Wednesday, April 27, 2011
Articles on Asherman's syndrome: Reproductive outcomes and Obstetric complications
The final section on references to peer-reviewed publications on Asherman's syndrome have been uploaded under pages (please see relevant tab above or click here). It includes case reports, studies and reviews of reproductive outcomes (pregnancy rates, live birth rates), obstetric complications in women with a past history of Asherman's syndrome (e.g. placenta accreta, IUGR etc.), as well as in women who have untreated intrauterine adhesions at the time of pregnancy. I also included some articles on fertility complications in women who have had Asherman's syndrome, such as thin endometrium. I will continue updating all pages with new articles when they are published. I also intend to add other articles such as those on stem cells, uterine transplantation, hysteroscopy, treatment of thin endometrium, and general articles on misoprostol and the risks of D&C, so stay tuned.
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After breiefly reading your previous blogs regarding the statistics of success rates on women with Ashermans achieving pregancy, I am wondering, what was the average time frame after treatment that these women were being studid? It is my understanding that the basal layer of the uterus is similar to bone marrow is made of stem cells. When given enough time and an unscared surface they will eventually rejuvenate themselves even though the process may take several years. I am curious if the statistics of women being able to achieve preganancy would increase as years go on specifically after the three year mark.
ReplyDeleteThat's a good point, as some studies did not seem to have a long follow-up period. I will look into the average time frame and report it. However, unfortunately the uterus is not really like bone marrow. Many tissues and organs like the uterus and heart do have adult stem cells and a potential, albeit limited, for self-repair. The problem is if those stem cells in the uterus are also removed during the same injury that caused the adhesions. I suspect that with very severe cases where the adhesions keep recurring or there is widespread fibrosis (unstuck Asherman's) this has happened and it is irreversible. There is still hope though for other cases that time, and hormonal stimulation (for example during IVF) will continue to repair the endometrium.
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