Effects of Intrauterine Device Combined with Different Doses of Estrogen on Uterine Adhesion, Menstrual Recovery and Pregnancy Rate after Laparoscopic Intrauterine Adhesions Separation
YE Feng-ru, HUANG Yu-ling, PENG Hai-yan, et al
Department of Obstetrics and Gynecology, Dalang Hospital of Dongguan, Dongguan, Guangdong 523770
Abstract：【Objective】To investigate the effects of intrauterine device(IUD) combined with different doses of estrogen on intrauterine adhesion (IUA), menstrual recovery and pregnancy rate after laparoscopic intrauterine adhesions separation by trans-cervical resection of adhesion (TCRA).【Methods】The clinical data of 60 patients with intrauterine adhesions in our hospital from January 2014 to January 2017 were analyzed retrospectively. All patients underwent trans-cervical resection of adhesion at 3~7 days after menstruation, and were given O-type metal IUD combined with estrogen after operation. According to the different doses of estrogen received, patients were divided into the low-dose group (3 mg/d) with 25 cases, the middle-dose group (6mg/d) with 19 cases, and the high-dose group (9mg/d) with 16 cases. Patients were followed up with three months after operation, and changes in endometrial thickness, incidence of intrauterine adhesions and recovery of menstruation were examined. Based on the requirements of the American Fertility Association (AFS), the intrauterine adhesions score was determined. For patients who had fertility requirements, conditions for pregnancy within 1 year after operation were noted. 【Results】The incidence of intrauterine re-adhesions in the low-dose group was less than that in the middle-and high-dose groups, and the percentile of menstruation recovery was higher than that in the middle-and high-groups. The differences were statistically significant (P<0.05). After treatment, the AFS score in the low-dose group decreased more obviously than that in the middle- and high-dose groups, and the difference was statistically significant (P<0.05). The thickness of the endometrium after treatment in the low-dose group increased more obviously than that in the middle- and high-dose groups and the difference was statistically significant (P<0.05). The pregnancy rates within 1 year after operation in the three groups were 54.5% (6/11), 50% (8/16), and 55.6% (5/9) respectively but the difference was not statistically significant (P>0.05).【Conclusion】Uterine cavity indwelling IUD combined with low dose estrogen (3mg/d) is conducive to the recovery of patients with intrauterine adhesions. It can reduce intrauterine re-adhesion, improve menstrual recovery, and have no significant effect on postoperative pregnancy rate.
叶凤如, 黄玉玲, 彭海燕, 王武, 李婵玉. 宫腔粘连分离术后宫腔留置节育器联合不同剂量雌激素对宫腔再粘连、月经恢复及妊娠率的影响[J]. 医学临床研究, 2018, 35(6): 1086-1088.
YE Feng-ru, HUANG Yu-ling, PENG Hai-yan, et al. Effects of Intrauterine Device Combined with Different Doses of Estrogen on Uterine Adhesion, Menstrual Recovery and Pregnancy Rate after Laparoscopic Intrauterine Adhesions Separation. JOURNAL OF CLINICAL RESEARCH, 2018, 35(6): 1086-1088.
2018, Vol. 35 
