  Volume : 7  |  Issue : 2  |  Page : 93-98
Autologous stem cell transplantation in refractory Asherman's syndrome: A novel cell based therapy


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

Correspondence Address:
Neeta Singh
Department of Obstetrics and Gynecology, Room No. 3090A, Third Floor, All India Institute of Medical Sciences, Ansari Nagar, New Delhi - 110 029
India
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Source of Support: Research grant from All India Institute of Medical Sciences, Conflict of Interest: None


DOI: 10.4103/0974-1208.138864

Clinical trial registration CTRI/2013/08/003896.

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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.


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