Hormonal support in women with Asherman syndrome does not lead to better outcomes: A randomized trial.

IF 2.7 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Reproductive Medicine and Biology Pub Date : 2023-06-29 eCollection Date: 2023-01-01 DOI:10.1002/rmb2.12526

Miriam M F Hanstede, Karlijn J van Stralen, Jan F M Molkenboer, Sebastiaan Veersema, Mark Hans Emanuel

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Abstract

Purpose: The purpose of the study was to investigate if adjuvant hormones after successful adhesiolysis lead to a reduction in spontaneous recurrence of adhesions and influence reproductive outcomes.

Methods: A single-blind randomized controlled trial comparing administration of oral estrogen (the usual care group) with not giving estrogen (no estrogen) in women after successful adhesiolysis for Asherman syndrome. Women were included between September 2013 and February 2017, with a follow-up of 3 years to monitor recurrences and reproductive outcomes. Analyses were based on an intention to treat analyses. This study was registered under NL9655.

Results: A total of 114 women were included. At 1 year, virtually all patients (except 3) were either having a recurrence or were pregnant. Women who did not receive estrogen did not have more recurrences of adhesions in the first year prior to pregnancy (66.1% in the usual care group, 52.7% in the no-estrogen group, p = 0.15). Of the women in usual care, 89.8% got pregnant within 3 years, and 67.8% got a living child; this was 83.6% and 60.0%, respectively, in the no-estrogen group (p = 0.33 and p = 0.39, respectively).

Conclusion: Usual care does not lead to better outcomes as compared with not giving exogenous estrogen but is associated with side effects.

Abstract Image

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对患有阿什曼综合征的妇女提供激素支持并不会带来更好的疗效：随机试验。

目的：该研究旨在探讨成功溶解粘连后辅助使用激素是否会减少粘连的自发复发并影响生殖结果：方法：一项单盲随机对照试验，比较对阿希曼综合征成功粘连切除术后的妇女给予口服雌激素（常规护理组）和不给予雌激素（无雌激素）。该试验于 2013 年 9 月至 2017 年 2 月间纳入妇女，随访 3 年，以监测复发情况和生殖结果。分析基于意向治疗分析。该研究在NL9655下注册：共纳入 114 名妇女。1年后，几乎所有患者（3人除外）要么复发，要么怀孕。未接受雌激素治疗的妇女在妊娠前一年的粘连复发率并不更高（常规治疗组为 66.1%，未接受雌激素治疗组为 52.7%，P = 0.15）。在接受常规护理的妇女中，89.8%的人在3年内怀孕，67.8%的人有了一个活生生的孩子；在无雌激素组中，这一比例分别为83.6%和60.0%（p = 0.33和p = 0.39）：结论：与不给予外源性雌激素相比，常规护理不会带来更好的结果，但会产生副作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Reproductive Medicine and Biology Multiple-

CiteScore

5.70

自引率

5.90%

发文量

审稿时长

20 weeks

期刊介绍： Reproductive Medicine and Biology (RMB) is the official English journal of the Japan Society for Reproductive Medicine, the Japan Society of Fertilization and Implantation, the Japan Society of Andrology, and publishes original research articles that report new findings or concepts in all aspects of reproductive phenomena in all kinds of mammals. Papers in any of the following fields will be considered: andrology, endocrinology, oncology, immunology, genetics, function of gonads and genital tracts, erectile dysfunction, gametogenesis, function of accessory sex organs, fertilization, embryogenesis, embryo manipulation, pregnancy, implantation, ontogenesis, infectious disease, contraception, etc.