Lyophilized Amniotic Membrane Combined With Human Umbilical Cord Mesenchymal Stem Cells In The Treatment Of Moderate To Severe Intrauterine Adhesions

Objective: Intrauterine adshesions(IUA)is a gynecological disease caused by damage to the basal layer of endometrium caused by various reasons,resulting in partial or total adhesion of the uterine cavity.Currently,transcervical resection of adhesion(TCRA)is the main treatment method,and estrogen and intrauterine iud are the main treatment methods.However,the postoperative recurrence rate of patients with moderate to severe intrauterine adhesion is high,and the fertility function is difficult to recover after conventional treatment.Therefore,the emerging method of freeze-dried amniotic membrane combined with stem cell transplantation is proposed to treat moderate and severe intrauterine adhesions,aiming to provide new hope for patients who have failed to respond to traditional treatment methods.Methods: the first part was the preparation of human umbilical cord mesenchymal stem cells(human umbilical cord mesenchymal stem cells,hUC-MSCs),frozen amniotic membrane and amniotic membrane loaded human umbilical cord mesenchymal stem cells.Part ii: clinical observation of frozen amniotic membrane combined with human umbilical cord mesenchymal stem cells in the treatment of intrauterine adhesions.30 cases with moderate or severe intrauterine adhesions were included and randomly divided into experimental group 1(7 cases),experimental group 2(13 cases)and control group(10 cases).All patients were treated with TCRA in our hospital on the 3rd to 7th day after menstruation.Experimental group 1 was treated with frozen amniotic membrane combined with human umbilical cord mesenchymal stem cells and sodium hyaluronate gel.Experimental group 2 was treated with frozen amniotic membrane combined with human umbilical cord mesenchymal stem cells and sodium hyaluronate gel.All patients underwent gynecological ultrasound and hysteroscopy in the outpatient department 3-7 days after the first menstrual period,and the postoperative endometrial thickness,American fertility society(AFS)score and pregnancy status were recorded.Results :(1)huc-mscs could grow and proliferate normally on the lyophilized amniotic membrane.(2)frozen amniotic membrane combined with huc-mscs,frozen amniotic membrane combined with huc-mscs and HA intrauterine transplantation can reduce AFS score and promote endometrial growth after TCRA.Conclusion: the results of this study indicate that frozen amniotic membrane combined with human umbilical cord mesenchymal stem cells can effectively treat intrauterine adhesions and promote the regeneration and repair of endometrium,indicating that frozen amniotic membrane combined with huc-mscs is feasible for the treatment of IUA.The amniotic membrane + huc-mscs was proved to be a better method by comparing the two treatments.