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An update on stem cell therapy for Asherman syndrome

Journal of Assisted Reproduction and Genetics volume 37, pages 1511–1529 (2020)Cite this article

Abstract

The current treatment for Asherman syndrome is limited and not very effective. The aim of this review is to summarize the most recent evidence for stem cells in the treatment of Asherman syndrome. The advent of stem cell therapy has propagated experimentation on mice and humans as a novel treatment. The consensus is that the regenerative capacity of stem cells has demonstrated improved outcomes in terms of fertility and fibrosis in both mice and humans with Asherman syndrome. Stem cells have effects on tissue repair by homing to the injured site, recruiting other cells by secreting chemokines, modulating the immune system, differentiating into other types of cells, proliferating into daughter cells, and potentially having antimicrobial activity. The studies reviewed examine different origins and administration modalities of stem cells. In preclinical models, therapeutic systemic injection of stem cells is more effective than direct intrauterine injection in regenerating the endometrium. In conjunction, bone marrow-derived stem cells have a stronger effect on uterine regeneration than uterine-derived stem cells, likely due to their broader differentiation potency. Clinical trials have demonstrated the initial safety and effectiveness profiles of menstrual, bone marrow, umbilical cord, and adipose tissue-derived stem cells in resumption of menstruation, fertility outcomes, and endometrial regeneration.

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Author information

Authors and Affiliations

  1. Department of Obstetrics & Gynecology, Maimonides Medical Center, 967 48th St., Brooklyn, NY, 11219, USA

    Ariel Benor

  2. Eunice Kennedy Shriver National Institute for Child Health and Human Development (NICHD), National Institutes of Health (NIH), Bethesda, MD, 20892, USA

    Steven Gay & Alan DeCherney

  3. Department of Reproductive Endocrinology & Infertility, NICHD, NIH, Bethesda, MD, USA

    Steven Gay & Alan DeCherney

Authors
  1. Ariel Benor
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  2. Steven Gay
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  3. Alan DeCherney
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Corresponding author

Correspondence to Ariel Benor.

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Benor, A., Gay, S. & DeCherney, A. An update on stem cell therapy for Asherman syndrome. J Assist Reprod Genet 37, 1511–1529 (2020). https://doi.org/10.1007/s10815-020-01801-x

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  • DOI: https://doi.org/10.1007/s10815-020-01801-x

Keywords

  • Intrauterine adhesions
  • Stem cell therapy
  • Asherman syndrome
  • Cell homing
  • Endometrial regeneration