Tubal abnormalities in patients with intrauterine adhesion: Evaluation using hysterosalpingography

Olawale, Balogun Babajide; Ademola, Adegboyega Olukayode; Gbadebo, Awosanya Gbolahan Olusegun

doi:10.4103/1596-3519.142288

Cited by 6 publications

(4 citation statements)

References 8 publications

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“…Although tubal abnormalities are a significant cause of infertility, little has been reported on the link between IUAs and tubal abnormalities. One study evaluated 1500 hysterosalpingograms, and among the 92 women whose radiographs showed IUAs, 62 (67.4%) had tubal abnormalities [ 39 ]. Once sperm cells have reached the tube, the process of fertilization of the oocyte seems not to be affected.…”

Section: Resultsmentioning

confidence: 99%

The link between intrauterine adhesions and impaired reproductive performance: a systematic review of the literature

Hooker

Leeuw

Emanuel

et al. 2022

BMC Pregnancy Childbirth

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Background Intrauterine adhesions (IUAs) are one of the main reproductive system diseases in women worldwide. Fusion between the injured opposing walls leads to partial-to-complete obliteration of the cavity and/or cervical canal. The main clinical manifestations in case of IUAs are menstrual disturbances, cyclic pain and reproductive disorders. The reproductive outcomes of women with IUAs remain limited and inefficient compared to women without IUAs, even after adhesiolysis. An exact understanding of the underlying mechanisms and processes to explain the compromised reproductive performance and outcomes in case of IUAs are lacking. Methods A systematic literature review of MEDLINE-PubMed (1966 to January 2022) and EMBASE (1974 to January 2022) was performed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies were included if they reported underlying causes, related mechanisms and processes to explain the association between IUAs and impaired reproductive performance, pregnancy and obstetric complications. Results After an extensive review of the literature, 58 articles were identified reporting underlying mechanisms to explain the association between IUAs and impaired fertility. Intrauterine scarring influences the process of fertilization, reproductive performance and ultimately reproductive outcome. IUAs can disturb the cervico-utero-tubal sperm transport and result in an avascular and unresponsive endometrium with decreased receptivity and thickness. Abnormal decidualization and abnormal trophoblastic infiltration leads to placental attachment disorders. Moreover, the risk for premature delivery, intrauterine fetal growth restriction and fetal anomalies is increased in case of IUAs. Conclusion The impact of IUAs on reproductive performance, even after adhesiolysis, is becoming more apparent. The postulated mechanisms to explain the association are related to sperm transport, embryo implantation and placentation. Prevention, by preserving the basal layer of the endometrium is essential. Effective and evidence-based strategies for the prevention of endometrial injury and formation of IUAs, are urgently needed.

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Section: Resultsmentioning

confidence: 99%

The link between intrauterine adhesions and impaired reproductive performance: a systematic review of the literature

Hooker

Leeuw

Emanuel

et al. 2022

BMC Pregnancy Childbirth

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“…Imaging diagnosticians evaluate pelvic adhesions by observing contrast media diffusion. When a water-based contrast agent is used for HSG, the delayed radiograph can be obtained after approximately 15 minutes [18]. As the dispersion and absorption of water-based contrast agents occur very quickly, the details of the diffusion image are difficult to capture, making the diagnostic value of the test for pelvic adhesions relatively low.…”

Section: Discussionmentioning

confidence: 99%

A prospective self-controlled study on shortening the time before taking delayed radiographs with iodized oil hysterosalpingography

Dan

Liu

et al. 2020

Ginekol Pol

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Objectives: To verify the feasibility of walking to shorten the time before obtaining delayed radiographs after iodized oil hysterosalpingography (HSG). Material and methods:One hundred women with infertility were selected for HSG from June 2018 to December 2018 at the Women's Hospital of Nanjing Medical University; the subjects were randomly divided into walking and control groups. The walking group was required to walk more than 12,000 steps within 6 hours after HSG, while the control group was prohibited from performing high-intensity exercise. The degree of pelvic adhesion was diagnosed with delayed radiographs acquired at 6 and 24 hours, and the diagnostic consistency of the radiographs at the two time points was evaluated.Results: No significant difference was observed in the baseline data between groups (p > 0.05). The delayed radiograph results in the walking group showed good agreement (p = 0.255 > 0.05, Kappa value 0.781 > 0.75), while those in the control group showed general agreement (p = 0.002 < 0.05, Kappa value 0.493 > 0.40 < 0.75). Conclusions:The time for acquiring delayed radiographs can be shortened by instructing patients to walk after HSG. This method improves the diagnostic efficiency of Iodized oil, saves time and costs, and may contribute to the popularization of HSG for female infertility screening, while offering good clinical application prospects.

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“…Несмотря на то что аномалии маточных труб представляют собой один значимых факторов бесплодия, доказательств связи между ВМС и аномалиями маточных труб в современной литературе достаточно мало, но все же показан негативный вклад ВМС в механизм имплантации. Так, например, изучение 1500 гистеросальпингограмм у 92 женщин с диагностированными ВМС показало, что 62 (67,4%) пациентки имели трубные аномалии [26]. Поскольку из числа обследуемых у 12 (13%) женщин было диагностировано первичное бесплодие, а у 80 (87%) -вторичное, по всей видимости, генез инфертильности был ассоциирован с нарушенным транспортом сперматозоидов через маточные трубы.…”

Section: влияние внутриматочных спаек на репродуктивную функциюunclassified

Intrauterine adhesions: from pathogenesis to effective coping technologies

et al. 2023

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Intrauterine adhesions (IUDs) are one of the unresolved and unsolved problems of modern reproductive medicine worldwide. Adhesive lesions lead to partial or complete obliteration of the uterine cavity and/or cervical canal. The main clinical manifestations of IUDs are menstrual irregularities, cyclical pain, infertility and other various reproductive disorders. Reproductive outcomes in women with IUDs remain poorly understood and difficult to verify. At the same time, there is currently no understanding of the basic mechanisms of IUD development, including the processes explaining the failures of the above complications. The problem of overcoming IUD recurrences after adhesiolysis remains far from being finally resolved. The gold-standard treatment for IUD is hysteroscopic adhesiolysis, which, however, is associated with a high frequency of complications and relapses, highlighting the need for preventive approaches to the management of IUD. The drugs with enzymatic activity inhibiting abnormal connective tissue include bovhyaluronidase azoximer created by the Russian developers back in 2005. The drug consists of two components – hyaluronidase and azoximer bromide. The former is an enzyme, and the latter is a stabilizer that prolongs the action of hyaluronidase. Several studies have shown that bovhyaluronidase azoximer causes the destruction of intrauterine adhesions and restores the endometrium status in inflammatory pelvic diseases. Due to prolonged antifibrotic effect of bovhyaluronidase, azoximer can be used to treat women with IUDs to reduce the risk of the subsequent development of adhesive process in the uterine cavity.

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Tubal abnormalities in patients with intrauterine adhesion: Evaluation using hysterosalpingography

Cited by 6 publications

References 8 publications

The link between intrauterine adhesions and impaired reproductive performance: a systematic review of the literature

The link between intrauterine adhesions and impaired reproductive performance: a systematic review of the literature

A prospective self-controlled study on shortening the time before taking delayed radiographs with iodized oil hysterosalpingography

Intrauterine adhesions: from pathogenesis to effective coping technologies

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