SYSTEMATIC REVIEW article
Front. Bioeng. Biotechnol.
Sec. Cell and Gene Therapy
Volume 13 - 2025 | doi: 10.3389/fbioe.2025.1619778
This article is part of the Research TopicThe Role of Mesenchymal Stem Cells in Transforming Organ Repair and Tissue RegenerationView all 4 articles
Meta-analysis of Mesenchymal Stem Cell Therapy for Intrauterine Adhesions: A Comprehensive Consideration of Efficacy and Safety
Provisionally accepted
Jiawei Gao1,2
Xinyue Zhou1,2Nan Jiang1,2Yongjuan Zhang1,2Jianpeng Han1,2Tianyu Jia1,2
Yanbiao Jiang1,2,3
Xiaoling Ma1,2
Haofei Shen1,2*- 1The First Hospital of Lanzhou University, Lanzhou, China, Lanzhou, China
- 2The First Clinical Medical College of Lanzhou University, Lanzhou, China, Lanzhou, China
- 3Gansu Provincial Hospital, Lanzhou, China, Lanzhou, China
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Background: Intrauterine adhesions (IUA), a common gynecological condition, often result from endometrial injury and fibrosis. Traditional therapies like hysteroscopic adhesiolysis and hormone therapy show limited efficacy in endometrial repair and high recurrence rates. Stem cell therapy, particularly using mesenchymal stem cells (MSCs), has emerged as a promising alternative. This meta-analysis evaluates the efficacy and safety of MSCs therapy for IUA. Methods: We systematically searched Embase, MEDLINE, and the Cochrane Library up to January 2025. Using random or fixed-effects models, we analyzed outcomes including pregnancy rates, endometrial thickness, menstrual improvement, and safety indicators. Subgroup analyses were performed based on stem cell sources and transplantation methods. Results: Twelve studies with 233 patients were included. Stem cell therapy significantly improved menstrual outcomes (RR=34.54, 95%CI: [15.07-79.18]), pregnancy rates (RR=21. 86,), live birth rates (RR=18.00, 95%CI: [6.67-48.55]), and endometrial thickness (MD=2.28mm, 95%CI: [1.60-2.96]). Subgroup analyses indicated that adipose-derived (MD=3.34 mm) and menstrual blood-derived (MD=3.62 mm) stem cells exhibited the highest efficacy. Safety data indicated mild abdominal pain in 5.15% and abnormal blood indices in 4.29% of patients, with no severe complications. Conclusion: Stem cell therapy may improve the reproductive prognosis of patients with IUA. Autologous adipose or menstrual blood-derived stem cells via local injection are cautiously recommended. Further large-scale RCTs are needed to confirm long-term safety and optimal treatment protocols.
Keywords: IUA, Stem Cell Therapy, Meta-analysis Trial registration, Safety, mesenchymal stem cells (MSCs)
Received: 28 Apr 2025; Accepted: 21 Jul 2025.
Copyright: © 2025 Gao, Zhou, Jiang, Zhang, Han, Jia, Jiang, Ma and Shen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Haofei Shen, The First Hospital of Lanzhou University, Lanzhou, China, Lanzhou, China
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