Abstract
Intrauterine adhesion refers to endometrial repair disorders which are usually caused by uterine injury and may lead to a series of complications such as abnormal menstrual bleeding, recurrent abortion and secondary infertility. At present, therapeutic approaches to intrauterine adhesion are limited due to the lack of effective methods to promote regeneration following severe endometrial injury. Therefore, to develop new methods to prevent endometrial injury and intrauterine adhesion has become an urgent need. For severely damaged endometrium, the loss of stem cells in the endometrium may affect its regeneration. This article aimed to discuss the characteristics of various stem cells and their applications for uterine tissue regeneration.
Highlights
In 1948, Joseph Asherman first described the diagnosis, anatomy, etiology, prophylaxis, therapy and complication of a specific type of amenorrhea, which was later referred as Asherman’s syndrome (AS) [1], a condition known as intrauterine adhesion (IUA).IUA refers to the complication due to damage of endometrial basal layer, for which mechanical trauma, infection and other factors may be attributable
The endometrial functional layer is periodically shed under hormone regulation, and the basal layers are important for the repair and regeneration of the surface
Formation of adhesion IUA may be classified as primary adhesion after pregnancy-related curettage or hysteroscopic surgery, as well as secondary adhesion reoccurred after adhesiolysis [4]
Summary
IUA refers to the complication due to damage of endometrial basal layer, for which mechanical trauma, infection and other factors may be attributable. Disturbances to the structures of basal layers, such as repair disorder, may exacerbate this process and lead to the occurrence of IUA [3]. More than 90% of IUA are related to pregnancy [6] It is usually developed following the manipulation of early abortion or postpartum-related curettage, and may be considered as a postoperative complication of intrauterine surgery [2, 7, 8]. Uterine trauma and postoperative infection, including abdominal myomectomy, cervical biopsy or polylectomy, and insertion of intrauterine device (IUD), are common causes of IUA [7]. Reproductive system infection, which may be due to non-pregnancy uterine cavity trauma and congenital uterine malformation, is another risk factor of IUA [9]. IUA may be correlated with irregular uterine dilation, inadequate disinfection, unsoftened cervix, long forceps scraping time or high intraoperative uterine negative pressure
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