Journal of Human Reproductive Science
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ORIGINAL ARTICLE Table of Contents   
Year : 2020  |  Volume : 13  |  Issue : 1  |  Page : 31-37
Autologous bone marrow-derived stem cell therapy for Asherman's syndrome and endometrial atrophy: A 5-year follow-up study


1 Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, Delhi, India
2 Department of Stem Cell Facility, All India Institute of Medical Sciences, Delhi, India
3 Department of Hematology, All India Institute of Medical Sciences, Delhi, India

Correspondence Address:
Dr. Neeta Singh
Department of Obstetrics and Gynaecology, 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: None, Conflict of Interest: None


DOI: 10.4103/jhrs.JHRS_64_19

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Background: Based on the role of bone marrow (BM) stem cells in regeneration of endometrium, refractory cases of Asherman's syndrome (AS) and endometrial atrophy (EA) may benefit with BM-derived intrauterine stem cell instillation. Aims and Objectives: To evaluate the role of BM-derived autologous stem cell therapy in endometrial regeneration and restoration of menstruation and fertility in refractory cases of AS and EA. Setting: This study was conducted at a tertiary care center. Design: This was a prospective, single-arm longitudinal study. Materials and Methods: Twenty-five cases with refractory AS or EA were included. BM-derived mononuclear stem cells were instilled into the subendometrial zone followed by oral estrogen therapy for 3 months. Menstrual flow and endometrial thickness (ET) were assessed at 3, 6, and 9 months and 5 years. Results: Statistical analysis was carried out using statistical software STATA version 12.0. Mean prestem cell transfer ET (mm) was 3.3 ± 1.0. At the end of 3 months, there was a significant increase in ET (mm) to 5.1 ± 1.9 (P = 0.001), but there was no significant change at 6 months (5.6 ± 1.5; P = 0.164), at 9 months (6.1 ± 1.7; P = 0.135), or at the end of 5 years. Six of the seven amenorrheic patients resumed menses. Three patients had a successful pregnancy outcome. Conclusion: Intrauterine stem cell treatment is a promising novel approach for refractory cases of AS and EA.


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