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Interview with Dr Antonio Pellicer at COGI Amsterdam 2016 – part two

View of Dr Antonio Pellicer on Asherman’s syndrome

Dr Antonio Pellicer -HD 1080p

A. Yes. Basically, the uterus has a line which is called the endometrium and this endometrium is renovated every month, which means the menstruation. When women have some surgery, and especially a D&C, curettage, this dramatic approach affects the endometrium and, as a result, the layers of the uterus come together and the space in the uterus is reduced. This is supposed to affect implantation because the endometrium does not develop so much and it affects a small proportion of patients, but many times it is very difficult to deal with.

Q. Could you tell us about the progress of stem cell therapy work, regarding Endometrial Atrophy?
A. Sometimes patients have also an atrophic endometrium and there is no reason, it is just because for some genetic reasons they don’t develop this layer of endometrium sufficiently.

The whole idea is that this endometrium that regenerates every month and up to 400 times at least in a woman’s lifespan, because every month during 30 years is a lot of regenerations. This regeneration comes from the existence of stem cells in the basal is layer of the endometrium. From the bottom of the endometrium, stem cells provide new cells which regenerate the whole wall, the whole endometrium.

The story is that these stem cells are not only there, but there are also cells coming from the bone marrow, and this has been proven because there are women who have received a bone marrow transplantation from a male donor and when we look at the endometrium it has male cells.  Bone marrow, somehow, is supporting the endometrial growth.<
In cases with atrophic endometrium or Asherman’s Syndrome, we thought about the possibility to deliver stem cells from the bone marrow in the uterus in order to increase the possibility of making this damaged endometrium growing.

Q. What is your take home message? 
A. In this study, looking at Asherman’s and atrophy, we treated 16 patients and in 15 out of 16 we saw how the endometrium regenerates and we had some pregnancies.  This is the proof of principle, but definitely there is a lot of work to be done, but we firmly believe that using stem cells we can regenerate uterine endometria that are seriously damaged and get regular pregnancies.

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