{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T04:30:43Z","timestamp":1786595443468,"version":"build-2736575974"},"reference-count":34,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T00:00:00Z","timestamp":1786579200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"publisher","award":["RS-2021KC10100418"],"award-info":[{"award-number":["RS-2021KC10100418"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003710","name":"Korea Health Industry Development Institute","doi-asserted-by":"publisher","award":["RS-2025-02213795"],"award-info":[{"award-number":["RS-2025-02213795"]}],"id":[{"id":"10.13039\/501100003710","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Severe refractory Asherman syndrome (SRAS) remains difficult to treat, and the benefit of regenerative blood-derived therapies remains uncertain. This study evaluated whether systemic granulocyte colony-stimulating factor (G-CSF) mobilisation combined with targeted intrauterine delivery of autologous peripheral blood platelet\u2013leukocyte concentrate (PBPLC) could improve endometrial thickness in women with SRAS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This prospective, single-centre, single-arm pilot study enrolled 10 women with infertility for at least 3 years, severe intrauterine adhesions, poor endometrial development, and failure of previous adhesiolysis, hormonal therapy, and platelet-rich plasma treatment. After G-CSF mobilisation, autologous PBPLC was injected into the endometrial\u2013myometrial junction under hysteroscopic guidance without concurrent formal adhesiolysis. The primary outcome was the change in late pre-ovulatory endometrial thickness (LPO-EMT), analysed using the exact Wilcoxon signed-rank test and Hodges\u2013Lehmann estimates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>LPO-EMT increased from 4.6 mm (SD 0.7) to 5.8 mm (SD 1.3), with a Hodges\u2013Lehmann paired difference of 1.08 mm (95% CI 0.45\u20132.50; p = 0.0039). Hysteroscopic cavity restoration, reduced adhesion severity, and subjective menstrual improvement were observed in all participants, and the AFS score decreased from 10.8 to 4.5. No grade 3 or higher treatment-related adverse events occurred. Among nine women who attempted conception, pregnancy was detected in six (66.7%; exact 95% CI 29.9\u201392.5), including four clinical pregnancies (44.4%; exact 95% CI 13.7\u201378.8). However, all clinical pregnancies ended in first-trimester miscarriage, and no ongoing pregnancies or live births were achieved during follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>These preliminary findings suggest that G-CSF-mobilised autologous PBPLC may be a feasible approach for improving endometrial thickness and uterine cavity restoration in women with SRAS. However, the findings do not establish reproductive efficacy, and larger controlled studies are warranted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical trial registration<\/jats:title>\n                    <jats:related-object>\n                      <jats:ext-link>https:\/\/cris.nih.go.kr\/<\/jats:ext-link>\n                      , identifier KCT0004208.\n                    <\/jats:related-object>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2026.1923604","type":"journal-article","created":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T04:24:18Z","timestamp":1786595058000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["First-in-human pilot trial of G-CSF\u2013mobilised platelet\u2013leukocyte concentrate for severe refractory Asherman syndrome"],"prefix":"10.3389","volume":"17","author":[{"given":"BingJie","family":"Rui","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, CHA University School of Medicine","place":["Pocheon, Republic of Korea"]},{"name":"Fertility Center, CHA University Bundang Medical Center","place":["Seongnam, Republic of Korea"]},{"name":"Department of Obstetrics and Gynecology, Fushun Second Hospital","place":["Fushun, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"YanFeng","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, CHA University School of Medicine","place":["Pocheon, Republic of Korea"]},{"name":"Fertility Center, CHA University Bundang Medical Center","place":["Seongnam, Republic of Korea"]},{"name":"Department of Obstetrics and Gynecology, Fushun Maternal and Child Health Hospital","place":["Fushun, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hye Kyung","family":"Yoon","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Infertility Center, CHA University Ilsan Medical Center","place":["Goyang, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jae Eun","family":"Jung","sequence":"additional","affiliation":[{"name":"Fertility Center, CHA University Bundang Medical Center","place":["Seongnam, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ji Hyang","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, CHA University School of Medicine","place":["Pocheon, Republic of Korea"]},{"name":"Fertility Center, CHA University Bundang Medical Center","place":["Seongnam, Republic of 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