The study on the safety and efficacy of amnion graft for preventing the recurrence of moderate to severe intrauterine adhesions

Publication date: Available online 30 March 2019Source: Genes &DiseasesAuthor(s): Changjiang Li, Aiqi Cai, Congcong Sun, Yanhua Mao, Benyuan Wu, Yingfeng Zhang, Yuhan Wang, Shanbi Zhou, Jia WangAbstractTranscervical resection of adhesion (TCRA) is the standard treatment for the intrauterine adhesions, but the recurrence of adhesions is a tough problem for the gynecologist. In addition, the therapeutic strategy after TCRA about prevention of recurrence remains controversial especially for the patients with moderate to severe intrauterine adhesions (IUAs). Hence, we designed this study to explore the safety and efficacy of fresh amnion grafts for preventing the recurrence after TCRA for patients with moderate to severe IUAs. One hundred patients with moderate to severe IUAs who presented with a history of hypomenorrhea, amenorrhea and infertility were included in the study from January 2015 to December 2017. Patients were divided into amnion group (52 patients) and chitosan group (48 patients). Fresh amnion grafts or intrauterine injections of chitosan were administered after TCRA. Transvaginal ultrasonography(TVUS) and hysteroscopy were performed at the first and third month after the operation. The surgical procedures for all patients were completed successfully without relevant complications. In amnion group, 8 patients exhibited relapse in the first month and 2 patients in three months after surgery; in chitosan group, 23 women exhibited relapse in the first month and 1...
Source: Genes and Diseases - Category: Genetics & Stem Cells Source Type: research

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Asherman syndrome is a reproductive disorder characterized by intrauterine adhesions and amenorrhea, infertility, abnormal placentation, or pregnancy loss. Treatment of Asherman syndrome involves hysteroscopic lysis of adhesions. Many surgeons utilize postoperative measures such as hormone therapy, solid mechanical devices, or barrier gels to prevent recurrent adhesions in this setting. However, there is limited high-quality evidence to support their use. Additional research is needed on the safety and efficacy of these commonly used methods to guide patient care.
Source: Clinical Obstetrics and Gynecology - Category: OBGYN Tags: Controversies in Gynecologic Surgery Source Type: research
Tissue regeneration disorder after endometrial injury is an important cause of intrauterine adhesions, amenorrhea, and infertility in women. Both bone marrow mesenchymal stem cell (BMSC) transplantation and el...
Source: Stem Cell Research and Therapy - Category: Stem Cells Authors: Tags: Research Source Type: research
ConclusionYounger age, earlier treatment within disease course, fewer cervical canal adhesions, and fewer surgical procedures improve reproductive outcome in patients with severe IUAs and amenorrhea.
Source: Journal of Minimally Invasive Gynecology - Category: OBGYN Source Type: research
This study has been designed to assess the prevalence and association between of clinical presentations, potential causes, and hysteroscopic March classification of AS among infertile women with endometrial thickness. A retrospective descriptive study was carried out that included 41 women diagnosed with AS. All of the patients underwent evaluation and detailed history. All cases classified according to March classification of AS were recorded. Patients were divided into 2 groups based on measurement of endometrial thickness. Group A consisted of 26 patients with endometrial thickness ≤5 mm, and group B included 15 p...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research
Abstract Severe uterine damage and infection lead to intrauterine adhesions, which result in hypomenorrhea, amenorrhea and infertility. Cell sheet engineering has shown great promise in clinical applications. Adipose-derived stem cells (ADSCs) are emerging as an alternative source of stem cells for cell-based therapies. In the present study, we investigated the feasibility of applying ADSCs as seed cells to form scaffold-free cell sheet. Data showed that ADSC sheets expressed higher levels of FGF, Col I, TGFβ and VEGF than ADSCs in suspension, while increased expression of this gene set was associated with st...
Source: Biology of Reproduction - Category: Reproduction Medicine Authors: Tags: Biol Reprod Source Type: research
Publication date: February 2018 Source:Journal of Minimally Invasive Gynecology, Volume 25, Issue 2 Author(s): Zaraq Khan, Jeffrey M. Goldberg In developed countries Asherman's syndrome is almost always the result of a prior intrauterine operative trauma. This is often asymptomatic but may result in hypo- or amenorrhea and can contribute to infertility and pregnancy complications. We review their etiology, clinical implications, and systems proposed to classify their extent. The numerous methods reported for performing lysis of intrauterine adhesions are summarized along with clinical results. Current strategies to preven...
Source: Journal of Minimally Invasive Gynecology - Category: OBGYN Source Type: research
Publication date: Available online 9 October 2017 Source:Journal of Minimally Invasive Gynecology Author(s): Zaraq Khan, Jeffrey M. Goldberg In developed countries, Asherman's Syndrome is almost always the result of a prior intrauterine operative trauma. This is often asymptomatic but may result in hypo- or amenorrhea and can contribute to infertility and pregnancy complications. We will review their etiology, clinical implications, and the systems which have been proposed to classify their extent. The numerous methods reported for performing lysis of intrauterine adhesions will be summarized along with the clinical resul...
Source: Journal of Minimally Invasive Gynecology - Category: OBGYN Source Type: research
In developed countries Asherman's syndrome is almost always the result of a prior intrauterine operative trauma. This is often asymptomatic but may result in hypo- or amenorrhea and can contribute to infertility and pregnancy complications. We review their etiology, clinical implications, and systems proposed to classify their extent. The numerous methods reported for performing lysis of intrauterine adhesions are summarized along with clinical results. Current strategies to prevent recurrence of intrauterine adhesions have not been conclusively shown to be clinically effective, but the potential for endometrial regenerati...
Source: The Journal of Minimally Invasive Gynecology - Category: OBGYN Authors: Tags: Special Article Source Type: research
Study Objective: To determine the effectiveness of hysteroscopic adhesiolysis in patients with Asherman's Syndrome and secondary amenorrhea, hypomenorrhea or infertility.
Source: The Journal of Minimally Invasive Gynecology - Category: OBGYN Authors: Source Type: research
Conclusion(s) Hysteroscopic adhesiolysis of IUAs is safe and effective in terms of reproductive outcome. The outcome is significantly affected by degree of intrauterine adhesions rather than the main complaint before the procedure.
Source: Archives of Gynecology and Obstetrics - Category: OBGYN Source Type: research
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