Autologous platelet concentrate (APC) is a platelet concentrate obtained by centrifugation of human or animal blood, mainly includes first-generation platelet concentrate platelet-rich plasma (PRP) and second-generation platelet concentrate platelet-rich fibrin (PRF), which is widely applied in varies fields such as dental implants, bone defect repairing and burn plastic surgery because of its role in wound healing and tissue repair. In recent years, autologous platelet concentrate has been applied to improve ovarian function, promote the repair of endometrial hyperplasia, treat cervical and vulvo-related lesions, and has achieved significant efficacy. However, there is a lack of effective integration of PRP and PRF research results in the field of gynecology. This paper systematically and comprehensively review the preparation, biological properties and applications in various gynecological diseases, in order to provide clinicians with new treatment ideas for gynecological diseases and reference for the further application of APC.

utologous platelet concentrate（APC）is a platelet concentrate obtained by centrifugation of human or animal blood, mainly includes first-generation platelet concentrate platelet-rich plasma（PRP）and second#2; generation platelet concentrate platelet-rich fibrin（PRF）, which is widely applied in varies fields such as dental implants, bone defect repairing and burn plastic surgery because of its role in wound healing and tissue repair. In recent years, autologous platelet concentrate has been applied to improve ovarian function, promote the repair of endometrial hyperplasia, treat cervical and vulvo-related lesions, and has achieved significant efficacy. However,there is a lack of effective integration of PRP and PRF research results in the field of gynecology. This paper systematically and comprehensively review the preparation, biological properties and applications in various gynecological diseases, in order to provide clinicians with new treatment ideas for gynecological diseases and reference for the further application of APC.

PurposeIntrauterine adhesion (IUA) is the most common cause of uterine infertility. This study aims to evaluate whether platelet-rich fibrin (PRF) treatment can stimulate damaged endometrium regeneration in rats.MethodsFirst, hematoxylin and eosin (HE) staining, scanning and transmission electron microscopy, and ELISAs were used to evaluate the microstructure of PRF. Then, mechanical damage was used to establish an IUA rat model. A total of 40 SD female rats were randomized to three groups: PRF transplantation group, IUA group, and sham group. Rats were sacrificed at 3, 7, and 14 days and uteruses were obtained for further analysis. Finally, functional and histological recovery of the damaged endometrium was analyzed by pregnancy test, HE staining, Masson’s staining, and immunohistochemistry.ResultsPRF has two distinct zones, platelets and fibrin zone. Long and narrow fibrin fibers interconnected with each other and formed a three-dimensional, flexible, and elastic structure; platelet aggregates were trapped in fibrin fibers, and each platelet is associated with several fibrin fibers. PRF exudates promoted endometrial stromal cell proliferation and migration in vitro. PRF transplantation was beneficial for maintaining uterine structure, promoting endometrial luminal epithelium and endometrial gland regeneration, and decreasing fibrotic areas in vivo.ConclusionIntrauterine administration of PRF was demonstrated to be effective in preventing IUA and stimulating damaged endometrium regeneration in rats. This study not only provided a promising method for its potential in endometrial regeneration in women who suffer from uterine infertility but also may prevent IUA after intrauterine surgery in clinical cases.

OBJECTIVES Thin endometrium is a common problem encountered in the field of assisted reproductive technology. We explored the effects of platelet-rich fibrin in a thin endometrium rat model. MATERIALS AND METHODS Twenty Sprague-Dawley rats were randomly divided into 2 groups. For the thin endometrium group, endometria of left uteri were injected with ethanol. For the experimental group, platelet-rich fibrin was sutured onto the left uteri of endometria injected with ethanol. Right uteri were kept as the normal (control) group. Two weeks after platelet-rich fibrin transplant, uteri were sampled for histology, immunohistochemistry, Western blot, and real-time reverse transcription-polymerase chain reaction. RESULTS Endometrium thicknesses in normal, thin endometrium, and experimental groups were 632.2 ± 38.28, 434.80 ± 41.37, and 603.0 ± 40.93 μm, respectively. Endometrium thickness in the experi-mental group was significantly increased versus the thin endometrium group (P = .011). Immunohistochemical examination showed that expression levels of cytokeratin 18, vimentin, and leukemia inhibitory factor in the experimental group were significantly higher versus the thin endometrium group (P < .001, P < .006, and P = .001, respectively). In Western blot analysis, cytokeratin 18, integrin β3, leukemia inhibitory factor, and vimentin protein expressions were slightly higher in the experimental and normal groups versus the thin endometrium group. Real-time reverse transcription-polymerase chain reaction showed significantly higher octamer-binding transcription factor 4 mRNA levels in the experimental group versus the thin endometrium group (P < .001). Interleukin 6 and matrix metalloproteinase 9 mRNA levels were significantly upregulated in the experimental group versus the thin endometrium group (P= .004 and P < .001, respectively). Interleukin 1β mRNA expression was significantly lower in the experimental group versus the thin endometrium group (P < .007). CONCLUSIONS Application of platelet-rich fibrin has a therapeutic effect on thin endometrium in rats. Our results provide new insight on clinical treatment of thin endometrium.

