title: [Prevention and treatment of intra-uterine synechiae: Review of the literature].
abstract: Intra-uterine adhesions are a major cause of secondary infertility. The prevalence of adhesions is probably underestimated due to the heterogeneity of the symptoms. An exhaustive literature search using search engines MEDLINE, Pubmed, Cochrane library and Web of Science was performed to make a focus on the origins, consequences and methods of prevention of intra-uterine adhesions. Intra-uterine adhesions are likely to occur after any endo-uterine surgery via dysregulated activation of coagulation chain linked to the inflammatory process. Early and late obstetric complications are also recognized as caused by adhesions. The diagnosis is currently performed by hysteroscopy but it remains an invasive procedure even if it can be done with an ambulatory management. Several research approaches inspired by intra-abdominal surgery for the prevention of pelvic adhesions have been developed. However, no current method of prevention has proven its effectiveness in terms of improving spontaneous fertility. The improvement in surgical practices, the design of new intra-uterine medical devices and new research especially in the field of endometrial stem cells can maybe reduce the rate of adhesions end their complications after intra-uterine surgery.
authors.affiliation: Service de gynécologie et obstétrique, CHU Carémeau, place du Pr-R.-Debré, 30029 Nîmes, France; UMR CNRS 5247, faculté de pharmacie, université Montpellier 1, institut des biomolécules Max-Mousseron (IBMM), 15, avenue C.-Flahault, 34093 Montpellier, France. Electronic address: sophie-warembourg@hotmail.fr.
authors.forename: S
authors.initials: S
authors.lastname: Warembourg
authors.affiliation: Service de gynécologie et obstétrique, CHU Carémeau, place du Pr-R.-Debré, 30029 Nîmes, France; UMR CNRS 5247, faculté de pharmacie, université Montpellier 1, institut des biomolécules Max-Mousseron (IBMM), 15, avenue C.-Flahault, 34093 Montpellier, France. Electronic address: stephanie.huberlant@chu-nimes.fr.
authors.forename: S
authors.initials: S
authors.lastname: Huberlant
authors.affiliation: UMR CNRS 5247, faculté de pharmacie, université Montpellier 1, institut des biomolécules Max-Mousseron (IBMM), 15, avenue C.-Flahault, 34093 Montpellier, France. Electronic address: xavier.garric@univ-montp1.fr.
authors.forename: X
authors.initials: X
authors.lastname: Garric
authors.affiliation: UMR CNRS 5247, faculté de pharmacie, université Montpellier 1, institut des biomolécules Max-Mousseron (IBMM), 15, avenue C.-Flahault, 34093 Montpellier, France. Electronic address: salome.leprince@etu.univ-montp1.fr.
authors.forename: S
authors.initials: S
authors.lastname: Leprince
authors.affiliation: Service de gynécologie et obstétrique, CHU Carémeau, place du Pr-R.-Debré, 30029 Nîmes, France. Electronic address: renaud.detayra@chu-nimes.fr.
authors.forename: R
authors.initials: R
authors.lastname: de Tayrac
authors.affiliation: Service de gynécologie et obstétrique, CHU Carémeau, place du Pr-R.-Debré, 30029 Nîmes, France; UMR CNRS 5247, faculté de pharmacie, université Montpellier 1, institut des biomolécules Max-Mousseron (IBMM), 15, avenue C.-Flahault, 34093 Montpellier, France. Electronic address: vincent.letouzey@chu-nimes.fr.
authors.forename: V
authors.initials: V
authors.lastname: Letouzey
mesh_terms: D005260:Female; D006175:Gynatresia / Q000150:complications / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D006801:Humans
keywords: Adhesion prevention; Adhésion intra-utérine; Asherman's syndrome; Fertility; Fertilité; Hysteroscopy; Hystéroscopie; Intra-uterine adhesion; Intra-uterine synechiae; Prévention des adhérences; Syndrome d’Asherman; Synéchie intra-utérine