A collagen scaffold loaded with human umbilical cord-derived mesenchymal stem cells facilitates endometrial regeneration and restores fertility
Abstract
In women of reproductive age, severe injuries to the endometrium are often accompanied by endometrial scar formation or intrauterine adhesions (IUAs), which can result in infertility or miscarriage. Although many approaches have been used to treat severe IUAs, high recurrence rates and endometrial thinning have limited therapeutic efficiency. In this study, a collagen scaffold (CS) loaded with human umbilical cord-derived mesenchymal stem cells (UC-MSCs) was fabricated and applied for endometrial regeneration. The CS/UC-MSCs promoted human endometrial stromal cell proliferation and inhibited apoptosis in vitro through paracrine effects. In a model of endometrial damage, transplantation with the CS/UC-MSCs maintained normal luminal structure, promoted endometrial regeneration and collagen remodeling, induced intrinsic endometrial cell proliferation and epithelium recovery, and enhanced the expression of estrogen receptor α and progesterone receptor. An improved ability of the regenerated endometrium to receive embryos was confirmed. Together, our results indicate that the CS/UC-MSCs promoted endometrial structural reconstruction and functional recovery. Topical administration of the CS/UC-MSCs after trans-cervical resection of adhesions might prevent re-adhesion, promote endometrium regeneration and improve pregnancy outcomes for patients with severe IUAs. STATEMENT OF SIGNIFICANCE: Intrauterine adhesions due to severe endometrium injuries happen frequently in clinic and becom…
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At 60 days post-transplantation, endometrial thickness in the CS/UC-MSC group reached 610 ± 30 μm, markedly greater than that in the CS (220 ± 20 μm) and NR (170 ± 20 μm) groups (p < 0.01).
“At 60 days post-transplantation, the endometrial thickness in the CS/UC-MSC group reached 610 ± 30 µm, markedly greater than that in the CS (220 ± 20 µm) and NR (170 ± 20 µm) groups (p < 0.01).”
From Biomaterials in Postoperative Adhesion Barriers and Uterine Tissue Engineering (2025) · cites this paper as [35]
Collagen deposition was significantly reduced to 41 ± 2% in the CS/UC-MSC group, comparable to the sham group (41 ± 3%) and far lower than in the CS (74 ± 2%) and NR (75 ± 2%) groups (p < 0.01).
“Collagen deposition was also significantly reduced to 41 ± 2%, comparable to the sham group (41 ± 3%) and far lower than in the CS (74 ± 2%) and NR (75 ± 2%) groups (p < 0.01).”
From Biomaterials in Postoperative Adhesion Barriers and Uterine Tissue Engineering (2025) · cites this paper as [35]
The CS/UC-MSCs system supports structural regeneration of the endometrium and restores its functional competence, offering a potent strategy for treating IUA and promoting fertility restoration.
“These findings demonstrate that the CS/UC-MSCs system not only supports the structural regeneration of the endometrium, but also restores its functional competence, offering a potent strategy for treating IUA and promoting fertility restoration (Figure 1(C1–C12, D1–D7)) [35].”
From Biomaterials in Postoperative Adhesion Barriers and Uterine Tissue Engineering (2025) · cites this paper as [35]
In a rat model of severe intrauterine adhesion, application of a collagen scaffold loaded with human umbilical-cord-derived mesenchymal stem cells significantly promoted endometrial regeneration and reduced adhesion recurrence.
“In a rat model of severe intrauterine adhesion (IUA), the application of a collagen scaffold (CS) loaded with human umbilical-cord-derived mesenchymal stem cells (UC-MSCs) significantly promoted endometrial regeneration and reduced adhesion recurrence [35].”
From Biomaterials in Postoperative Adhesion Barriers and Uterine Tissue Engineering (2025) · cites this paper as [35]
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Biomaterials in Postoperative Adhesion Barriers and Uterine Tissue Engineering
Fazel Anvari-Yazdi, A., Badea, I., & Chen, X. (2025) · Gels · doi:10.3390/gels11060441 · Cited by 20 · see citing works
- Authors
- Xin, L., Lin, X., Pan, Y., Zheng, X., Shi, L., Zhang, Y., Ma, L., Gao, C., & Zhang, S.
- Affiliations
- Sir Run Run Shaw Hospital (CN)
- Zhejiang University (CN)
- Corresponding author
- Ma, Lie
- Zhang, Songying
- Venue
- Acta Biomaterialia
- Publisher
- Elsevier BV
- Published
- 2019-07
- Volume
- 92
- Pages
- 160-171
- ISSN
- 1742-7061 (ISSN-L)
- OpenAlex
- W2944793886
- Cited by
- 201
- References
- 0
- Citations by year
- 2026: 22 · 2025: 27 · 2024: 31 · 2023: 38 · 2022: 28 · 2021: 34 · 2020: 19 · 2019: 2
- FWCI
- 22.24
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Acta Biomaterialia (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Key Research Program of China (2018YFC1004800, 2017YFA0104900)
- Wu Jieping medical fund (320.6755.15028)
- National Natural Science Foundation of China (51673167)
- Key Research and Development Program of Zhejiang Province (2017C03022)
- Topics
- Health Sciences › Medicine › Obstetrics and Gynecology › Gynecological conditions and treatments
- Health Sciences › Medicine › Surgery › Tissue Engineering and Regenerative Medicine
- Health Sciences › Medicine › Genetics › Mesenchymal stem cell research
- Keywords
- collagen scaffolds, human umbilical cord mesenchymal stem cells, endometrial regeneration, intrauterine adhesions, infertility, fertility restoration, paracrine effects, endometrial stromal cells, estrogen receptor alpha, progesterone receptor, collagen remodeling
- MeSH terms
- Human Embryonic Stem Cells, Becaplermin, Animals, Cattle, Collagen, Endometrium, Epithelium, Female, Fertility, Humans, Keratins, Receptors, Progesterone, Regeneration, Umbilical Cord, Uterus, Rats, Sprague-Dawley, Ki-67 Antigen, Paracrine Communication, Vascular Endothelial Growth Factor A, Mesenchymal Stem Cell Transplantation, Estrogen Receptor alpha, Cell Proliferation, Transforming Growth Factor beta1, Tissue Scaffolds, Mesenchymal Stem Cells
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