目的 探讨翻转课堂与传统教学法对妇产科住院医师岗位胜任力的影响效果对比.方法 选取在妇产科进行住院医师规范化培训的50名学员作为研究对象,采用1:1随机对照的方法,将学员分配A、B两组,每组25人.A组前3个月先接受翻转课堂教学模式的培养,后3个月接受传统教学模式;B组前3个月接受传统教学模式,后3个月接受翻转课堂教学模式的培养.分别在研究开始时、3个月、6个月对学员进行以临床胜任力为基础的教学效果评价.结果 两组在接受翻转课堂教学模式期间,其临床胜任力评估结果明显优于于同期接受传统教学模式的学员,差异具有统计学意义(P<0.05).结论 相较于传统教学法,翻转课堂教学应用在妇产科住院医师培养中,可以显著提升学员的临床胜任力.

Aim To evaluate the efficacy and safety of autologous platelet-rich fibrin (PRF) for the treatment of infertility with intrauterine adhesions. Methods Forty patients who suffered from infertility with intrauterine adhesions (IUAs) were enrolled in this prospective trial from October 2018 to December 2019. They were randomly divided into a PRF group and a control group. Both groups underwent transcervical resection of adhesions (TCRA) during the follicular phase. PRF group: PRF prepared from autologous venous blood was placed in the uterine cavity after TCRA and after the first menstrual re-fluid; control group: no PRF insertion. After the second menstrual re-fluid, both groups underwent hysteroscopy to reevaluate adhesion severity. Pregnancy rate, intrauterine adhesion score, menstrual volume and duration, and endometrial thickness were assessed and adverse events were recorded. Results (1) PRF group pregnancy rate was significantly higher than the control group (55.0% vs. 20.0%). Mean follow-up time was (17.63 +/- 2.33) months. All patients fell pregnant naturally. Four (PRF) and one (control) patients delivered live births without placental complications. (2) Intrauterine adhesion scores decreased compared with treatment-before. (3) In the pictorial blood loss assessment chart, score and menstrual duration during the 3rd menstrual cycle showed significant improvements for both groups. (4) Endometrial thickness also showed an increasing trend, and subendometrial bloodflow improved. (5) No treatment-related serious adverse events were noted. Conclusion Placing PRF into the uterine cavity of infertility patients with IUAs following TCRA is a safe and effective therapeutic method.

Abstract Menstruation is an important indicator of women's health. Identification of abnormal menstrual patterns in adolescence may improve early diagnosis of potential health concerns in adulthood. This study aimed to evaluate menstrual patterns and disorders of Chinese women of reproductive age based on an APP. From December 2015 to January 2016, a cross-sectional study was conducted. We utilized a mobile application (APP) to collect information about participants’ age at menarche, length of menstruation, duration of menstruation, amount of menstrual flow, regularity of menstrual cycle, prevalence of abnormal uterine bleeding and dysmenorrhoea. A total of 156,055 women (25,716 from the questionnaire survey and 130,000 from the mobile APP users) participated in the study. The average age of the subjects was 26.32 ± 6.97 years (median age, 25 years). Mean age at menarche was 13.08 ± 1.87 years; average length of menstrual cycle, 30.9 ± 4.28 days (median 30 days); and average duration of menstruation, 5.01 ± 1.13 days (median 5 days). Women with irregular menstrual cycles accounted for 36.41%. Women aged < 18 years and > 30 years were more likely to experience irregular menstrual cycles. The prevalence of secondary amenorrhoea was 4.07%. More than 20% of women reported abnormal menstrual flow. About 20.11% of women had abnormal uterine bleeding, and 77.65% had dysmenorrhoea. A hot compress was the most commonly used approach to ameliorate dysmenorrhoea. Women with low education and low income and those with high education and high income tended to have menstrual problems. A mobile APP as a survey tool has the advantages of large sample size, low cost, and high efficiency. The use of a mobile APP is an emerging approach for collecting big data in the field of health research. The results showed that the prevalence of menstrual disorders among Chinese reproductive women was high. Healthcare providers should educate girls and their caregivers about menstrual physiology, normal menstrual pattern, and reproductive health to prevent long-term diseases.

