Nagori Chaitanya B, Panchal Sonal Y, Patel Himanshu
Dr. Nagori's Institute for Infertility and IVF, Ahmedabad, India.
J Hum Reprod Sci. 2011 Jan;4(1):43-8. doi: 10.4103/0974-1208.82360.
In a woman with severe Asherman's syndrome, curettage followed by placement of intrauterine contraceptive device (IUCD) (IUCD with cyclical hormonal therapy) was tried for 6 months, for development of the endometrium. When this failed, autologous stem cells were tried as an alternative therapy. From adult autologous stem cells isolated from patient's own bone marrow, endometrial angiogenic stem cells were separated using immunomagnetic isolation. These cells were placed in the endometrial cavity under ultrasound guidance after curettage. Patient was then given cyclical hormonal therapy. Endometrium was assessed intermittently on ultrasound. On development of endometrium with a thickness of 8 mm and good vascularity, in vitro fertilization and embryo transfer was done. This resulted in positive biochemical pregnancy followed by confirmation of gestational sac, yolk sac, and embryonic pole with cardiac activity on ultrasound. Endometrial angiogenic stem cells isolated from autologous adult stem cells could regenerate injured endometrium not responding to conventional treatment for Asherman's syndrome.
对于一名患有严重阿谢曼综合征的女性，尝试刮宫后放置宫内节育器（IUCD）（IUCD联合周期性激素治疗）6个月，以促进子宫内膜生长。当此方法失败后，尝试使用自体干细胞作为替代疗法。从患者自身骨髓中分离出成人自体干细胞，通过免疫磁珠分离法分离出子宫内膜血管生成干细胞。刮宫后，在超声引导下将这些细胞置于子宫内膜腔内。随后给予患者周期性激素治疗。通过超声间歇性评估子宫内膜情况。当子宫内膜发育至厚度达8mm且血管良好时，进行体外受精和胚胎移植。这导致生化妊娠呈阳性，随后超声确认有妊娠囊、卵黄囊及有心跳活动的胚胎极。从自体成人干细胞分离出的子宫内膜血管生成干细胞能够使对阿谢曼综合征常规治疗无反应的受损子宫内膜再生。
