RESUMEN
Asherman syndrome (AS) occurs due to fibrosis or uterine adhesions as a result of damage to the basal layer of the endometrium. The aim of this study is investigating the effects of adipose tissue-derived mesenchymal stem cell (ADMSC) application on the expression of vascular endothelial growth factor (VEGF), insulin-like growth factor (IGF-1), miRNA-98, miRNA199a in endometrial tissue in rats with AS. Study groups were designed as, control (C), Asherman syndrome (AS), AS + oral estrogen (ASO), AS + ADMSC (ASSC), AS + oral estrogen + ADMSC (ASSCO) with 7 samples in each group. Characterization and differentiation experiments were performed in ADMSC obtained. Two weeks after the development of the AS, ADMSC therapy was applied. BrdU (5-bromo-2'-deoxyuridine) labeling was performed to show the presence of ADMSC in the tissues. Rats were sacrificed after 8 weeks and bilateral uterine horn resection was performed. Tissues were fixed in formaldehyde. After routine tissue follow-up, sections were taken and evaluated with hematoxylin eosin staining. VEGF1 and IGF1 expressions were evaluated by immunohistochemical staining and western blot analysis. Expression changes of miR-98 and miR-199a were detected by RT-PCR. Our results showed that stem cells and estrogen giving together reduced inflammation and fibrosis in the endometrium. Immunohistochemistry and western blot results suggested that this effect was achieved especially through IGF-1. In our study, decreased miR-98 and miR-199a expressions were determined in Asherman syndrome. Furthermore, no changes of miRNA expressions were observed in treatment groups.
Asunto(s)
Endometrio/metabolismo , Ginatresia/terapia , Células Madre Mesenquimatosas/metabolismo , Tejido Adiposo/metabolismo , Animales , Diferenciación Celular/efectos de los fármacos , Proliferación Celular/efectos de los fármacos , Células Cultivadas , Modelos Animales de Enfermedad , Endometrio/efectos de los fármacos , Estrógenos/farmacología , Femenino , Fibrosis/metabolismo , Ginatresia/metabolismo , Factor I del Crecimiento Similar a la Insulina/metabolismo , Trasplante de Células Madre Mesenquimatosas/métodos , MicroARNs/genética , MicroARNs/metabolismo , Ratas , Ratas Wistar , Factor A de Crecimiento Endotelial Vascular/metabolismoRESUMEN
PURPOSE: The primary objective of this study was to evaluate the prevalence, characteristics and the most frequently used complementary and alternative medicine (CAM) methods among infertile couples. A secondary aim was to assess predictors and patients' attitude to disclose the usage of CAM. METHODS: This study was designed as a cross-sectional survey and conducted on patients admitted to infertility clinics of two hospitals. RESULTS: The overall prevalence of CAM among 324 infertile participants (162 couples) was 25.6 % (n = 83). 48 % of the infertile couples had experience with at least one type of CAM method and the most commonly used CAM was herbal products (84 %). The frequency of CAM tended to be higher among females compared to males (33 % versus 17 %, respectively; p = 0.02). Patients who failed to conceive with previous medical therapies were more inclined to use CAM (p = 0.01). After logistic regression analyses, only gender and previous unsuccessful ART treatment were found to be associated independently with CAM use. CONCLUSION: CAM use is common among infertile population. CAM users were more likely to be women at any age who had failed to achieve a pregnancy with previous artificial reproductive treatment(s), mainly used herbal products and mostly reluctant to report the use of CAM.