Objective To evaluate the efficacy of autologous platelet-rich fibrin (PRF) in the treatment of infertility due to intrauterine adhesion. Methods From October 2018 to October 2019, 40 patients diagnosed as intrauterine adhesion and excluded other infertility factors in Beijing Shijitan Hospital were randomly divided into PRF group and control group, with 20 cases in each group. The intervention lasted for 8 weeks. Patients in both groups underwent transcervical resection of adhesion (TCRA), and PRF was placed in the uterine cavity immediately after TCRA and 4 weeks later in the PRF group. After 8 weeks of TCRA, a second hysteroscopy was performed, and then follow-up was performed. Pregnancy rate, intrauterine adhesions score, menstruation, and endometrial thickness (EMT) were compared between two groups. Results The pregnancy rate of the PRF group was 70.00%, which was significantly higher than 20.00% of the control group (P 0.05). Conclusion The placement of PRF combined with the TCRA can improve the pregnancy rate of infertility due to intrauterine adhesion, reduce intrauterine adhesion scores, and improve clinical symptom.

Objective:To evaluate the effect of WeChat platform in the diagnosis and treatment of menopausal-related diseases for gynecologists.Methods:In March 2017, 47 gynecologists who voluntarily participated in the offline continuing medical education project "Diagnosis and Treatment training of menopause-related diseases" in Beijing Shijitan Hospital Affiliated to Capital Medical University were selected as the control group (traditional teaching mode), and 52 gynecologists who volunteered to participate in WeChat platform training were selected as the experimental group (WeChat teaching mode). The main outcome measure was the knowledge level of menopause-related diseases and curriculum satisfaction before and after training. SPSS was used to perform t-test or chi-square test for inter-group data. Results:All gynecologists completed the study, the recovery rate of the evaluation questionnaire before and after training was 100%. Before training, the average score of menopause-related disease knowledge and the test passing rate of knowledge examination in experimental group were (63.65±21.42) and 65.4%, while those in the control group were (60.85±24.83) and 63.8%, respectively. No significant difference was found ( P>0.05). After training, the knowledge level of menopause-related diseases and the test passing rate significantly improved in both groups ( P<0.05). The average score of students and the passing rate in the experimental group were (77.50±16.19) and 90.1%, which were better than those in the control group [(78.72±16.89), 87.2%]. However, there was no significant difference between the two groups ( P>0.05). Besides, the experimental group was more satisfied, but the difference was not statistically significant compared with control group ( P>0.05). Conclusion:WeChat platform training for gynecologists not only has the same effects as the traditional teaching model on menopausal disease diagnosis and treatment training, but also gains higher training satisfaction, suggesting WeChat platform training can be further applied to other subdisciplines.

Objective To investigate the preconception status and influencing factors of women of childbearing age in China, and provide a scientific basis for regulating pre-pregnancy health services. Methods Using a cross-sectional study method, a self-designed questionnaire was used to investigate women of childbearing age who used an app to manage menstruation from November to December 2015, collecting basic information and pregnancy-related information. Results A total of 15,434 women of childbearing age participated in the survey, with an average age of (26.32 ± 6.97) years. The knowledge of pregnancy was mainly derived from acquaintances or parental experiences, online or professional media. There was a statistically significant difference between the menstrual regularity women and the irregular women in the length of preconception and whether or not to consider assisted reproduction (P<0.05). Compared with women without dysmenorrhea, dysmenorrhea women had statistical significance in the source of pregnancy knowledge, choice of pregnancy services, length of preconception, and whether or not to consider assisted reproductive differences (P<0.05). Conclusion Women of childbearing age have limited sources of pre-pregnancy health knowledge. The government should give corresponding policy guidance, expand the influence of pre-pregnancy health services, pay attention to the diversity of pre-pregnancy health care services, smooth access to pre - pregnancy health services, regulate pre - pregnancy health services, and promote reproduction health.

