Intrauterine Adhesions (IUAs) or Asherman’s Syndrome (AS) and the Stem Cells Treatment: A Systemic Review and Meta-Analysis

Sichen Zhang,Ying Mao,Huiwen Zhang,Xingbo Long,Min Ma,Xiaodong Zhao,Shaowei Wang

doi:10.4236/jbm.2021.91009

Abstract

Background: Intrauterine Adhesions (IUAs) or Asherman’s Syndrome (AS) usually contains symptoms such as decreased menstrual flow or even amenorrhea, chronic pelvic pain, recurrent abortion and infertility. The current treatment of IUAs includes hysteroscopic adhesiolysis, oral hormone and biological barriers, but each of them has limitation. Stem cell therapy may be an expanding field seeking for therapy in IUAs. Objective: We will discuss current advances in stem cell therapy as a treatment for endometrial pathophysiology. Materials and Methods: We search on PubMed, Embase and Cochrane library and select several keywords on researches, then review the cell biology theories and animal experiments, finally do meta-analysis in human clinical trials. Results: 77 articles on PubMed, 71 articles on Embase and 17 articles on Cochrane Library, as a result, 37 articles are included under the criteria, which are intrauterine adhesions (IUAs), Asherman’s Syndrome (AS), cell therapy, stem cells, bone marrow stem cells, clinical trials, recent 10 years and human or animal experiments. The included criteria: original articles, cohort study, case control study, animal experiments, human clinical trials, high quality, 10 years recent. The excluded articles are case reports, meeting reports, low quality or more than 10 years ago. Conclusion: Stem cell may be a new therapeutic schedule for IUAs in the future clinical treatment, but it is necessary to compare it with traditional therapy such as oral hormone, also the development of random clinical tests should proceed. For clinical treatment on IUAs, stem cells could be a new choice.

Highlights

Intrauterine Adhesions (IUAs) or Asherman’s Syndrome (AS) is common caused by inflammatory or trauma damaging the endometrial basal layer after delivery or surgery [1] [2] [3]
Nesrine [19] et al Investigated the Transforming Growth Factors-β (TGF-β), Tumor Necrosis Factor-α (TNF-α) and Vascular Endothelial Growth Factor (VEGF) are significant decreased in extracellular vesicles derived from human umbilical cord mesenchymal stem cells (UCMSCs-EVs) alone or combined with estrogen therapeutic groups
A great deal of studies reported that endometrial stem cells could contribute to endometrial repairing physiologically, which may be crucial for the treatment of IUAs

Summary

Introduction

Intrauterine Adhesions (IUAs) or Asherman’s Syndrome (AS) is common caused by inflammatory or trauma damaging the endometrial basal layer after delivery or surgery [1] [2] [3]. The typical symptoms of IUAs or AS include decreased menstrual flow or amenorrhea, chronic pelvic pain, recurrent abortion and infertility [2] [8] [9]. Intrauterine Adhesions (IUAs) or Asherman’s Syndrome (AS) usually contains symptoms such as decreased menstrual flow or even amenorrhea, chronic pelvic pain, recurrent abortion and infertility. Results: 77 articles on PubMed, 71 articles on Embase and 17 articles on Cochrane Library, as a result, 37 articles are included under the criteria, which are intrauterine adhesions (IUAs), Asherman’s Syndrome (AS), cell therapy, stem cells, bone marrow stem cells, clinical trials, recent 10 years and human or animal experiments. The included criteria: original articles, cohort study, case control study, animal experiments, human clinical trials, high quality, 10 years recent. For clinical treatment on IUAs, stem cells could be a new choice

Objectives

Methods

Results

Conclusion