Эффективность лечения внутриматочных синехий у женщин репродуктивного возраста. Клинический случай

1. Boivin J, Bunting L, Collins JA, et al. International estimates of infertility prevalence and treatment-seeking: potential need and demand for infertility medical care. Human reproduction (Oxford, England). 2007;22(6):1506-12. DOI:10.1093/humrep/dem046
2. Попов А.А., Мананникова Т.Н., Алиева А.С., и др. Внутриматочные синехии: век спустя. РМЖ. 2017;12:895-9 [Popov AA, Manannikova TN, Alieva AS, et al. Vnutrimatochnye sinehii: vek spustja. RMJ. 2017;12:895-9 (in Russian)].
3. Оразов М.Р., Краснопольская К.В., Силантьева Е.С., и др. «Проблемный» эндометрий как фактор бесплодия: поиск путей преодоления продолжается. Трудный пациент. 2020;18(8-9):13-9 [Orazov MR, Krasnopol'skaya KV, Silanteva ES, et al. “Problemnyj” endometrij kak faktor besplodiya: poisk putej preodoleniya prodolzhaetsya. Trudnyj pacient. 2020;18(8-9):13-9 (in Russian)]. DOI:10.24411/2074-1995-2020-10054
4. Сухих Т.А. Бесплодный брак. Современные подходы к диагностике и лечению: руководство. М.: ГЭОТАР-Медиа, 2010 [Suhih TA. Besplodnyj brak. Sovremennye podhody k diagnostike i lecheniyu: rukovodstvo. Moscow: GEOTAR-Media, 2010 (in Russian)].
5. Pietro CDi, Cicinelli E, Guglielmino MR, et al. Altered transcriptional regulation of cytokines, growth factors, and apoptotic proteins in the endometrium of infertile women with chronic endometritis. Am J Reprod Immunol. 2013;69(5):509-17.
6. Сидельникова В.М. Невынашивание беременности: современный взгляд на проблему. Акушерство и гинекология. 2007;5:24-7 [Sidelnikova VM. Nevynashivanie beremennosti: sovremennyj vzglyad na problemu. Akusherstvo i ginekologiya. 2007;5:24-7 (in Russian)].
7. Попов Э.Н., Корсак В.С., Исакова Э.В., Забелкина О.И. Диагностика патологии полости матки у больных, страдающих трубно-перитонеальной формой бесплодия. Журнал акушерства и женских болезней. 2005;3:50-3 [Popov EN, Korsak VS, Isakova EV, Zabelkina OI. Diagnostika patologii polosti matki u bolnyh, stradayushchih trubno-peritonealnoj formoj besplodiya. ZHurnal akusherstva i zhenskih boleznej. 2005;3:50-3 (in Russian)].
8. Valle RF, Sciarra JJ. Intrauterine adhesions: hysteroscopic diagnosis, classification, treatment, and reproductive outcome. Am J Obstet Gynecol. 1988;158(6 Pt. 1):1459-70.
9. Asherman JG. Traumatic intra-uterine adhesions. The Journal of Obstetrics and Gynaecology of the British Empire. 1950;57(6):892-6.
10. Sabry D, Mostafa A, Mekawey D, et al. An experimental model: intrauterine adhesion versus subendometrial fibrosis. Biomed Res. 2018;29(17):3311-8.
11. Westendorp IC, Ankum WM, Mol WJ, et al. Prevalence of Asherman’s syndrome after secondary removal of placental remnants or a repeat curettage for incomplete abortion. Hum Reprod. 1998;13(12):3347-50.
12. Smikle C, Yarrarapu SNS, Khetarpal S. Asherman Syndrome. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing, 2021. 
13. Kim T, Ahn KH, Choi DS, et al. A randomized, multi-center, clinical trial to assess the efficacy and safety of alginate carboxymethylcellulose hyaluronic acid compared to carboxymethylcellulose hyaluronic acid to prevent postoperative intrauterine adhesion. J Minim Invasive Gynecol. 2012;19:731-6.
14. Al-Inany H. Intrauterine adhesions. An update. Acta Obstet Gynecol Scand. 2001;80(11):986-93.
15. Pongpattanawut C, Pantasri T, Sreshthaputra O, Sanmee U. Intrauterine Adhesions: Causes and Treatment Outcomes among Thai Women. Journal of the Medical Association of Thailand. Chotmaihet thangphaet. 2016;99:1067-72.