Objective To evaluate the effect of WeChat learning platform combined with problem-based learning ( PBL) teaching model in refresher physician training of gynecology. Methods A total of 63 refresher doctors who studied in Obstetrics and Gynecology Department of Beijing Shijitan Hospital were selected as observation group ( PBL+ WeChat group, n= 30) or control group ( PBL group, n= 33) randomly. Knowledge of abnormal uterine bleeding ( AUB) and job competency score were used to evaluate the training effect. Results Compared with pre-training and post-training, the competency of PBL+WeChat group in clinical basic ability [ 5( 4,5) vs 2( 1,3) ] , medical professional quality and spirit [ 5( 4,5) vs 4( 3,4) ] , basic public health service ability [4(4,5) vs 3(2,4)] was significantly improved, with statistical significance (all P<0. 05). AUB average knowledge points of PBL+ WeChat group were 76. 00±19. 41 which were significantly higher than 61. 52 ± 22. 10 of PBL group ( t=2. 753, P=0. 008) . Conclusions WeChat learning platform combined with PBL teaching model can help to improve clinician's clinical skills and job competency.

Background Intrauterine adhesion (IUA) is characterized by progressive intrauterine fibrosis as a consequence of trauma to the basal layer of the endometrium. In an attempt to relieve IUA, many approaches have been applied in the clinic but show limited effects. In this study, we investigated the effect of autologous oral mucosal epithelial cells (OMECs) seeded on decellularized and lyophilized amniotic membrane (DL-AM) on preventing the development of IUA in a rat model. Methods IUA model was established by surgical scraping of the endometrium in the left uteri (the right uteri were kept as control) of SD rats. Wounds were randomly treated as unrepaired (IUA group), repaired with DL-AM alone (DL-AM group), and DL-AM seeded with autologous OMECs (DL-AM+OMECs group), respectively, in a total of 54 rats ( n = 18 each). Uterus samples were harvested for histological and immunohistochemical evaluation after 3, 7, 14, and 28 days ( n = 3 in each time point) of operations. Results After surgery, the uterine cavity was observed to be filled with extensive fibrosis in the IUA and DL-AM groups, respectively, while a lower ratio of the fibrotic area was identified in the DL-AM transplantation group. Transplantation of OMECs seeded on DL-AM significantly reduced fibrosis of IUA with recovered uterine cavity and regenerated epithelium and endometrial glands as determined by CK-18 immunostaining. OMECs transplantation resulted in extensive cellular proliferation as revealed by the Ki-67 immunofluorescent staining exhibited. Meanwhile, microvessel density was significantly increased in uteri that received OMECs transplantation, which was concomitant with elevated expression of vascular endothelial growth factor. The pregnancy test ( n = 6 in each group) showed successful conception in the OMEC-transplanted uteri, but not in the IUA and DL-AM groups. Conclusions Engineered epithelium developed from DL-AM seeded with OMECs showed great potential in preventing progression of intrauterine adhesion by improved endometrial epithelium regeneration.

目的 宫腔粘连是一种严重损害女性生殖健康的疾病.为了进一步研究宫腔粘连的发生机制,采用经典的子宫内膜刮除法制作宫腔粘连大鼠模型,并对该模型进行评价和改进.方法 60只SD大鼠随机分为3组:假手术组、子宫内膜刮除组和子宫内膜及部分间质刮除组,每组20只.假手术组打开宫腔后即缝合并关腹.子宫内膜刮除组用刀片刮除双侧子宫内膜.子宫内膜及部分间质刮除组用刀片刮除双侧子宫内膜和间质层,直至表面有粗糙感为止.术后3、7、14、21、28 d取材,行组织学和免疫组织化学评估.结果 刮宫后两组大鼠子宫内膜上皮层消失,子宫内膜刮除组大鼠术后7d可发现重新长出的子宫内膜.而子宫内膜和部分间质刮除组大鼠各时间点组织学染色见上皮层消失,间质减少50％以上,腺体数目减少,子宫内膜纤维化面积比随着刮宫时间延长而增高.刮宫后转化生长因子β1的表达增高,基质金属蛋白酶9的表达降低.与宫腔粘连发生的机制相符.结论 刮除子宫内膜和部分间质能够制备出大鼠宫腔粘连的模型;该宫腔粘连大鼠模型能反映宫腔粘连的组织学和病理学变化,可用于宫腔粘连的实验研究.

