TY - JOUR
T1 - Hormonal support in women with Asherman syndrome does not lead to better outcomes
T2 - A randomized trial
AU - Hanstede, Miriam M F
AU - van Stralen, Karlijn J
AU - Molkenboer, Jan F M
AU - Veersema, Sebastiaan
AU - Emanuel, Mark Hans
N1 - Publisher Copyright:
© 2023 The Authors. Reproductive Medicine and Biology published by John Wiley & Sons Australia, Ltd on behalf of Japan Society for Reproductive Medicine.
PY - 2023/1/1
Y1 - 2023/1/1
N2 - 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.
AB - 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.
KW - estrogen
KW - fertility
KW - gynartresia
KW - hysteroscopy
KW - pregnancy
UR - http://www.scopus.com/inward/record.url?scp=85164014935&partnerID=8YFLogxK
U2 - 10.1002/rmb2.12526
DO - 10.1002/rmb2.12526
M3 - Article
C2 - 37396823
SN - 1445-5781
VL - 22
JO - Reproductive medicine and biology
JF - Reproductive medicine and biology
IS - 1
M1 - e12526
ER -