The Effects of Filgrastim and Hyaluronic acid on the Endometrium in Experimentally Induced Asherman Syndrome Rat Models: A Prospective Labrotory Study

Background and Objectives: The aim of the present study was to explore the histopathological effects and tissue Vascular Endothelial Growth Factor (VEGF) levels of filgrastim and hyaluronic acid treatment in a rat model with experimentally induced Asherman Syndrome. In this study, 26 female Sprague Dawley rats were used. First, a rat model of Asherman Syndrome model was established in 2 rats. The remaining rats were randomly divided into three groups. A total of 0.1 ml trichloroacetic acid was applied to the right uterine horns of all groups to induce adhesion formation. Group I received no treatment. Group II received intrauterine hyaluronic acid treatment (0.01), Group III received subcutaneous Filgrastim treatment (50 μg/kg/day), and Group IV received both intrauterine hyaluronic acid and subcutaneous Filgrastim treatment. Histopathological analysis of uterine corns in the rats with and without Asherman Syndrome, inflammation, glandular count, and fibrosis levels were examined. Tissue VEGF levels were investigated immunohistochemically. Hyaluronic acid treatment resulted in an increase only in uterine lumen diameter and VEGF levels, while filgrastim treatment led to an increase in uterine wall diameter, lumen diameter, gland count, and VEGF levels, as well as a decrease in fibrosis and inflammation scores. Combined treatment with filgrastim and hyaluronic acid showed an increase in lumen diameter, gland count, and VEGF levels, along with a decrease in inflammation and fibrosis scores (P< 0.05). Filgrastim treatment resulted in better effects for Asherman Syndrome compared to hyaluronic acid treatment. There were no beneficial effects seen with the combined therapy.