Should we consider alternative therapies to operative hysteroscopy for the treatment of Asherman syndrome?

Santamaría, Xavier Alegre; Liu, James H.; Aghajanova, Lusine; Isaacson, Keith; Movilla, Peter; Fernandez, H.; Capmas, P.; Donnez, Jacques; Simón, Carlos

doi:10.1016/j.fertnstert.2020.01.022

Cited by 12 publications

(6 citation statements)

References 80 publications

(79 reference statements)

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“…In 2020, a review gathered the controversial views of different researchers on the treatment of IUA [ 64 ]. One perspective advocated that the adjuvant treatment after the surgery should be given more attention, and another suggested that IUA be treated with multiple operations.…”

Section: Discussionmentioning

confidence: 99%

The Top 100 Most Cited Articles on Intrauterine Adhesion: a Bibliometric Analysis

Zhao

et al. 2021

Reprod. Sci.

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Bibliometric analysis is a statistical method that attempts to assess articles by their citations, analyzing their frequency and citation pattern, which subsequently gleans direction and guidance for future research. Over the past few years, articles focused on intrauterine adhesions have been published with increasing frequency. Nevertheless, little is known about the properties and qualities of this research, and no current analysis exists that has examined the progress in intrauterine adhesion research. Web of Science Core Collection, BIOSIS Citation Index, and MEDLINE database were searched to identify articles on intrauterine adhesion published from 1950 to October 2020. The 100 most cited articles were chosen to analyze citation count, citation density, authorship, theme, geographic distribution, time-related flux, level of evidence, and network analysis. An overwhelming majority of these 100 articles were published in the 2010s (35%). Citations per article ranged from 30 to 253. Chinese authors published the most papers in the top 100, followed by the USA, France, Israel, and Italy. The most salient study themes included operative hysteroscopy and adjunctive treatments for improving reproductive outcomes. The most common level of evidence was level II, and there was no statistical difference in the number of citations between the levels. The network analysis indicated that hysteroscopy, hysteroscopic adhesiolysis, infertility, and the reproductive outcome had a great degree of centrality in the 2000s and 2010s. In comparison, placental implantation had a great degree of centrality in the 2000s, and stem cell and fibrosis had a great degree of centrality in the 2010s. The value of IUA investigation has been gradually appreciated recently. Hysteroscopic adhesiolysis was continuously explored to achieve better reproductive outcome. Over time, the main focus of research has gradually shifted from complications to postoperative adjuvant treatment. Moreover, breakthrough progress is needed in underlying mechanism and early prevention of IUA.

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Section: Discussionmentioning

confidence: 99%

The Top 100 Most Cited Articles on Intrauterine Adhesion: a Bibliometric Analysis

Zhao

et al. 2021

Reprod. Sci.

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“…In cases of AS, the common clinical management is directed towards hysteroscopic removal of intrauterine adhesions, prevention of their recurrence, and reformation [28][29][30]. While adhesiolysis may appear as a sound management strategy, the treatment often fails particularly in subjects with severe intrauterine adhesions and significant clinical presentation such as amenorrhea [29].…”

Section: Asherman's Syndromementioning

confidence: 99%

Making More Womb: Clinical Perspectives Supporting the Development and Utilization of Mesenchymal Stem Cell Therapy for Endometrial Regeneration and Infertility

Strug

Aghajanova

2021

JPM

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The uterus is a homeostatic organ, unwavering in the setting of monthly endometrial turnover, placental invasion, and parturition. In response to ovarian steroid hormones, the endometrium autologously prepares for embryo implantation and in its absence will shed and regenerate. Dysfunctional endometrial repair and regeneration may present clinically with infertility and abnormal menses. Asherman’s syndrome is characterized by intrauterine adhesions and atrophic endometrium, which often impacts fertility. Clinical management of infertility associated with abnormal endometrium represents a significant challenge. Endometrial mesenchymal stem cells (MSC) occupy a perivascular niche and contain regenerative and immunomodulatory properties. Given these characteristics, mesenchymal stem cells of endometrial and non-endometrial origin (bone marrow, adipose, placental) have been investigated for therapeutic purposes. Local administration of human MSC in animal models of endometrial injury reduces collagen deposition, improves angiogenesis, decreases inflammation, and improves fertility. Small clinical studies of autologous MSC administration in infertile women with Asherman’s Syndrome suggested their potential to restore endometrial function as evidenced by increased endometrial thickness, decreased adhesions, and fertility. The objective of this review is to highlight translational and clinical studies investigating the use of MSC for endometrial dysfunction and infertility and to summarize the current state of the art in this promising area.