16. Ludwin A, Martins WP, Ludwin I. Ultrasound-guided repeat intrauterine balloon dilatation for prevention of adhesions. Ultrasound Obstet Gynecol. 2019;54(4):566-8.
17. Chikazawa K, Imai K, Liangcheng W, et al. Detection of Asherman’s syndrome after conservative management of placenta accreta: a case report. J Med Case Rep. 2018;12(1):344.
18. Fernandez H, Benifla JL, Fritel X, et al. Post-curettage and aspiration synechiae: is there value in an anti-adhesion agent? J Gynecol Obstet Biol Reprod. 2012;41(2):8-12.
19 March CM. Management of Asherman’s syndrome. Reproductive BioMedicine Online. 2011;23(1):63-76.
20. Tchente NC, Brichant G, Nisolle M. Asherman’s syndrome : management after curettage following a postnatal placental retention and literature review. Rev Med Liege. 2018;73(10):508-12.
21. Asimakopulos N. Traumatic intrauterine adhesions. The Fritsch-Asherman Syndrome. Can Med Assoc J. 1965;93:298-302.
22. Адамян Л.В., Кулаков В.И. Эндоскопия в гинекологии. М.: Медицина, 2000 [Adamian LV, Kulakov VI. Endoskopiia v ginekologii. Moscow: Meditsina, 2000 (in Russian)].
23. Pabuçcu R, Atay V, Orhon E, et al. Hysteroscopic treatment of intrauterine adhesions is safe and effective in the restoration of normal menstruation and fertility. Fertil Steril. 1997;68(6):1141-3.
24. Fernandez H, Gervaise A, de Tayrac R. Operative hysteroscopy for infertility using normal Saline solution and a coaxial bipolar electrode: a pilot study. Hum Reprod. 2000;15(8):1773-5.
25. Newton JR, MacKenzie WE, Emens MJ, Jordan JA. Division of uterine adhesions (Asherman’s syndrome) with the Nd-YAG laser. Br J Obstet Gynaecol. 1989;96:102-4.
26. Chapman R, Chapman K. The value of two stage laser treatment for severe Asherman’s syndrome. Br J Obstet Gynaecol. 1996;103(12):1256-8.
27. Sugimoto O. Diagnostic and therapeutic hysteroscopy for traumatic intrauterine adhesions. Am J Obstet Gynecol. 1978;131(5):539-47.
28. Huang H, Zou L, Zhang A, et al. A preliminary study on a patented intrauterine stent in the treatment of recurrent intrauterine adhesions with poor prognosis. Ann Transl Med. 2020;8(4):57. DOI:10.21037/atm.2020.01.77
29. Istre O, Bjoennes J, Naess R, et al. Postoperative cerebral oedema after transcervical endometrial resection and uterine irrigation with 1.5% glycine. Lancet. 1994;344(8931):1187-9.
30. Hanstede MMF, van der Meij E, Goedemans L, Emanuel MH. Results of centralized Asherman surgery, 2003–2013. Fertil Steril. 2015;104(6):1561-8.
31. Capella-Allouc S, Morsad F, Rongières-Bertrand C, et al. Hysteroscopic treatment of severe Asherman’s syndrome and subsequent fertility. Hum Reprod. 1999;14(5):1230-3.
32. Yamamoto N, Takeuchi R, Izuchi D, et al. Hysteroscopic adhesiolysis for patients with Asherman’s syndrome: menstrual and fertility outcomes. Reprod Med Biol. 2013;12(4):159-66.
33. Bougie O, Lortie K, Shenassa H, et al. Treatment of Asherman’s syndrome in an outpatient hysteroscopy setting. J Minim Invasive Gynecol. 2015;22(3):446-50.
34. Broome JD, Vancaillie TG. Fluoroscopically guided hysteroscopic division of adhesions in severe Asherman syndrome. Obstet Gynecol. 1999;93(6):1041-3.
35. Robinson JK, Colimon LMS, Isaacson KB. Postoperative adhesiolysis therapy for intrauterine adhesions (Asherman’s syndrome). Fertil Steril. 2008;90(2):409-14.
