AAGL Practice Report: Practice Guidelines on Intrauterine Adhesions Developed in Collaboration With the European Society of Gynaecological Endoscopy (ESGE)

Surgery, Aagl Elevating Gynecologic

doi:10.1016/j.jmig.2016.11.008

Cited by 77 publications

(25 citation statements)

References 100 publications

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“…[ 20 ] Copper-bearing IUDs may induce an excessive inflammatory reaction and are not recommended for the use by the European Society of Gynecological Endoscopy. [ 21 ] Some investigators reported that the IUD may provoke local inflammation and increase the likelihood of reformation of adhesions. [ 19 ]…”

Section: Discussionmentioning

confidence: 99%

“…[ 25 ] Another study reported that for moderate-to-severe IUAs, HA gel combined with IUD may be an alternative approach for reducing adhesion recurrence after hysteroscopic adhesiolysis. [ 21 ] However, another study showed that the insertion of IUD is more effective than the use of HA in the prevention of IUA. [ 7 ] Our study demonstrated that HA was superior to IUD.…”

Section: Discussionmentioning

confidence: 99%

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Comparison of autocross-linked hyaluronic acid gel and intrauterine device for preventing intrauterine adhesions in infertile patients: A randomized clinical trial

Wang

Song

et al. 2020

Gynecol Minim Invasive Ther

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Objectives: The objective of this study is to evaluate the efficacy of autocross-linked hyaluronic acid (HA) compared with intrauterine device (IUD) for preventing intrauterine adhesions (IUAs) in infertile patients after hysteroscopic adhesiolysis. Materials and Methods: A randomized clinical trial (ChiCTR-IOR-16007746). Upon completion of adhesiolysis, 3 ml of HA gel was placed into the uterine cavity in Group A; 3 ml of HA gel and an IUD were placed in Group B; and only an IUD was placed in Group C. A second hysteroscopic examination was performed in all patients at approximately 1 month postoperatively for the evaluation of IUA. The primary outcome measure was the effective rate of IUA prevention based on the American Fertility Society (AFS) scoring system. Results: Eighty-nine women were randomly distributed into two groups for intention to treat with 30 patients in Group A, 24 patients in Group B, and 35 patients in Group C. Patients were scored and stratified into three degrees and were enrolled using the simple random sampling method. The three groups were well balanced. There were no significant differences in age, endometrial thickness, the previous number of pregnancy, and the distribution of adhesion categories across mild, moderate, and severe between the three groups. The effective rate of IUA prevention, the AFS score after therapy, and the percentage improvements of Chinese score and AFS score before and after surgery were statistically significant difference between Groups A and C. The clinical pregnancy rate in Group A was higher than those in Groups B and C, but the difference was not statistically significant. Conclusion: HA gel has an advantage over an IUD in reducing IUA recurrence and decreasing adhesions.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Comparison of autocross-linked hyaluronic acid gel and intrauterine device for preventing intrauterine adhesions in infertile patients: A randomized clinical trial

Wang

Song

et al. 2020

Gynecol Minim Invasive Ther

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“…10,11 A recent American Association of Gynecologic Laparoscopists/European Society of Gynecologic Endoscopy (AAGL/ESGE) practice guideline commented in favor of Lippes loop IUD for secondary prevention. 12 In our practice, with its peculiar trapezoidal shape, the Lippes loop has been the method of choice for a long while, albeit it is no longer available in the global market.…”

Section: Discussionmentioning

confidence: 99%

New Crosslinked Hyaluronan Gel, Intrauterine Device, or Both for the Prevention of Intrauterine Adhesions

Pabuçcu

Kovancı

Şahin

et al. 2019

JSLS

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Background and Objectives: To compare the efficacy of 3 different techniques for prevention of adhesion reformation after hysteroscopic adhesiolysis in patients with moderate-to-severe intrauterine adhesions. Short-term assisted reproductive outcomes were also compared. Study Design: Total of 72 cases were randomized to Lippes loop intrauterine device (IUD) only, IUD plus a new crosslinked hyaluronan (NCH) gel, or NCH gel only following hysteroscopic adhesiolysis. All cases received hormonal therapy and a second hysteroscopy was carried out. Endometrial thickness values were measured using transvaginal ultrasonography and American Fertility Society adhesion scores were noted during first and second hysteroscopy in all groups. Reproductive outcomes were also compared for those who received in vitro fertilization treatment. Results: Transvaginal ultrasonography revealed significantly better endometrial thickness in the IUD+NCH (7.5 mm) and NCH-only groups (6.5 mm) than the IUD-only group (5 mm) ( P < .001). All groups revealed enhanced but comparable American Fertility Society adhesion scores on second-look hysteroscopy. A total of 37 patients received in vitro fertilization treatment after surgical management of adhesions. Ongoing pregnancy rates after in vitro fertilization were 27%, 40%, and 36% in IUD, IUD+NCH, and NCH groups, respectively. However, the difference between the groups did not reach statistically significant difference. Conclusion: All interventions are of similar efficacy in the prevention of adhesion reformation after hysteroscopic adhesiolysis for moderate to severe intrauterine adhesions. However, better endometrial thickness values were observed in those who received NCH gel either alone or in combination with IUD. Assisted reproductive outcomes of both groups were comparable for ongoing pregnancy rates.

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“…Hysteroscopic resection of the intrauterine lesions is associated with significantly lower risk for de novo adhesion formation as compared to curettage [74]. Therefore, uterine curettage in order to obtain endometrial samples in women undergoing diagnosis for infertility should be avoided.…”

Section: Iatrogenic Adhesions After Hysteroscopymentioning

confidence: 99%

Polish Society of Gynecologists and Obstetricians Guidelines for the application of hysteroscopy in gynecology

et al. 2019

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This guideline presents current management recommendations which may be modified and altered in justifiable cases, after careful analysis of a given clinical case, which in the future might constitute grounds for modification and updating. OBJECTIVESThe objective of this guideline is to present up-to-date knowledge about the application of hysteroscopy in gynecology, based on the experience of the authors and reliable sources from the literature.

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AAGL Practice Report: Practice Guidelines on Intrauterine Adhesions Developed in Collaboration With the European Society of Gynaecological Endoscopy (ESGE)

Cited by 77 publications

References 100 publications

Comparison of autocross-linked hyaluronic acid gel and intrauterine device for preventing intrauterine adhesions in infertile patients: A randomized clinical trial

Comparison of autocross-linked hyaluronic acid gel and intrauterine device for preventing intrauterine adhesions in infertile patients: A randomized clinical trial

New Crosslinked Hyaluronan Gel, Intrauterine Device, or Both for the Prevention of Intrauterine Adhesions

Polish Society of Gynecologists and Obstetricians Guidelines for the application of hysteroscopy in gynecology

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