Title: Short-term reproductive outcomes Analysis and Prediction of the Modified Uterine Stent
Treatment for Mild to Moderate Intrauterine Adhesions: experience at a single institution
Version: 3 Date: 10 Dec 2023
Reviewer:  Angelo B. Hooker
Reviewer's report:
Reviewer statement:
Short-term reproductive outcomes Analysis and Prediction of the Modified Uterine Stent
Treatment for Mild to Moderate Intrauterine Adhesions: experience at a single institution.
Prevention, treatment and management of intrauterine adhesions still remains a challenge. IUAs
are  considered one of the main reproductive system diseases affecting women’s wellbeing.
There is lack of evidence based, efficient and effective treatment strategies while intrauterine
adhesions can have serious implications on women health and fertility. Hysteroscopic
adhesiolysis is considered the standard treatment method in women with intrauterine adhesions
but there is no consensus which surgical method is preferable. Although, little is reported in
the literature on pregnancy and obstetric outcomes following adhesiolysis. The authors report
the results of a retrospective cohort study evaluating the efficacy of modified uterine stent in
the treatment of mild-to-moderate intrauterine adhesions and explore the relative indicators
affecting prognosis prediction which is interesting and clinical relevant. This study can add
valuable information on the knowledge on the treatment and pregnancy outcomes and could
guide further knowledge treatment and research on this topic.
Title: The title reflects the subjects being investigated and the type of study conducted which
is excellent.
Overall: The paper is written in clear and concise English. It was a pleasant to read this interesting
article.
Abstract : see overall remarks and remarks throughout the article
Introduction:
The introduction section is attractive to read form a reader point of view, explaining the
background and reason for conducting this study.
No comments on this section.
Materials and methods:
This section is well written and was easy to read explain how the study was conducted, which
is excellent.
No comments on this section.
Results
This section is well written and was easy to read. The result are presented in a way making the
interpretation of the result easy for the reader. The authors should be complimented for doing
this.
Discussion
This section is well written and was easy to read. The discussion section is well written and
discussed the reported results appropriately. There are some minor points needing attention.
1. The sentence in line 131-132 should be rephrased. Please do so.
2. The authors report in line 144-145 on page 7 the following: “  It showed that endometrial
thickness and volume might reflect the uterine cavity environment ready for pregnancy,
especially the endometrial thickness after 3-months surgery.” When looking at table 3-1, the
following result are presented: Endometrial thickness after 3-months surgery (mm) pregnant
group 8.00(7.00,9.00) versus non-pregnant group 8.00(5.50,9.00), p = 0.5352b. Implying that
endometrial thickness does not reflect the pregnancy chances. Please reply.
3. The authors report in line 146-147 on page 7 the following: “  This result suggests that we may
attempt to use ultrasonography as a non-invasive method to follow up IUAs after surgery, or even
as an alternative to repeated hysteroscopy.”  The authors sis not report the differences between
ultrasound and hysteroscopy, making it impossible for the reader to check this statement, Was
there discrepancies between endometrial thickness and hysteroscopic features?
Tables and Figure
No comments.