The aim of this systematic review and meta-analysis was to assess the effect of oestrogen therapy as a preoperative intervention for improving clinical outcomes and fertility outcomes in women with intrauterine adhesions (IUA). A systematic search of PubMed, Embase, The Cochrane Library, clinicaltrials.gov, OVID and Chinese databases was carried out to identify relevant studies published before December 2019. Outcomes were expressed as odds ratios and 95% confidence intervals. Five cohort studies with moderate to high methodological quality were included in the meta-analysis. Preoperative oestrogen therapy was strongly associated with better clinical outcome at second-look hysteroscopy (OR 2.72; 95% CI 1.49 to 4.96; P = 0.001); whereas no significant difference was found in menstruation improvement and conception rate (OR 1.45; 95% CI, 0.95 to 2.23; P = 0.09; and OR 0.96; 95% CI 0.60 to 1.54; P = 0.87, respectively). The overall quality of the evidence ranged from moderate to very low. Preoperative oestrogen therapy may improve the short-term prognosis of IUA at second-look hysteroscopy, whereas the long-term prognosis-fertility outcome was similar to the control group. More strictly designed research studies are needed to assess the effectiveness of oestrogen administration before hysteroscopic adhesiolysis.

本系统评价和荟萃分析的目的是评估雌激素疗法作为术前干预措施对改善宫腔粘连 (IUA) 女性临床结局和生育结局的效果。对PubMed、Embase、Cochrane 图书馆、clinicaltrials.gov、OVID和中文数据库进行系统搜索，以确定 2019 年 12 月之前发表的相关研究。结果表示为优势比和 95% 置信区间。荟萃分析包括了五项具有中等至高方法学质量的队列研究。术前雌激素治疗与第二次宫腔镜检查中更好的临床结果密切相关（OR 2.72；95% CI 1.49 至 4.96；P = 0.001); 而在月经改善和受孕率方面没有发现显着差异（OR 1.45；95% CI，0.95 至 2.23；P  = 0.09；和 OR 0.96；95% CI，0.60 至 1.54；P  = 0.87，分别）。证据的总体质量从中等到非常低不等。术前雌激素治疗可能会改善宫腔镜下 IUA 的短期预后，而长期预后 - 生育结果与对照组相似。需要更严格设计的研究来评估宫腔镜粘连松解术前雌激素给药的有效性。