Factors affecting pregnancy outcomes following the surgical removal of intrauterine adhesions and subsequent in vitro fertilization and embryo transfer.

This study aimed to investigate the clinical factors affecting pregnancy rates following the surgical removal of intrauterine adhesions (IUAs) and subsequent in vitro fertilization and embryo transfer (IVF-ET). We retrospectively evaluated case data from patients who had undergone hysteroscopic surgery to remove varying degrees of IUAs and who had subsequently received assisted reproductive treatments with IVF-ET (in all 140 cycles) at our hospital between January, 2011 and January, 2015. The patient data were divided into either the pregnancy or non-pregnancy groups based on the pregnancy outcomes, and a number of clinicopathological variables were compared these two groups, such as age, infertility (type and duration), the number of prior surgical treatments for and severity of IUAs, the baseline follicle-stimulating hormone/luteinizing hormone (FSH/LH) ratio and estradiol level, endometrial thickness on the day of human chorionic gonadotropin (hCG) administration, etc. We selected the variables with statistically significant differences to generate multivariate logistic regression and linear correlation analyses. We found that i) the mean endometrial thickness on the day of hCG administration was greater in the pregnancy group, and that the average gestational age was younger than that in the non-pregnancy group. The different age groups had significantly different pregnancy rates. The mean baseline FSH/LH ratio of the women in the pregnancy group was lower than that in th...
Source: Experimental and Therapeutic Medicine - Category: General Medicine Tags: Exp Ther Med Source Type: research

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We report a case of AS with adhesion recurrence and endometrial atrophy who was successfully treated with intrauterine autologous platelet –rich plasma (PRP) infusion. This therapy allowed endometrial tissue regeneration, leading to increased vascularity and endometrium thickness, and restoration of endometrial function that led to a successful pregnancy. Though there is limited experience supporting the use of PRP to improve endomet rial function, it has been safely used in other fields of medicine; besides, it is easy to obtain, not expensive, and harmless being an autologous source. Future studies are encouraged t...
Source: Updates in Surgery - Category: Surgery Source Type: research
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
Asherman syndrome (AS) is an acquired condition defined by the presence of intrauterine adhesions (IUAs) that result when the bona fide endometrium is replaced by fibrotic tissues. IUAs provoke symptoms such as menstrual abnormalities, pelvic pain, recurrent miscarriage, infertility, abnormal placentation, and attendant psychological distress (1). The destruction of healthy endometrium arises from multiple factors that affect the endometrial stem cell niche and create IUAs. The most common is curettage of the pregnant uterus after delivery of miscarriage.
Source: Fertility and Sterility - Category: Reproduction Medicine Authors: Tags: Fertile battle Source Type: research
This study aimed to assess the feasibility and efficacy of office hysteroscopy to diagnose and treat the specific uterine pathologies frequently diagnosed and thought to be associated with female infertility.Material and methods: Using office hysteroscopy, we examined the uterine cavity in women with primary or secondary infertility and evaluated the reproductive outcomes of those affected by one or more pathologies, including cervico-isthmic adhesions, intrauterine polyps and intrauterine adhesions. Additional patient characteristics considered were age and parity, uterine pathology, pain during hysteroscopy, and outcomes...
Source: Minimally Invasive Therapy and Allied Technologies - Category: Surgery Tags: Minim Invasive Ther Allied Technol Source Type: research
This study aims to assess whether increasing time intervals between hysteroscopy for IUAs and ET affects pregnancy outcomes in the ideal study group of those undergoing euploid frozen ET.
Source: The Journal of Minimally Invasive Gynecology - Category: OBGYN Authors: Tags: Open Communications 3: Hysteroscopy (11:00 AM — 12:45 PM) 11:21 AM Source Type: research
This study aimed to assess if the fecundity of women after surgical correction of the uterine septum is associated with septum size. A retrospective, single-center, cohort study was conducted in Peking Union Medical College Hospital using patients aged between 21 and 37 years. Hysteroscopic metroplasty was performed on 121 patients with a uterine septum. The septum size was assessed by ultrasonography and hysteroscopy. The subjects were divided into 3 groups: Group A consisted of 35 women with complete uterine septum (mean ± standard deviation (SD) age 28.29 ± 3.53; group B consisted of 48 women with ute...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Observational Study 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
Introduction: Either appearing after miscarriage or abortion by request, the trophoblastic retention is often easy to diagnose, but the management can be difficult. Therefore, severe consequences may appear: endometritis, infertility, intrauterine adhesions, persistent molar pregnancy.
Source: European Journal of Obstetrics, Gynecology, and Reproductive Biology - Category: OBGYN Authors: Tags: Oral Poster at Breakfast 7 – EARLY PREGNANCY LOSS and ECTOPIC 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
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