Anti-adhesion Gel versus No gel following Operative Hysteroscopy prior to Subsequent fertility Treatment or timed InterCourse (AGNOHSTIC), a randomised controlled trial: protocol

Visual Analysis of Uterine Adhesion Research Based on CiteSpace: Bibliometric Analysis From 2006 to 2021

Background

Intrauterine adhesionis caused by a variety of reasons, such as damage of the endometrial basal layer, adhesion or occlusion of the uterine cavity or cervix in different degrees. Seriously endangering women's physical and mental health.

Objective

The purpose of this paper is to analyze the research development of intrauterine adhesions in recent 15 years, explore the future development direction, and promote the development of this field.

Methods

With intrauterine adhesions and Ashman's syndrome as the theme, the related literatures from January 2006 to July 2021 in the Web of Science were searched, and the visual atlas was analyzed by CiteSpace software.

Results

A total of 644 literatures were included. The key words related to intrauterine adhesion mainly include adhesion, pregnancy, expression, intrauterine adhesions, women, adhesion molecule, diagnosis, activation, hysteroscopy and fertility, etc. Six clusters were obtained by keywords analysis, involving hysteroscopy, placenta, office hysteroscopy, uterus and laparoscopy. Co-occurrence of keywords shows that the research focus in recent years is on endometrial repair and regeneration.

Conclusions

Through the bibliometric analysis of WOS research on intrauterine adhesions in recent 15 years, the comprehensive analysis of countries, institutions, authors and keywords is obtained, which has a clear guiding significance for guiding the future development of intrauterine adhesions.

Focus on the Primary Prevention of Intrauterine Adhesions: Current Concept and Vision

Intrauterine adhesion (IUA), and its severe form Asherman syndrome (Asherman’s syndrome), is a mysterious disease, often accompanied with severe clinical problems contributing to a significant impairment of reproductive function, such as menstrual disturbance (amenorrhea), infertility or recurrent pregnancy loss. Among these, its correlated infertility may be one of the most challenging problems. Although there are many etiologies for the development of IUA, uterine instrumentation is the main cause of IUA. Additionally, more complicated intrauterine surgeries can be performed by advanced technology, further increasing the risk of IUA. Strategies attempting to minimize the risk and reducing its severity are urgently needed. The current review will expand the level of our knowledge required to face the troublesome disease of IUA. It is separated into six sections, addressing the introduction of the normal cyclic endometrial repairing process and its abruption causing the formation of IUA; the etiology and prevalence of IUA; the diagnosis of IUA; the classification of IUA; the pathophysiology of IUA; and the primary prevention of IUA, including (1) delicate surgical techniques, such as the use of surgical instruments, energy systems, and pre-hysteroscopic management, (2) barrier methods, such as gels, intrauterine devices, intrauterine balloons, as well as membrane structures containing hyaluronate–carboxymethylcellulose or polyethylene oxide–sodium carboxymethylcellulose as anti-adhesive barrier.