36. Polishuk WZ, Kohane S. Intrauterine adhesions: diagnosis and therapy. Obstet Gynecol Digest. 1966;8:41.
37. Ventolini G, Zhang M, Gruber J. Hysteroscopy in the evaluation of patients with recurrent pregnancy loss. Surg Endosc. 2004;18:1782-4.
38. Polishuk WZ, Weinstein D. The Soichet intrauterine device in the treatment of intrauterine adhesions. Acta Eur Fertil. 1976;7:215-8.
39. Vesce F, Jorizzo G, Bianciotto A, Gotti G. Use of the copper intrauterine device in the management of secondary amenorrhea. Fertil Steril. 2000;73:162-5.
40. March CM. Intrauterine adhesions. Obstet Gynecol Clin North Am. 1995;22:491-505.
41. Johary J, Xue M, Zhu X, et al. Efficacy of Estrogen Therapy in Patients With Intrauterine Adhesions: Systematic Review. J Minim Invasive Gynecol. 2014;21:44-54.
42. Dreisler E, Kjer JJ, Asherman’s syndrome: current perspectives on diagnosis and management. Int J Women’s Health. 2019;11:191-8.
43. Khan Z, Goldberg JM, Hysteroscopic Management of Asherman’s Syndrome. J Minim Invasive Gynecol. 2018;25:218-28.
44. Guida M, Acunzo G, di Spiezio Sardo A, et al. Effectiveness of auto-crosslinked hyaluronic acid gel in the prevention of intrauterine adhesions after hysteroscopic surgery: a prospective, randomized, controlled study. Hum Reprod. 2004;19:1461-4.
45. Zhang Y, Liu Q, Yang N, Zhang X. Hyaluronic acid and oxidized regenerated cellulose prevent adhesion reformation after adhesiolysis in rat models. Drug Design Develop Ther. 2016;10:3501-7.
46. Tsapanos VS, Stathopoulou LP, Papathanassopoulou VS, Tzingounis VA. The role of Seprafilm bioresorbable membrane in the prevention and therapy of endometrial synechiae. J Biomed Mater Res. 2002;63:10-4.

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1. Boivin J, Bunting L, Collins JA, et al. International estimates of infertility prevalence and treatment-seeking: potential need and demand for infertility medical care. Human reproduction (Oxford, England). 2007;22(6):1506-12. DOI:10.1093/humrep/dem046
2. Popov AA, Manannikova TN, Alieva AS, et al. Vnutrimatochnye sinehii: vek spustja. RMJ. 2017;12:895-9 (in Russian).
3. Orazov MR, Krasnopol'skaya KV, Silanteva ES, et al. “Problemnyj” endometrij kak faktor besplodiya: poisk putej preodoleniya prodolzhaetsya. Trudnyj pacient. 2020;18(8-9):13-9 (in Russian). DOI:10.24411/2074-1995-2020-10054
4. Suhih TA. Besplodnyj brak. Sovremennye podhody k diagnostike i lecheniyu: rukovodstvo. Moscow: GEOTAR-Media, 2010 (in Russian).
5. Pietro CDi, Cicinelli E, Guglielmino MR, et al. Altered transcriptional regulation of cytokines, growth factors, and apoptotic proteins in the endometrium of infertile women with chronic endometritis. Am J Reprod Immunol. 2013;69(5):509-17.
6. Sidelnikova VM. Nevynashivanie beremennosti: sovremennyj vzglyad na problemu. Akusherstvo i ginekologiya. 2007;5:24-7 (in Russian).
7. Popov EN, Korsak VS, Isakova EV, Zabelkina OI. Diagnostika patologii polosti matki u bolnyh, stradayushchih trubno-peritonealnoj formoj besplodiya. ZHurnal akusherstva i zhenskih boleznej. 2005;3:50-3 (in Russian).
8. Valle RF, Sciarra JJ. Intrauterine adhesions: hysteroscopic diagnosis, classification, treatment, and reproductive outcome. Am J Obstet Gynecol. 1988;158(6 Pt. 1):1459-70.
9. Asherman JG. Traumatic intra-uterine adhesions. The Journal of Obstetrics and Gynaecology of the British Empire. 1950;57(6):892-6.
