Treatment of Severe Asherman Syndrome by Collagen Scaffold Loaded With Autologous Bone Marrow Mononuclear Cells
Condition: Infertility; Asherman Syndrome
MeSH terms: Infertility; Gynatresia; Syndrome
Study type: Interventional

Summary: 
      This study evaluates the addition of collagen scaffold loaded with autologous bone marrow
      mononuclear cells(ABMNC) to Foley catheter balloon after hysteroscopic adhesiolysis in the
      treatment of severe asherman syndrome. Half of participants will receive collagen/ABMNC
      scaffold after hysteroscopic adhesiolysis, while the other half will receive Foley catheter
      balloon.
    

Detailed description: 
      Severe asherman syndrome will lead to infertility, and the most common method to treat
      asherman syndrome is operating to dissect adhesions. In order to prevent the postoperative
      re-adhesion, many physical isolation measures have been tried. However, they don't improve
      the microenvironment of endometrial regeneration. It's reported that bone marrow mononuclear
      cells have good effects on the functional recovery of injured uterus. This study will
      determine whether collagen scaffolds loaded with autologous bone marrow mononuclear cells
      will be more effective than Foley balloon catheters at treating infertile women with severe
      intrauterine adhesions who have taken hysteroscopic adhesiolysis. In addition, the study will
      be carried out in 2 centers, one is the Affiliated Nanjing Drum Tower Hospital of Nanjing
      University Medical School, the other is Changzhou Maternal and Child Health Care Hospital
      that is in Jiangsu Province.
    

Intervention name(s): collagen/ABMNC scaffold; Foley catheter balloon
Intervention type(s): Device; Device
Intervention description(s): The patients will receive a bone marrow puncture to collect bone marrow cells which are used to isolation of ABMNCs. After that, hysteroscopic adhesiolysis will be done according to the patient's uterine adhesion. Then, the collagen/ABMNCs scaffold was covered on a Foley catheter balloon and placed into the uterine cavity. The catheter balloon was kept for 24 hours and then removed. Oral antibiotics were given to prevent infection in the second and third days after operation. 72 hours after the surgery, a vaginal speculum examinations will be done in order to make patients unknown about their arms. Estrogen will be administrated for 3 cycles to support the endometrial regeneration after the surgery. The clinical follow up will be done at 1, 3 and 6 months after the procedure.; The patients will receive a sham bone marrow puncture which just has a local anesthesia and collects no bone marrow cells to isolation. After that, hysteroscopic adhesiolysis will be done according to the patient's uterine adhesion. And then, a Foley catheter balloon will be placed into the uterine cavity and kept for 72 hours before it is removed. Oral antibiotics were given to prevent infection in the second and third days after operation. Estrogen will be administrated for 3 cycles to support the endometrial regeneration after the surgery. The clinical follow up will be done at 1, 3 and 6 months after the procedure.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: BMSCs group (BMSCs-scaffold plus Foley catheter) or control group (only Foley catheter).
Masking: Single (Participant)
Primary purpose: Treatment