目的 观察健康教育联合性激素补充治疗对功能性下丘脑性闭经(FHA)的效果.方法 选择2016年1月～2017年8月北京世纪坛医院和北京航天总医院妇科门诊收治的130例FHA患者,其中70例有明确的减肥史、36例为精神刺激、24例为运动过度.排除性激素使用禁忌证后,针对病因进行健康教育的同时,均给予患者芬吗通(2/10)治疗,28 d为1个疗程,均服药6个疗程.用药前及用药6个月后,检测性激素五项[卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E2)、睾酮(T)、垂体泌乳素(PRL)],测量子宫大小及内膜厚度.随访6～12个月,观察月经周期恢复情况.结果 130例患者中,99例患者月经恢复,总有效率为76.2％.用药前患者FSH、LH、E2均下降,LH下降更明显,用药6个月后检测FSH、LH、E2水平均有不同程度的升高(P＜0.01),T、PRL水平变化不大(P＞0.05).与用药前比较,用药6个月后子宫体积增大、内膜增厚,差异有高度统计学意义(P＜0.01).结论 健康教育同时给予性激素补充治疗可明显改善FHA患者的性激素水平、增大子宫体积及增厚内膜,尽快恢复月经.同时防止骨质疏松和生殖器官萎缩引发的一系列问题,改善雌激素低下引发的各种症状.

更年期多学科综合管理门诊是以妇科专业特色为基础的多学科团队式协作门诊,采用三步诊疗法高效诊治更年期,团体治疗结合个体化指导为中年女性提供多学科、多层次、全面的保健措施及全方位的生命周期管理.

<span id="ChDivSummary" name="ChDivSummary" class="abstract-text">目的依托应用程序调查中国育龄女性经前期综合征,为进一步做好女性经期及经前期保健提供理论依据。方法于2015年1—12月在"大姨吗"应用程序首页发放调查问卷,共对24670人进行一般情况及经前期综合征相关症状调查。结果随着年龄增加,经前期和经期便秘、痤疮、发热、腹泻、乳房胀痛、身体酸痛、食欲不佳、头痛、小腹坠胀、眩晕症状的发生率逐渐降低（均P&lt;0.01）;轻体重女性经前期和经期痤疮、发热、腹泻、乳房胀痛、身体酸痛、食欲不佳、头痛、眩晕的发生率高于其他体重组（P&lt;0.05）。有性生活的女性痤疮发生率（11.95%）低于无性生活者（12.95%）（P&lt;0.05）,而乳房胀痛（15.37%）、身体酸痛（17.83%）、眩晕（12.60%）的发生率均高于无性生活者的12.26%、16.48%、11.44%（均P&lt;0.05）。已生育女性痤疮（10.17%）、发热（5.79%）、腹泻（7.57%）、身体酸痛（16.83%）、食欲不佳（13.52%）、小腹坠胀（14.97%）的发生率均低于未生育女性的13.30%、8.15%、10.70%、18.12%、14.72%、19.16%（均P&lt;0.05）。有痛经女性经前期和经期便秘（11.45%）、痤疮（13.18%）、发热（8.25%）、腹泻（10.96%）、乳房胀痛（15.89%）、身体酸痛（19.08%）、食欲不佳（15.95%）、头痛（14.77%）、小腹坠胀（19.85%）、眩晕（13.39%）症状发生率均明显高于无痛经女性的7.94%、9.02 0%、5.27%、6.59%、10.63 0%、12.51%、10.47%、10.03%、12.17%、8.94%（均P&lt;0.01）。结论女性经期和经前期症状与年龄、体质指数、性生活、生育、月经是否规律、痛经等因素有关。</span>

目的:依托“大姨吗”应用程序调查中国育龄女性性骚扰的情况以及对性骚扰的态度,为性健康教育提供理论依据.方法:在“大姨吗”应用程序首页发放调查问卷,问卷主要内容包括:一般情况(年龄、情感状况、收入、学历等)和性骚扰情况(近一年是否遭遇过性骚扰、在哪些方面遭遇过性骚扰、是否担心性骚扰).发放时间为2015年1月至2015年12月.共有28021名女性参与调查,其中有效问卷27854份.结果:年轻、非单身、学历较低、收入较高的女性更容易遭遇性骚扰;而年龄较大、收入较高、学历较高的女性,对于性骚扰的警惕性较低.结论:女性遭遇性骚扰与年龄、情感状况、收入、学历有关.