10. Sabry D, Mostafa A, Mekawey D, et al. An experimental model: intrauterine adhesion versus subendometrial fibrosis. Biomed Res. 2018;29(17):3311-8.
11. Westendorp IC, Ankum WM, Mol WJ, et al. Prevalence of Asherman’s syndrome after secondary removal of placental remnants or a repeat curettage for incomplete abortion. Hum Reprod. 1998;13(12):3347-50.
12. Smikle C, Yarrarapu SNS, Khetarpal S. Asherman Syndrome. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing, 2021. 
13. Kim T, Ahn KH, Choi DS, et al. A randomized, multi-center, clinical trial to assess the efficacy and safety of alginate carboxymethylcellulose hyaluronic acid compared to carboxymethylcellulose hyaluronic acid to prevent postoperative intrauterine adhesion. J Minim Invasive Gynecol. 2012;19:731-6.
14. Al-Inany H. Intrauterine adhesions. An update. Acta Obstet Gynecol Scand. 2001;80(11):986-93.
15. Pongpattanawut C, Pantasri T, Sreshthaputra O, Sanmee U. Intrauterine Adhesions: Causes and Treatment Outcomes among Thai Women. Journal of the Medical Association of Thailand. Chotmaihet thangphaet. 2016;99:1067-72.
16. Ludwin A, Martins WP, Ludwin I. Ultrasound-guided repeat intrauterine balloon dilatation for prevention of adhesions. Ultrasound Obstet Gynecol. 2019;54(4):566-8.
17. Chikazawa K, Imai K, Liangcheng W, et al. Detection of Asherman’s syndrome after conservative management of placenta accreta: a case report. J Med Case Rep. 2018;12(1):344.
18. Fernandez H, Benifla JL, Fritel X, et al. Post-curettage and aspiration synechiae: is there value in an anti-adhesion agent? J Gynecol Obstet Biol Reprod. 2012;41(2):8-12.
19 March CM. Management of Asherman’s syndrome. Reproductive BioMedicine Online. 2011;23(1):63-76.
20. Tchente NC, Brichant G, Nisolle M. Asherman’s syndrome : management after curettage following a postnatal placental retention and literature review. Rev Med Liege. 2018;73(10):508-12.
21. Asimakopulos N. Traumatic intrauterine adhesions. The Fritsch-Asherman Syndrome. Can Med Assoc J. 1965;93:298-302.
22. Adamian LV, Kulakov VI. Endoskopiia v ginekologii. Moscow: Meditsina, 2000 (in Russian).
23. Pabuçcu R, Atay V, Orhon E, et al. Hysteroscopic treatment of intrauterine adhesions is safe and effective in the restoration of normal menstruation and fertility. Fertil Steril. 1997;68(6):1141-3.
24. Fernandez H, Gervaise A, de Tayrac R. Operative hysteroscopy for infertility using normal Saline solution and a coaxial bipolar electrode: a pilot study. Hum Reprod. 2000;15(8):1773-5.
25. Newton JR, MacKenzie WE, Emens MJ, Jordan JA. Division of uterine adhesions (Asherman’s syndrome) with the Nd-YAG laser. Br J Obstet Gynaecol. 1989;96:102-4.
26. Chapman R, Chapman K. The value of two stage laser treatment for severe Asherman’s syndrome. Br J Obstet Gynaecol. 1996;103(12):1256-8.
27. Sugimoto O. Diagnostic and therapeutic hysteroscopy for traumatic intrauterine adhesions. Am J Obstet Gynecol. 1978;131(5):539-47.
28. Huang H, Zou L, Zhang A, et al. A preliminary study on a patented intrauterine stent in the treatment of recurrent intrauterine adhesions with poor prognosis. Ann Transl Med. 2020;8(4):57. DOI:10.21037/atm.2020.01.77
29. Istre O, Bjoennes J, Naess R, et al. Postoperative cerebral oedema after transcervical endometrial resection and uterine irrigation with 1.5% glycine. Lancet. 1994;344(8931):1187-9.
30. Hanstede MMF, van der Meij E, Goedemans L, Emanuel MH. Results of centralized Asherman surgery, 2003–2013. Fertil Steril. 2015;104(6):1561-8.