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“…The main treatment strategy for the mentioned endometrial dysfunction consists of medical therapy (estrogen therapy, vitamin E, pentoxifylline, L-arginine, aspirin, tamoxifen, sildenafil), surgical procedures (dilatation and curettage, hysteroscopy), devices and materials of re-adhesion prevention (intrauterine device, uterine stent, Foley's catheter, adhesion barriers), autologous cellular therapy (intrauterine infusion of granulocyte colony stimulating factor or autologous platelet-rich plasma) and assisted reproductive technology (ART) procedures (AAGL Elevating Gynecologic Surgery, 2017;Ranisavljevic et al, 2019;Santamaria et al, 2020;Mouanness et al, 2021;Strug and Aghajanova, 2021). Although multiple approaches to treatment are available, the overall curative outcome is quite inconsistent.…”

Section: Introductionmentioning

confidence: 99%

In Celebration of Women in Molecular and Cellular Reproduction

2024

Frontiers Research Topics

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Frontiers is more than just an open access publisher of scholarly articles: it is a pioneering approach to the world of academia, radically improving the way scholarly research is managed. The grand vision of Frontiers is a world where all people have an equal opportunity to seek, share and generate knowledge. Frontiers provides immediate and permanent online open access to all its publications, but this alone is not enough to realize our grand goals. Frontiers journal seriesThe Frontiers journal series is a multi-tier and interdisciplinary set of openaccess, online journals, promising a paradigm shift from the current review, selection and dissemination processes in academic publishing. All Frontiers journals are driven by researchers for researchers; therefore, they constitute a service to the scholarly community. At the same time, the Frontiers journal series operates on a revolutionary invention, the tiered publishing system, initially addressing specific communities of scholars, and gradually climbing up to broader public understanding, thus serving the interests of the lay society, too. Dedication to qualityEach Frontiers article is a landmark of the highest quality, thanks to genuinely collaborative interactions between authors and review editors, who include some of the world's best academicians. Research must be certified by peers before entering a stream of knowledge that may eventually reach the public -and shape society; therefore, Frontiers only applies the most rigorous and unbiased reviews. Frontiers revolutionizes research publishing by freely delivering the most outstanding research, evaluated with no bias from both the academic and social point of view. By applying the most advanced information technologies, Frontiers is catapulting scholarly publishing into a new generation. What are Frontiers Research Topics?Frontiers Research Topics are very popular trademarks of the Frontiers journals series: they are collections of at least ten articles, all centered on a particular subject. With their unique mix of varied contributions from Original Research to Review Articles, Frontiers Research Topics unify the most influential researchers, the latest key findings and historical advances in a hot research area.

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Should we consider alternative therapies to operative hysteroscopy for the treatment of Asherman syndrome?

Abstract: Disclaimer: Authors for ''fertile battles'' are chosen to represent the full breadth of opinions. Individual authors, even within one side of the debate, do not necessarily agree with all viewpoints expressed.

Cited by 12 publications

References 80 publications

The Top 100 Most Cited Articles on Intrauterine Adhesion: a Bibliometric Analysis

The Top 100 Most Cited Articles on Intrauterine Adhesion: a Bibliometric Analysis

Making More Womb: Clinical Perspectives Supporting the Development and Utilization of Mesenchymal Stem Cell Therapy for Endometrial Regeneration and Infertility

In Celebration of Women in Molecular and Cellular Reproduction

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