Objective To evaluate the gynecologist's diagnostic ability and competence on gynecological endocrine disease and to provide some scientific evidence for cultivating doctors for gynecological endocrinology and standardized diagnosis and treatment of gynecological endocrine disease.Methods From January 2013 to July 2017,115 gynecologists from 94 hospitals were investigated, including the diagnosis and treatment of gynecological endocrine diseases and Chinese clinicians'competency.Results The pass rate of gynecologists on gynecological endocrine diseases was 55.65%,and judgment of hormone report(44.35%),treatment of abnormal uterine bleeding-ovulation dysfunction(22.09%),treatment of abnormal uterine bleeding-endometrial lesions(17.39%) and treatment of corpus luteum insufficiency(23.48%)were poorly understood.The competence score of medical professional spirit and quality(3.85 ± 0.68)and team work ability(3.98 ± 0.73)were higher,while that of information and management capacity(3.31 ± 0.68)and academic research ability(3.13 ± 0.67)were lower.Conclusion The diagnostic level of gynecologists on gynecological endocrine diseases is not optimistic.We should establish competency-oriented gynecological endocrine training system to improve gynecological treatment of gynecological endocrine diseases and standardize treatment.

The PALM-COEIN classification for causes of abnormal uterine bleeding (AUB) was proposed by the International Federation of Gynecology and Obstetrics (FIGO) in 2011, which has been gradually applied in the diagnosis of AUB in the past 2 years in China. However, there are no reports yet on the causes of chronic AUB among Chinese women with this new classification system.The purpose of this study was to describe the prevalence of the causes of chronic AUB among Chinese women of reproductive age using the PALM-COIEN classification system.This is a cross-sectional study. Beijing Shijitan Hospital, Capital Medical University.A total of 1053 women aged 15 to 55 years with chronic AUB were evaluated between November 2016 and May 2017.Prevalence of the causes of chronic AUB using the PALM-COEIN classification. AUB-O was the most frequent finding in women with chronic AUB, accounting for 608 (57.7%) cases. AUB-P was found in 171 (16.2%) women, AUB-L in 130 (12%) women, AUB-A in 52 (4.94%) women, AUB-E in 28 (2%) women, AUB-I in 23 (2%) women, AUB-M in 20 (1.9%) women, AUB-C in 10 (1%) women, and AUB-N in 10 (0.9%) women.Ovulatory dysfunction (AUB-O) is the most common cause of AUB among the nonstructural causes. Endometrial polyps (AUB-P) are the most common among the structural causes, followed by uterine fibroids (AUB-L) and uterine adenomyosis (AUB-A).

OBJECTIVES Intrauterine adhesion is a disease involving endometrial fibrosis that arises from injury to the basal layer of the endometrium. Here, we aimed to explore the preventive effects of decellularized and lyophilized amniotic membrane on endometrial fibrosis in a rat model of intrauterine adhesion. MATERIALS AND METHODS Twenty-four Sprague-Dawley rats were randomly divided into 2 groups. For the intrauterine adhesion group, endometria of left uteri were scraped without treatment. For the intrauterine adhesion plus decellularized and lyophilized amniotic membrane transplant group, decellularized and lyophilized amniotic membrane was sutured onto the scraped wound of left uteri. Right uteri were kept as the control group. At 3, 7, 14, and 28 days after transplant, uteri were sampled for histologic and immunohistochemical evaluation. RESULTS Histology examination revealed extensive fibrosis with significantly reduced numbers of endometrial glands in uteri in the intrauterine adhesion group. Immunohistochemical staining showed a remarked increase in expression of transforming growth factor β1 (P < .01) and decreased expression of matrix metalloproteinase-9 (P < .01) in the intrauterine adhesion group. In rats with transplant of decellularized and lyophilized amniotic membrane, endometrial fibrosis apparently improved (P < .05) with reduced expression of transforming growth factor β1 and increased matrix metalloproteinase-9 expression (P < .05). However, there were no significant differences in the number of endometrial glands or endometrial thickness between the 2 groups (P > .05). CONCLUSIONS Development of intrauterine adhesion was prevented with transplant of decellularized and lyophilized amniotic membrane via suppression of transforming growth factor β1 and increased production of matrix metalloproteinase-9 in a rat model.