31. Capella-Allouc S, Morsad F, Rongières-Bertrand C, et al. Hysteroscopic treatment of severe Asherman’s syndrome and subsequent fertility. Hum Reprod. 1999;14(5):1230-3.
32. Yamamoto N, Takeuchi R, Izuchi D, et al. Hysteroscopic adhesiolysis for patients with Asherman’s syndrome: menstrual and fertility outcomes. Reprod Med Biol. 2013;12(4):159-66.
33. Bougie O, Lortie K, Shenassa H, et al. Treatment of Asherman’s syndrome in an outpatient hysteroscopy setting. J Minim Invasive Gynecol. 2015;22(3):446-50.
34. Broome JD, Vancaillie TG. Fluoroscopically guided hysteroscopic division of adhesions in severe Asherman syndrome. Obstet Gynecol. 1999;93(6):1041-3.
35. Robinson JK, Colimon LMS, Isaacson KB. Postoperative adhesiolysis therapy for intrauterine adhesions (Asherman’s syndrome). Fertil Steril. 2008;90(2):409-14.
36. Polishuk WZ, Kohane S. Intrauterine adhesions: diagnosis and therapy. Obstet Gynecol Digest. 1966;8:41.
37. Ventolini G, Zhang M, Gruber J. Hysteroscopy in the evaluation of patients with recurrent pregnancy loss. Surg Endosc. 2004;18:1782-4.
38. Polishuk WZ, Weinstein D. The Soichet intrauterine device in the treatment of intrauterine adhesions. Acta Eur Fertil. 1976;7:215-8.
39. Vesce F, Jorizzo G, Bianciotto A, Gotti G. Use of the copper intrauterine device in the management of secondary amenorrhea. Fertil Steril. 2000;73:162-5.
40. March CM. Intrauterine adhesions. Obstet Gynecol Clin North Am. 1995;22:491-505.
41. Johary J, Xue M, Zhu X, et al. Efficacy of Estrogen Therapy in Patients With Intrauterine Adhesions: Systematic Review. J Minim Invasive Gynecol. 2014;21:44-54.
42. Dreisler E, Kjer JJ, Asherman’s syndrome: current perspectives on diagnosis and management. Int J Women’s Health. 2019;11:191-8.
43. Khan Z, Goldberg JM, Hysteroscopic Management of Asherman’s Syndrome. J Minim Invasive Gynecol. 2018;25:218-28.
44. Guida M, Acunzo G, di Spiezio Sardo A, et al. Effectiveness of auto-crosslinked hyaluronic acid gel in the prevention of intrauterine adhesions after hysteroscopic surgery: a prospective, randomized, controlled study. Hum Reprod. 2004;19:1461-4.
45. Zhang Y, Liu Q, Yang N, Zhang X. Hyaluronic acid and oxidized regenerated cellulose prevent adhesion reformation after adhesiolysis in rat models. Drug Design Develop Ther. 2016;10:3501-7.
46. Tsapanos VS, Stathopoulou LP, Papathanassopoulou VS, Tzingounis VA. The role of Seprafilm bioresorbable membrane in the prevention and therapy of endometrial synechiae. J Biomed Mater Res. 2002;63:10-4.

М.Р. Оразов1, В.Е. Радзинский1, Л.М. Михалева2, Е.С. Силантьева3, М.Б. Хамошина1, С.Я. Исмаилзаде1

1 ФГАОУ ВО «Российский университет дружбы народов», Москва, Россия;
2 ФГБНУ «Научно-исследовательский институт морфологии человека им. акад. А.П. Авцына», Москва, Россия;
3 Группа компаний «Мать и дитя», Москва, Россия
*omekan@mail.ru

________________________________________________

Mekan R. Orazov*1, Viktor E. Radzinsky1, Ljudmila M. Mihaleva2, Elena S. Silantieva3, Marina B. Khamoshina1, Sevindj Ya. Ismailzade1 

1 People’s Friendship University of Russia, Moscow, Russia;
2 Avtsyn Research Institute of Human Morphology, Moscow, Russia;
3 MD Medical Group Healthcare Center “Mother and Child”, Moscow, Russia
*omekan@mail.ru