{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T15:08:53Z","timestamp":1784300933196,"version":"3.55.0"},"reference-count":21,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T00:00:00Z","timestamp":1771459200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T00:00:00Z","timestamp":1771459200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To compare the effects of the levonorgestrel\u2010releasing intrauterine system (LNG\u2010IUS) and dienogest (DNG) on systemic inflammatory markers and anemia parameters in patients with adenomyosis after 6\u2009months of treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This retrospective longitudinal observational cohort study included 162 women diagnosed with adenomyosis at \u0130zmir Buca Seyfi Demirsoy Training and Research Hospital between 2020 and 2025. A total of 89 patients received LNG\u2010IUS (Mirena), and 73 were treated with DNG 2\u2009mg\/day. Hemoglobin (Hb), neutrophil, lymphocyte, and platelet counts were obtained before treatment (baseline) and at 6\u2009months to calculate the neutrophil\u2010to\u2010lymphocyte ratio (NLR), platelet\u2010to\u2010lymphocyte ratio (PLR), and systemic immune\u2010inflammation index (SII). Statistical analyses were performed using SPSS 27.0, with\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.05 considered significant.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Baseline demographic and obstetric characteristics were similar between the groups (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&gt;\u20090.05). At 6\u2009months, hemoglobin levels increased significantly more in the LNG\u2010IUS group compared with the DNG group (2.29\u2009\u00b1\u20093.61 vs. 0.84\u2009\u00b1\u20094.82;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.035). No significant differences were observed between groups in neutrophil, lymphocyte, platelet counts, or inflammatory indices (NLR, PLR, SII) before and after treatment (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&gt;\u20090.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Both LNG\u2010IUS and DNG are safe and effective medical options for adenomyosis management. LNG\u2010IUS provided superior improvement in hemoglobin levels and bleeding control, while neither treatment significantly altered systemic inflammatory indices. These findings suggest that inflammation in adenomyosis is largely confined to the local uterine environment and that hematologic markers such as NLR, PLR, and SII may have limited sensitivity in reflecting short\u2010term therapeutic response.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ijgo.70903","type":"journal-article","created":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T04:12:27Z","timestamp":1771560747000},"page":"817-823","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparison of the effects of levonorgestrel\u2010releasing intrauterine system and dienogest treatment on systemic inflammatory markers (\n                    <scp>NLR<\/scp>\n                    ,\n                    <scp>PLR<\/scp>\n                    ,\n                    <scp>SII<\/scp>\n                    ) and anemia parameters in patients with adenomyosis at 6\u2009months"],"prefix":"10.1002","volume":"174","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3344-2935","authenticated-orcid":false,"given":"Mehmet Emre","family":"Peker","sequence":"first","affiliation":[{"name":"Manisa Merkezefendi State Hospital  Manisa Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4751-5944","authenticated-orcid":false,"given":"Duygu U\u00e7ar","family":"Kartal","sequence":"additional","affiliation":[{"name":"Manisa Merkezefendi State Hospital  Manisa Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2109-1373","authenticated-orcid":false,"given":"Ufuk","family":"Atl\u0131han","sequence":"additional","affiliation":[{"name":"Manisa Merkezefendi State Hospital  Manisa Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0841-0480","authenticated-orcid":false,"given":"Can","family":"Ata","sequence":"additional","affiliation":[{"name":"\u0130zmir Buca Seyfi Demirsoy Training and Research Hospital  Izmir Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9021-5125","authenticated-orcid":false,"given":"Haydar","family":"Kaya","sequence":"additional","affiliation":[{"name":"Manisa Merkezefendi State Hospital  Manisa Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,2,19]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/humupd\/4.4.312"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpobgyn.2006.01.016"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.12688\/f1000research.17242.1"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.26436"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1080\/09513590.2016.1197200"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12958-025-01349-4"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/deg179"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.3109\/09513590.2014.926882"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1159\/000529185"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.5301\/je.5000261"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1155\/2024\/9977750"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000026691"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.13798"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2024.03.012"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2017.07.017"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1177\/1933719117732312"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s43032-020-00238-4"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/jog.15302"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jri.2021.103338"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12905-022-01647-2"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2023.1172456"}],"container-title":["International Journal of Gynecology &amp; 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