RECONSTRUCTIVE APPROACHES TO TREATING SECONDARY INFERTILITY


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Abstract

Secondary infertility is one of the most pressing health problems often resulting from endometrial injury after abortions or complicated delivery, as well as in hormonal dysregulation, Asherman’s syndrome (AS) is the most severe form, in which there are uterine synechiae, the adhesions connecting the opposite uterine walls, which complicates a normal menstrual process. Existing approaches can help some women with AS become pregnant and carry a baby, but the eff iciency of therapy remains relatively low, which requires further investigation. The review considers new promising approaches to treating AS, by using tissue engineering, cell technologies, and biologically active substances. Tissue engineering techniques can contribute to the restoration of one's own tissue or organ. The body is able to regenerate damaged tissue in the presence of the matrix that is the supporting framework for the functional cells of the endometrium in the event of damage to the cells of the uterus. W hen designing the biomaterials that promote the restoration of damaged tissue, the thing that matters is a material and the latter’s incorporated biologically active components with regenerative activity. The biomaterials should ensure mechanical support for tissue repair, partially mimicking the natural environment through the metered release of extracellular vesicles, growth factors, and other signaling molecules. The review gives data on the efficiency of using the populations of stem cells and progenitor cells derived from bone marrow, endometrium, and umbilical cord Wharton’s jelly for the treatment of endometrial diseases.

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About the authors

Alexander Yu. Pulver

Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia; Institute of Biology of Aging LLC

Email: pulver.ibs@gmail.com
operating surgeon, senior researcher of the Laboratory of Clinical Immunology; General Director, Head of Laboratory 4, Oparin str., Moscow, 117997, Russia

Natalia A. Pulver

Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia; Voronezh City Emergency Clinical Hospital No 10

Email: elektronikal0@yandex.ru
PhD (Med. Sci.), general physician, occupational pathologist, Head of the Admission Department; senior researcher of the Laboratory of Clinical Immunology 4, Oparin str., Moscow, 117997, Russia

Rimma A. Poltavtseva

Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: rimpol@mail.ru; r_poltavtseva@oparina4.ru
PhD, leading researcher of the Laboratory of Clinical Immunology 4, Oparin str., Moscow, 117997, Russia

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