Controversy in the management of oestrogen therapy before hysteroscopic adhesiolysis: a systematic review and meta-analysis

REPRODUCTIVE BIOMEDICINE ONLINE

卷:41

Review

Chang, Yanan¹  Duan, Hua¹  Shen, Xue²  Wang, Sha¹  Guo, Zhengchen¹  Chen, Shujian¹ 

[1] Capital Med Univ, Beijing Obstet & Gynecol Hosp, Dept Minimally Invas Gynecol, 17 Qi Helou Rd, Beijing 100006, Peoples R China

[2] Hubei Univ Med, Xiangyang Peoples Hosp1, Dept Obstet & Gynecol, Xiangyang 441000, Hubei, Peoples R China

关键词: Estrogen therapy;    Hysteroscopic adhesiolysis;    Intrauterine adhesions;    Preoperative therapy;    Reproductive outcome;   

DOI  :  10.1016/j.rbmo.2020.06.012

来源: Elsevier

【 摘 要 】

The aim of this systematic review and meta-analysis was to assess the effect of oestrogen therapy as a preoperative intervention for improving clinical outcomes and fertility outcomes in women with intrauterine adhesions (IUA). A systematic search of PubMed, Embase, The Cochrane Library, clinicaltrials.gov , OVID and Chinese databases was carried out to identify relevant studies published before December 2019. Outcomes were expressed as odds ratios and 95% confidence intervals. Five cohort studies with moderate to high methodological quality were included in the meta-analysis. Preoperative oestrogen therapy was strongly associated with better clinical outcome at second-look hysteroscopy (OR 2.72; 95% CI 1.49 to 4.96; P = 0.001); whereas no significant difference was found in menstruation improvement and conception rate (OR 1.45; 95% CI, 0.95 to 2.23; P = 0.09; and OR 0.96; 95% CI 0.60 to 1.54; P = 0.87, respectively). The overall quality of the evidence ranged from moderate to very low. Preoperative oestrogen therapy may improve the short-term prognosis of IUA at second-look hysteroscopy, whereas the long-term prognosis-fertility outcome was similar to the control group. More strictly designed research studies are needed to assess the effectiveness of oestrogen administration before hysteroscopic adhesiolysis.

【 授权许可】

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