Fusion Protein-Collagen Scaffolds: A New Potential Therapy for Thin Endometrium

Background: Thin endometrium (TE), a leading cause of uterine factor infertility, remains a clinical challenge with limited therapeutic options. This study evaluates the effect of intrauterine perfusion with fusion protein-collagen scaffolds (FP-CS) derived from engineered umbilical cord mesenchymal stem cells (UC-MSCs) on TE. Methods: In this retrospective observational study, 34 patients with TE (endometrial thickness [ET] <7 mm) received FP-CS therapy on days 8, 10, and 12 of their menstrual cycles. ET was monitored via transvaginal ultrasound over three post-treatment menstrual cycles. Results: No treatment-related serious adverse events were reported. The mean endometrial thickness (MET) increased significantly from 5.46 ± 1.12 mm to 7.84 ± 1.72 mm ([Formula: see text] < 0.0001). Sustained improvement was observed throughout the three-month observation period, with younger patients ([Formula: see text]40 years) demonstrating continuous endometrial thickening. Patients with baseline ET [Formula: see text]5 mm showed the most pronounced improvement in the first cycle (1.91 ± 1.35 mm vs. 1.18 ± 1.30 mm in the 5-6 mm group, [Formula: see text]). Conclusion: FP-CS therapy effectively enhances ET in TE patients, offering an innovative regenerative approach. Further randomized controlled trials are warranted to validate its impact on pregnancy outcomes.