| خلاصه مقاله | Abstract
Background Asherman syndrome (AS), characterized by intrauterine adhesions, is a significant cause of infertility and menstrual irregularities. Traditional treatments have shown limited success, prompting the exploration of regenerative therapies.
Aims This study investigates the potential of co-treating mesenchymal stem cells (MSCs) and exosomes derived from umbilical cords (UC) as a novel therapeutic approach for AS-related infertility.
Methods Twelve patients with AS were randomly allocated into four groups: (1) single injection of MSCs, (2) two exosome injections, (3) co-treatment with MSCs and exosomes, and (4) phosphate-buffered saline control. Endometrial gene expression, thickness, adhesions, pregnancy, and live birth rates were assessed.
Results The co-treatment group exhibited significant upregulation of genes involved in endometrial regeneration (TGF-β1, ADAM15, ADAM17, SMAD3, Integrinβ3) and downregulation of SMAD7. This group also demonstrated the highest mean endometrial thickness, reduced intrauterine adhesions, and the highest pregnancy (66.7%) and live birth rates. No severe adverse events were reported.
Conclusion Co-treatment with UC-derived MSCs and exosomes shows promise as a safe and effective therapy for AS-related infertility, with synergistic effects on endometrial regeneration and reproductive outcomes. These findings warrant further investigation in more extensive clinical trials. |