Umbilical cord blood shows promise for regenerating the endometrium in women with complex uterine conditions

The condition of the endometrium is one of the decisive factors in the success of a fertility treatment, along with embryo quality. For this reason, much of the research in reproductive medicine focuses on the uterus, the tissue that lines it, and the options for helping the embryo implant and develop favorably.

At the annual congress of the American Society for Reproductive Medicine (ASRM), researchers of IVI Institute Foundation presented a study that addresses this issue, with encouraging results. Specifically, it analyzed the potential of umbilical cord plasma to regenerate the endometrium in patients with infertility.

A study focused on patients with Asherman’s syndrome

The endometrium is the tissue that lines the inside of the uterus, and its optimal condition supports embryo implantation. That is why, in fertility treatments, doctors look for adequate endometrial thickness to decide the date of the embryo transfer.

Researchers at IVI Institute Foundation are working to offer new alternatives to patients with endometrial conditions. Specifically, the study presented at the ASRM congress focused on women with Asherman’s syndrome. This condition involves a thin endometrium or endometrial atrophy, which makes embryo implantation difficult because the tissue does not have the conditions needed for it.

As Dr. Irene Cervelló, lead investigator of the study presented by IVI Institute Foundation and La Fe Health Research Institute (IIS LAFE), explains: “These patients present a particularly complex problem because their endometrium has a limited capacity to regenerate. Without functional, properly developed tissue, the chances of embryo implantation decrease considerably.”

Platelet-rich plasma from umbilical cord blood

Blood obtained from donated umbilical cords contains platelet-rich plasma (PRP), which is used in a variety of treatments because of its high regenerative potential. In reproductive medicine, the plasma is administered by subendometrial injection through hysteroscopy.

The main difference from conventional PRP, which is usually obtained from the patient’s own blood, is that the plasma extracted from the umbilical cord comes from a much younger biological source. As a result, it is rich in proteins, biomolecules, and growth factors that may support endometrial regeneration.

Promising results for complex cases

While it is true that the study’s results need to be confirmed in larger samples, the conclusions reached so far are promising. They suggest that improved vascularization and endometrial regeneration could improve the conditions for embryo implantation.

The initial study was carried out in 15 patients treated at IVI Fertility Valencia and the Hospital Universitari i Politècnic La Fe in Valencia. According to Dr. Cervelló, nearly all of these women experienced improvements in endometrial thickness and function after treatment.

It is important to remember that the sample included patients with an especially difficult prognosis. For them, this represents a hopeful step forward. “Our goal is to offer an alternative to women who currently have very few reproductive options when their endometrium doesn’t respond to conventional treatments. The results are preliminary. However, they open a very promising path for this group of patients,” Dr. Cervelló emphasizes.

Formation of new blood vessels in the endometrium

The researchers have found that treatment with umbilical cord plasma promotes the formation of new blood vessels in the endometrium. This process is called neoangiogenesis. Specifically, the neoangiogenic vascular area increased from 32.23% to 45.60% after PRP administration.

“Having observed this neoangiogenesis tells us that the treatment is having a real biological effect on the tissue. The new vascularization delivers blood, oxygen, growth factors, and the signals the endometrium needs to regenerate and become functional again,” explains Dr. Irene Cervelló.

What options does this treatment offer for pregnancy?

The next step for this new treatment will, of course, be to study the chances of pregnancy after endometrial regeneration. To that end, the team is already developing a new study with 35 patients from IVI Fertility clinics, approved by Spain’s National Transplant Organization (ONT).

The goal is to validate the results obtained and determine whether they actually translate into improved implantation and pregnancy rates.

“One of the most important messages is that the endometrium deserves more attention in reproductive medicine. Often the focus is on the embryo, but for proper implantation to occur, we also need a prepared, functional endometrium. Our work adds a new piece to our understanding of how we can support the regeneration of a tissue that, in some patients, has a limited capacity to recover,” the researcher concludes.

Conclusions

One of the studies presented by the IVI Institute Foundation at the ASRM congress focuses on the role of the endometrium in embryo implantation. Here are some of the main conclusions:

• Administration of platelet-rich plasma from umbilical cord blood promotes endometrial regeneration
• The study was carried out in 15 women, who achieved endometrial regeneration thanks to increased vascularization
• The next step will be to study and determine improvements in embryo implantation and pregnancy rates in patients