Abstract:

Intrauterine adhesions (IUA) is the primary uterine factor contributing to female infertility, and current therapeutic measures are difficult to improve endometrial regeneration with a high risk of recurrence. Mesenchymal stem cells (MSCs) have been widely used in regenerative medicine research, and the sources of MSCs include bone marrow, umbilical cord, amniotic membrane, adipose, and menstrual blood. Numerous studies demonstrated that MSCs may inhibit endometrial fibrosis, promote endometrial repair, suggesting that MSCs can be used to treat IUA in clinical study. The mechanisms involve three main functions of MSCs: paracrine, immunomodulatory and direct differentiation into endometrial cells. However, the in vitro survivability and utilization rate of MSCs are low, and the long-term retention of MSCs is difficult for both systemic and local applications. Biomaterial scaffolds can be loaded with MSCs to build an in situ delivery system and prolong the retention time of MSCs after intrauterine perfusion. Commonly used biomaterials include hyaluronic acid, collagen, temperature-sensitive hydrogels and other materials. Some biomaterial scaffolds can even improve the properties of MSCs, enhance their chemotactic and secretory abilities, and improve the therapeutic efficacy. This article reviews the application of MSCs and the combined biomaterial scaffolds in the experimental treatment of IUA.

Key words: Uterus, Tissue adhesions, Mesenchymal stem cells, Biocompatible materials, Tissue scaffolds, Regenerative medicine, Therapy