Transdermal estrogen gel vs oral estrogen after hysteroscopy for intrauterine adhesion separation: A prospective randomized study
BackgroundThis randomized controlled trial (RCT) aimed to compare two different routes of postoperative estrogen treatment on the improvements of menstruation, postoperative endometrial thickness, and fertility outcomes in patients with moderate to severe intrauterine adhesions (IUA).MethodsThis stu...
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Frontiers Media S.A.
2023-03-01
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| Series: | Frontiers in Endocrinology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fendo.2023.1066210/full |
| _version_ | 1811158410497884160 |
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| author | Tianjin Yi Tianjin Yi Xiaofang Zhang Xiaofang Zhang Vani Gupta Li Li Li Li Qian Zhong Qian Zhong |
| author_facet | Tianjin Yi Tianjin Yi Xiaofang Zhang Xiaofang Zhang Vani Gupta Li Li Li Li Qian Zhong Qian Zhong |
| author_sort | Tianjin Yi |
| collection | DOAJ |
| description | BackgroundThis randomized controlled trial (RCT) aimed to compare two different routes of postoperative estrogen treatment on the improvements of menstruation, postoperative endometrial thickness, and fertility outcomes in patients with moderate to severe intrauterine adhesions (IUA).MethodsThis study prospectively included 78 women (age: 25 to 45 years) with moderate to severe IUA who underwent hysteroscopic resection of adhesions between March 2019 and October 2020. The enrolled patients were randomized 1:1 into either the transdermal gel group (n = 39) or the estradiol valerate oral tablet group (n = 39) on the day of receiving hysteroscopy. Postoperative endometrial thickness, AFS (American Fertility Society) score, estrogen level, and the pattern and amount of menstruation were compared. Pregnancy information was actively collected during 1-year follow-up after the operation.ResultsThe postoperative endometrium thickness was improved in both groups, and both groups gained menstruation improvement rates of 67%. For patients who underwent second-look hysteroscopy (17 from the oral group and 19 from the transdermal group), the mean AFS score declined greater than 2 in both groups. For patients with postoperative pregnancy intention, the pregnancy rates at 1-year follow-up after the procedures were 40.5% and 28% in the transdermal group and oral group, respectively. Although no statistically significant difference was observed between the two groups, patients in the transdermal group had a tendency toward increased pregnancy rate.ConclusionsTransdermal administration of estrogen is equally efficacious as oral estrogen in postoperative treatment of IUA patients with a relatively safe profile. It is very likely to broaden its indication to the field of IUA.Trial Registrationhttp://www.chictr.org.cn/showproj.aspx?proj=37197, identifier ChiCTR1900022110. |
| first_indexed | 2024-04-10T05:23:04Z |
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| language | English |
| last_indexed | 2024-04-10T05:23:04Z |
| publishDate | 2023-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Endocrinology |
| spelling | doaj.art-e87c0dd9a973495a84c018fc385977da2023-03-08T06:04:28ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922023-03-011410.3389/fendo.2023.10662101066210Transdermal estrogen gel vs oral estrogen after hysteroscopy for intrauterine adhesion separation: A prospective randomized studyTianjin Yi0Tianjin Yi1Xiaofang Zhang2Xiaofang Zhang3Vani Gupta4Li Li5Li Li6Qian Zhong7Qian Zhong8Department of Gynecology and Obstetrics, West China Second University Hospital of Sichuan University, Chengdu, ChinaKey Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, ChinaDepartment of Gynecology and Obstetrics, West China Second University Hospital of Sichuan University, Chengdu, ChinaKey Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, ChinaCollege of Osteopathic Medicine, New York Institute of Technology College of Osteopathic Medicine in Long Island, NY, United StatesDepartment of Gynecology and Obstetrics, West China Second University Hospital of Sichuan University, Chengdu, ChinaKey Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, ChinaDepartment of Gynecology and Obstetrics, West China Second University Hospital of Sichuan University, Chengdu, ChinaKey Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, ChinaBackgroundThis randomized controlled trial (RCT) aimed to compare two different routes of postoperative estrogen treatment on the improvements of menstruation, postoperative endometrial thickness, and fertility outcomes in patients with moderate to severe intrauterine adhesions (IUA).MethodsThis study prospectively included 78 women (age: 25 to 45 years) with moderate to severe IUA who underwent hysteroscopic resection of adhesions between March 2019 and October 2020. The enrolled patients were randomized 1:1 into either the transdermal gel group (n = 39) or the estradiol valerate oral tablet group (n = 39) on the day of receiving hysteroscopy. Postoperative endometrial thickness, AFS (American Fertility Society) score, estrogen level, and the pattern and amount of menstruation were compared. Pregnancy information was actively collected during 1-year follow-up after the operation.ResultsThe postoperative endometrium thickness was improved in both groups, and both groups gained menstruation improvement rates of 67%. For patients who underwent second-look hysteroscopy (17 from the oral group and 19 from the transdermal group), the mean AFS score declined greater than 2 in both groups. For patients with postoperative pregnancy intention, the pregnancy rates at 1-year follow-up after the procedures were 40.5% and 28% in the transdermal group and oral group, respectively. Although no statistically significant difference was observed between the two groups, patients in the transdermal group had a tendency toward increased pregnancy rate.ConclusionsTransdermal administration of estrogen is equally efficacious as oral estrogen in postoperative treatment of IUA patients with a relatively safe profile. It is very likely to broaden its indication to the field of IUA.Trial Registrationhttp://www.chictr.org.cn/showproj.aspx?proj=37197, identifier ChiCTR1900022110.https://www.frontiersin.org/articles/10.3389/fendo.2023.1066210/fullintrauterine adhesionestrogentransdermalmenstruationpregnancyhysteroscopy |
| spellingShingle | Tianjin Yi Tianjin Yi Xiaofang Zhang Xiaofang Zhang Vani Gupta Li Li Li Li Qian Zhong Qian Zhong Transdermal estrogen gel vs oral estrogen after hysteroscopy for intrauterine adhesion separation: A prospective randomized study Frontiers in Endocrinology intrauterine adhesion estrogen transdermal menstruation pregnancy hysteroscopy |
| title | Transdermal estrogen gel vs oral estrogen after hysteroscopy for intrauterine adhesion separation: A prospective randomized study |
| title_full | Transdermal estrogen gel vs oral estrogen after hysteroscopy for intrauterine adhesion separation: A prospective randomized study |
| title_fullStr | Transdermal estrogen gel vs oral estrogen after hysteroscopy for intrauterine adhesion separation: A prospective randomized study |
| title_full_unstemmed | Transdermal estrogen gel vs oral estrogen after hysteroscopy for intrauterine adhesion separation: A prospective randomized study |
| title_short | Transdermal estrogen gel vs oral estrogen after hysteroscopy for intrauterine adhesion separation: A prospective randomized study |
| title_sort | transdermal estrogen gel vs oral estrogen after hysteroscopy for intrauterine adhesion separation a prospective randomized study |
| topic | intrauterine adhesion estrogen transdermal menstruation pregnancy hysteroscopy |
| url | https://www.frontiersin.org/articles/10.3389/fendo.2023.1066210/full |
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