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We randomly assigned 25 subfertile women with RTE, in a 1:1 ratio, to receive hysteroscopic adhesiolysis and plowing plus either hUC-MSC\/CS or saline\/CS (control) for intrauterine implantation. Uterine fluid was collected on the embryo transfer day for RNA-sequencing to explore the potential mechanisms by which hUC-MSCs exert their effects. The primary outcome was the cLBR. Live births occurred in 3 out of 11 women in the hUC-MSC\/CS group and in 1 out of 13 women in the control group (27.3% vs 7.7%; relative risk [RR], 3.55; 95% confidence interval [CI], 0.43 to 29.42; P\u2005=\u2005.30). The cumulative frequencies of clinical pregnancy were 5\/11 and 1\/13 in the hUC-MSC\/CS group and control group, respectively (45.5% vs. 7.7%; RR, 5.91; 95% CI, 0.81-43.28; P\u2005=\u2005.06). Two of 11 participants developed urticaria in the hUC-MSC\/CS group. Enrichment analysis showed that T-cell activation had the largest proportion in the biological process category. Kyoto Encyclopedia of Genes and Genomes pathway analysis showed that most genes were related to cytokine-cytokine receptor interaction. In conclusion, there was a non-significant trend toward a higher cLBR with hUC-MSC\/CS compared to controls, potentially through the cytokine-cytokine receptor interaction pathway. hUC-MSCs appeared to be relatively safe in a 1-year follow-up. Therefore, this novel therapy can be proposed to patients with RTE.<\/jats:p>","DOI":"10.1093\/stcltm\/szaf011","type":"journal-article","created":{"date-parts":[[2025,5,15]],"date-time":"2025-05-15T11:27:53Z","timestamp":1747308473000},"source":"Crossref","is-referenced-by-count":13,"title":["hUC-MSCs loaded collagen scaffold for refractory thin endometrium caused by Asherman syndrome: a double-blind randomized controlled trial"],"prefix":"10.1093","volume":"14","author":[{"given":"Zhaojuan","family":"Hou","sequence":"first","affiliation":[{"name":"Center for Reproductive Medicine, Xiangya Hospital of Central South University , Changsha 410000 ,","place":["People\u2019s Republic of China"]},{"name":"the Clinical Research Center For Women\u2019s Reproductive Health in Hunan Province , Changsha 410000 ,","place":["People\u2019s Republic of 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