Small Intestine Submucosa Is a Potential Material for Intrauterine Adhesions Treatment in a Rat Model

Gynecol Obstet Invest. 2018;83(5):499-507. doi: 10.1159/000479086. Epub 2017 Jul 20.

Abstract

Objective: To study whether small intestine submucosa (SIS) could be a treatment option for preventing the formation of intrauterine adhesions (IUAs).

Methods: The IUAs model was established by mechanical curettage and infectious injury in a rat model. One uterine horn of the rat model was treated with the transplantation of SIS (SIS group) and the other one was left without any treatment (control group). The endometrium was evaluated with endometrial thickness, number of glands and fibrosis area. The endometrial receptive factors were detected by quantitative real-time polymerase chain reaction The number and location of embryos were documented to assess the function of endometrium.

Results: In the SIS group, endometrial thickness was significantly thicker than that in the control group on the 14th and 21st day and the percentage of fibrosis area was significantly lower during the entire observation process (p < 0.05). The number of glands was similar between the 2 groups (p > 0.05). Receptive factors changed as follows: in the SIS group, the expression of uteroglobin was higher and peaked on the 21st day (3.42-fold, p < 0.05); the HOXA10 level was significantly higher on the 10th day (2.16-fold, p < 0.05), and it then decreased. More embryos were seen in SIS horns (5.13 vs. 1.25, p < 0.05).

Conclusions: SIS could be a potential physical barrier for the formation of IUAs. It contributes to the regeneration of and improvement of the receptivity of endometrium, and helps in the implantation and development of embryos in a rat model.

Keywords: Endometrial receptivity; Intrauterine adhesions; Regeneration; Small intestine submucosa.

MeSH terms

  • Animals
  • Disease Models, Animal
  • Endometrium / pathology*
  • Female
  • Homeodomain Proteins / analysis
  • Humans
  • Intestinal Mucosa*
  • Intestine, Small
  • Rats
  • Real-Time Polymerase Chain Reaction
  • Tissue Adhesions / pathology
  • Tissue Adhesions / prevention & control*
  • Uterine Diseases / pathology
  • Uterine Diseases / prevention & control*

Substances

  • Homeodomain Proteins