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      Mini-Review of the New Therapeutic Possibilities in Asherman Syndrome—Where Are We after One Hundred and Twenty-Six Years?

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          Abstract

          Asherman syndrome is a multifaceted condition describing the partial or complete removal of the uterine cavity and/or cervical canal. It is a highly debatable topic because of its pronounced influence on both reproductive outcomes and gynaecologic symptoms. The latest reports demonstrated that trauma to the endometrium is the main cause of intrauterine adhesion formation. Left untreated, such adhesions gradually lead to a range of repercussions ranging from mild to severe. Considering the lack of non-invasive approaches, the advent of hysteroscopy has revolutionized the entire field, being otherwise considered the most efficient tool offering new directions and amplifying the chances of treating the Asherman syndrome.

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          Most cited references150

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          Asherman syndrome--one century later.

          To provide an update on the current knowledge of Asherman syndrome. Literature review. The worldwide reports of this disease. Patients with Asherman syndrome who presented with amenorrhea or hypomenorrhea, infertility, or recurrent pregnancy loss. Hysteroscopy and hysteroscopic surgery have been the gold standard of diagnosis and treatment respectively for this condition. The etiology, pathology, symptomatology, diagnosis, treatment, and reproductive outcomes were analyzed. This syndrome occurs mainly as a result of trauma to the gravid uterine cavity, which leads to the formation of intrauterine and/or intracervical adhesions. Despite the advances in hysteroscopic surgery, the treatment of moderate to severe Asherman syndrome still presents a challenge. Furthermore, pregnancy after treatment remains high risk with complications including spontaneous abortion, preterm delivery, intrauterine growth restriction, placenta accrete or praevia, or even uterine rupture. The management of moderate to severe disease still poses a challenge, and the prognosis of severe disease remains poor. Close antenatal surveillance and monitoring are necessary for women who conceive after treatment.
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            The American Fertility Society classifications of adnexal adhesions, distal tubal occlusion, tubal occlusion secondary to tubal ligation, tubal pregnancies, müllerian anomalies and intrauterine adhesions.

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              Autologous cell therapy with CD133+ bone marrow-derived stem cells for refractory Asherman's syndrome and endometrial atrophy: a pilot cohort study.

              Could cell therapy using autologous peripheral blood CD133+ bone marrow-derived stem cells (BMDSCs) offer a safe and efficient therapeutic approach for patients with refractory Asherman's syndrome (AS) and/or endometrial atrophy (EA) and a wish to conceive?
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                Author and article information

                Journal
                Diagnostics (Basel)
                Diagnostics (Basel)
                diagnostics
                Diagnostics
                MDPI
                2075-4418
                17 September 2020
                September 2020
                : 10
                : 9
                : 706
                Affiliations
                [1 ]Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, University Street, No. 16, 700115 Iasi, Romania; bogdandoroftei@ 123456gmail.com (B.D.); dabu_93@ 123456yahoo.com (A.-M.D.); dr.radu.maftei@ 123456gmail.com (R.M.); emil.anton@ 123456yahoo.com (E.A); gabi.ginecologie@ 123456gmail.com (G.S.)
                [2 ]Clinical Hospital of Obstetrics and Gynecology “Cuza Voda”, Cuza Voda Street, No. 34, 700038 Iasi, Romania; matei.theodor1@ 123456gmail.com (T.M.); theodoraarmeanu@ 123456yahoo.com (T.A.)
                [3 ]Origyn Fertility Center, Palace Street, No. 3C, 700032 Iasi, Romania
                [4 ]Department of Research, Faculty of Biology, Alexandru Ioan Cuza University, Carol I Avenue, No. 20A, 700505 Iasi, Romania
                Author notes
                Author information
                https://orcid.org/0000-0002-6618-141X
                https://orcid.org/0000-0002-4023-1765
                https://orcid.org/0000-0002-8244-0522
                Article
                diagnostics-10-00706
                10.3390/diagnostics10090706
                7554703
                32957624
                3401c299-334f-47ec-85e7-2b567babde22
                © 2020 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 16 August 2020
                : 16 September 2020
                Categories
                Review

                asherman syndrome,intrauterine adhesions,intrauterine synechiae,hysteroscopy

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