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Related Concept Videos

In Vitro Fertilization01:24

In Vitro Fertilization

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In vitro fertilization (IVF) is a form of assisted reproductive technology where an egg is fertilized with sperm in a controlled laboratory environment before transferring the resulting embryo into the uterus. This process is designed to help individuals and couples experiencing difficulties conceiving.
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Progressively optimized fixation method for levonorgestrel-releasing intrauterine device.

Xiao-Wan Huang1, Xiao-Bo Zeng1, Xi-Shao Luo1

  • 1Department of Gynecology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China.

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|November 30, 2025
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Summary
This summary is machine-generated.

This study introduces an improved hysteroscopic method to secure levonorgestrel-releasing intrauterine devices (LNG-IUDs) in adenomyosis patients, significantly reducing expulsion rates. The technique is simple, fast, and highly effective for long-term contraception.

Keywords:
LNG-IUDadenomyosisfixationhysteroscopy

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Area of Science:

  • Gynecology
  • Minimally Invasive Surgery
  • Reproductive Medicine

Background:

  • High expulsion rates of levonorgestrel-releasing intrauterine devices (LNG-IUDs) are a clinical challenge in adenomyosis patients.
  • Existing fixation methods may lack efficacy or feasibility in this specific patient group.

Purpose of the Study:

  • To present an optimized, hysteroscopic sutureless fixation technique for LNG-IUDs in adenomyosis patients.
  • To address and reduce the high expulsion rates associated with LNG-IUD use in this population.
  • To enhance the clinical feasibility and simplicity of LNG-IUD fixation.

Main Methods:

  • A case series methodology was employed, featuring a detailed technical surgical video of the optimized hysteroscopic sutureless fixation.
  • The technique involves a three-step knot-forming process designed for stability and ease of removal/reinsertion.
  • Procedures were performed using an integrated continuous flow hysteroscope by a single operator.

Main Results:

  • The optimized fixation procedure was successfully completed in an average of 5 minutes.
  • A low expulsion rate of 1.4% (3/212 patients) was observed over a 2-year period.
  • The technique demonstrated high efficacy, with no expulsions in patients with a history of prior expulsion and a low rate in those with uterine depth ≥9 cm.

Conclusions:

  • The optimized hysteroscopic fixation method is highly effective in minimizing LNG-IUD expulsion rates in adenomyosis patients.
  • The technique offers significant advantages, including simplicity, ease of learning, minimal instrument requirements, and broad applicability.
  • This method represents a significant advancement in improving LNG-IUD clinical feasibility and patient outcomes.