Document Detail


Efficiency and pregnancy outcome of serial intrauterine device-guided hysteroscopic adhesiolysis of intrauterine synechiae.
MedLine Citation:
PMID:  18774563     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To highlight the efficiency of intrauterine device (IUD) guidance during hysteroscopic adhesiolysis for severe intrauterine adhesions. DESIGN: A prospective, randomized trial. SETTING: Private tertiary and referral infertility clinic. PATIENT(S): Seventy-one subfertile patients who underwent hysteroscopic treatment of intrauterine synechiae or adhesions. INTERVENTION(S): Thirty-six women in group 1 were initially examined by laparoscopy-hysteroscopy at first look, and an IUD was inserted during hysteroscopic adhesiolysis. The adhesions were further lysed by the guidance of IUD during the second-look office hysteroscopy, 1 week later. Patients were prescribed 2 months of estrogen as well as P therapy, and the IUD was removed by the end of this period. The uterine cavity was evaluated, and adhesions were further lysed by a third-look office hysteroscopy, 1 week after the removal of IUD. Thirty-five women in group 2 were similarly examined by first-look office hysteroscopy, and an IUD was inserted during hysteroscopic adhesiolysis. These patients did not undergo early intervention of office hysteroscopy, 1 week after the first procedure. They also used 2 months of estrogen and P therapy. The IUD was removed by the end of this period, and the uterine cavity was evaluated and adhesions were further lysed during a second-look office hysteroscopy. MAIN OUTCOME MEASURE(S): Pregnancy rate and live birth rate. RESULT(S): Spontaneous pregnancy rates after treatment were 17/36 (47.2%) and 11/35 (30%), and live birth rates were 10/36 (28%) and 7/35 (20%) in groups 1 and 2, respectively. These differences between the two groups were not statistically significant. CONCLUSION(S): The method described especially for early intervention may prevent complications during the treatment of severe intrauterine adhesions and may present a secure and effective alternative for constructive clinical outcomes.
Authors:
Recai Pabuccu; Gogsen Onalan; Cemil Kaya; Belgin Selam; Temel Ceyhan; Turkan Ornek; Ebru Kuzudisli
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial     Date:  2008-09-06
Journal Detail:
Title:  Fertility and sterility     Volume:  90     ISSN:  1556-5653     ISO Abbreviation:  Fertil. Steril.     Publication Date:  2008 Nov 
Date Detail:
Created Date:  2008-11-10     Completed Date:  2008-12-10     Revised Date:  2009-11-19    
Medline Journal Info:
Nlm Unique ID:  0372772     Medline TA:  Fertil Steril     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1973-7     Citation Subset:  IM    
Affiliation:
Centrum Clinic, Ankara, Turkey. rpabuccu@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Estrogens / administration & dosage
Estrogens, Conjugated (USP) / administration & dosage
Female
Fertilization in Vitro
Humans
Hysteroscopy* / adverse effects
Infertility, Female / drug therapy,  etiology*,  pathology,  surgery
Intrauterine Devices*
Laparoscopy* / adverse effects
Live Birth
Medroxyprogesterone Acetate / administration & dosage
Pregnancy
Pregnancy Rate
Progestins / administration & dosage
Prospective Studies
Time Factors
Tissue Adhesions
Treatment Outcome
Uterine Diseases / complications,  drug therapy,  pathology,  surgery*
Chemical
Reg. No./Substance:
0/Estrogens; 0/Estrogens, Conjugated (USP); 0/Progestins; 71-58-9/Medroxyprogesterone Acetate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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