{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:14:45Z","timestamp":1787015685209,"version":"build-2736575974"},"reference-count":21,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2021,10,21]],"date-time":"2021-10-21T00:00:00Z","timestamp":1634774400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Obstet and Gynaecol"],"published-print":{"date-parts":[[2022,1]]},"abstract":"Abstract<\/jats:title>\n \n Aim<\/jats:title>\n The levonorgestrel\u2010releasing intrauterine (LNG\u2010IUS) system is an effective primary treatment for adenomyosis; however, it has high expulsion rates. We aimed to modify the system\u2014allowing affixion to the myometrium\u2014and evaluate the expulsion rate, effectiveness, and side effects in patients with adenomyosis and heavy menstrual bleeding.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n This study included patients with adenomyosis and heavy menstrual bleeding who underwent implantation of: a modified LNG\u2010IUS (experimental group,\n n<\/jats:italic>\n \u00a0=\u00a047); and the original system after gonadotropin\u2010releasing hormone agonist treatment (control group,\n n<\/jats:italic>\n \u00a0=\u00a047), between January 2014 and April 2016.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n In the experimental group, two device expulsions occurred 12\u201318\u2009months postimplantation. In the remaining 45 patients, the system was safely removed after the 60\u2010month validity period, and no extrauterine device movement or infection occurred. In the control group, downward displacement and expulsion of the device occurred in eight (17%) patients within 60\u2009months. The 5\u2010year total expulsion rates were 4.3% and 17.0% in the experimental and control groups, respectively (\n p<\/jats:italic>\n \u00a0=\u00a00.045). There were significant changes in the pretreatment severity of dysmenorrhea, menstrual volume, uterine volume (cm\n 3<\/jats:sup>\n ), and hemoglobin level in each group compared with after 1\u00a0year (\n p<\/jats:italic>\n \u2009<\u20090.01 in all groups). The severity of dysmenorrhea, menstrual volume, uterine volume, and hemoglobin level after 1\u00a0year were similar between the two groups (\n p<\/jats:italic>\n \u2009>\u20090.05 in all groups).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Use of the modified LNG\u2010IUS is a safe, cost\u2010effective, and simple method for reducing the downward movement and expulsion rate in patients with adenomyosis and heavy menstrual bleeding.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/jog.15031","type":"journal-article","created":{"date-parts":[[2021,10,21]],"date-time":"2021-10-21T12:19:47Z","timestamp":1634818787000},"page":"161-168","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Effect of modified levonorgestrel\u2010releasing intrauterine system in human adenomyosis with heavy menstrual bleeding"],"prefix":"10.1111","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7324-9240","authenticated-orcid":false,"given":"Hong","family":"Yang","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Hainan Provincial People's Hospital Affiliated to Hainan Medical College Haikou City China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shengtan","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Hainan Provincial People's Hospital Affiliated to Hainan Medical College Haikou City China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoyan","family":"Fu","sequence":"additional","affiliation":[{"name":"Department of Ultrasound Hainan Provincial People's Hospital Haikou City China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruihong","family":"Lan","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Hainan Provincial People's Hospital Affiliated to Hainan Medical College Haikou City China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Humin","family":"Gong","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Hainan Provincial People's Hospital Affiliated to Hainan Medical College Haikou City China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,10,21]]},"reference":[{"key":"e_1_2_9_2_1","first-page":"1088","article-title":"Analysis of unplanned taking\u2010out and expulsion of LNG\u2010IUS and related factors during the treatment of symptomatic adenomyosis (in Chinese)","volume":"11","author":"Li L","year":"2016","journal-title":"Chin J Pract Gynecol Obstet"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2014.02.017"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/deh004"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tjog.2014.05.009"},{"key":"e_1_2_9_6_1","first-page":"161","article-title":"Guideline for the diagnosis and treatment of endometriosis","volume":"50","author":"Cooperative Group of Endometriosis, Chinese Society of Obstetrics and Gynecology, Chinese Medical Association","year":"2015","journal-title":"Zhonghua Fu Chan Ke Za Zhi"},{"key":"e_1_2_9_7_1","first-page":"815","article-title":"Chinese expert panel consensus recommendations on the clinical application of levonorgestrel\u2010releasing intrauterine system","volume":"54","author":"Lang JH","year":"2019","journal-title":"Zhonghua Fu Chan Ke Za Zhi"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1159\/000351431"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1990.tb16249.x"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2011.09.002"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/jog.12007"},{"key":"e_1_2_9_12_1","first-page":"1706","article-title":"Fixation of levonorgestrel\u2010releasing intrauterine system prevents its expulsion or malposition (in Chinese)","volume":"37","author":"Yang H","year":"2021","journal-title":"J Pract Med"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.2147\/IJWH.S122579"},{"key":"e_1_2_9_14_1","first-page":"949","article-title":"The clinical observation of the fixed intrauterine sustained\u2010release levonorgestrel in the treatment of adenomyosis major (in Chinese)","volume":"6","author":"Zhang X","year":"2014","journal-title":"Matern Child Health Care of China"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jogoh.2018.06.003"},{"key":"e_1_2_9_16_1","volume-title":"Diagnosis and Management of Endometriosis in New Zealand","author":"Ministry of Health"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/det457"},{"key":"e_1_2_9_18_1","volume-title":"Heavy menstrual bleeding: assessment and management","author":"National Institute for Health and Care Excellence"},{"key":"e_1_2_9_19_1","first-page":"179","article-title":"The progress of levonorgestrel intrauterine birth control system combined with GnRH\u2010a drug in the treatment of adenomyosis (in Chinese)","volume":"26","author":"Zhang JL","year":"2015","journal-title":"Chin J Clin Rational Drug Use"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2014.11.023"},{"key":"e_1_2_9_21_1","first-page":"433","article-title":"Expert consensus on clinical application of immediate placement of stent\u2010less fixed intrauterine device during menstrual period and after induced abortion","volume":"7","author":"Huang LL","year":"2020","journal-title":"Chin J Obstet Gynecol"},{"key":"e_1_2_9_22_1","first-page":"376","article-title":"Chinese medical doctor association branch of obstetricians and gynecologists, endometriosis professional committee. Chinese experts' consensus on diagnosis and treatment of adenomyosis (in Chinese). Chin J","volume":"6","author":"Leng JH","year":"2020","journal-title":"Obstet Gynecol"}],"container-title":["Journal of Obstetrics and Gynaecology Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jog.15031","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jog.15031","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jog.15031","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,28]],"date-time":"2023-08-28T07:25:38Z","timestamp":1693207538000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/jog.15031"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,10,21]]},"references-count":21,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2022,1]]}},"alternative-id":["10.1111\/jog.15031"],"URL":"https:\/\/doi.org\/10.1111\/jog.15031","archive":["Portico"],"relation":{},"ISSN":["1341-8076","1447-0756"],"issn-type":[{"value":"1341-8076","type":"print"},{"value":"1447-0756","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,10,21]]},"assertion":[{"value":"2021-07-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-09-09","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-10-21","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}