Asherman’s Syndrome (AS) is an uncommon, acquired, and refractory gynecological disorder. Current treatment was still limited, and stem cell-based therapy has been proposed as a novel strategy for management of AS. Here, we conducted a meta-analysis of self-controlled clinical trials to assess the effectiveness and safety of stem cell-based therapy in Asherman syndrome patients who have failed in conventional treatment. We systematically searched PubMed, Embase, Cochrane, and Web of Science database (published up to October 3, 2020). Our main evaluation outcomes were menses improvement, endometrial thickness changes, pregnancy outcome, and side effects. All analyses were performed by using RevMan5.4 software. 427 studies were identified, eight of which were eligible and included in our analysis. Stem cell combined hormone therapy achieved a higher likelihood of improving menstruation (risk ratio [RR] 22.43, 95% CI: 8.03 to 62.68, ), an enhancement of pregnancy outcome (risk ratio [RR] 11.1, 95% CI: 3.58 to 34.38, ), and a mean increase of 3-month endometrial thickness (standardized mean difference [SMD] 2.43, 95% CI: 1.72 to 3.13, ). Subgroup analysis also indicated that 6-month and 9-month endometrial thickness increased significantly with the stem cell-based treatment. Moreover, no obvious and severe adverse reactions were observed during the process of stem cell therapy. There were 3 patients (3.57%) reported with lost appetite, mild gastritis, vomiting, or abdominal cramps, whereas, these symptoms relieved subsequently. This meta-analysis systematically reviewed and synthesized the outcomes of stem cell-based therapy in treating Asherman syndrome, which suggest that stem cell and hormone combination therapy was safe and more effective in improving menstruation duration, pregnancy outcome, and endometrial thickness. However, further trials with large sample sizes are needed to establish more solid evidence for administrating this therapy in clinic.

中文翻译：

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基于干细胞的疗法治疗阿舍曼综合征的临床疗效和安全性：系统评价和荟萃分析

Asherman综合征（AS）是一种罕见，后天性和难治性妇科疾病。当前的治疗仍然是有限的，并且已经提出了基于干细胞的治疗作为管理AS的新策略。在这里，我们进行了一项自我控制的临床试验的荟萃分析，以评估基于干细胞疗法在常规治疗失败的Asherman综合征患者中的有效性和安全性。我们系统地搜索了PubMed，Embase，Cochrane和Web of Science数据库（截至2020年10月3日发布）。我们的主要评估结果是月经改善，子宫内膜厚度改变，妊娠结局和副作用。所有分析均使用RevMan5.4软件进行。鉴定出427项研究，其中八项符合条件并纳入我们的分析。），提高妊娠结局（风险比[RR] 11.1，95％CI：3.58至34.38，），以及3个月子宫内膜厚度的平均增加（标准化平均差异[SMD] 2.43、95％CI：1.72至3.13，）。亚组分析还表明，以干细胞为基础的治疗可使6个月和9个月子宫内膜厚度显着增加。此外，在干细胞治疗过程中未观察到明显的严重不良反应。3例（3.57％）食欲不振，轻度胃炎，呕吐或腹部绞痛报告，但这些症状随后缓解。这项荟萃分析系统地综述和综合了以干细胞为基础的疗法治疗阿舍曼综合征的结果，这表明干细胞和激素联合疗法在改善月经持续时间，妊娠结局和子宫内膜厚度方面是安全且有效的。但是，需要更多的大样本试验来建立更可靠的证据，以在临床上使用这种疗法。