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Factors affecting reproductive outcome of hysteroscopic adhesiolysis for Asherman's syndrome
Dan Yu1, Tin-Chiu Li, Enlan Xia
1Hysteroscopic Center, Fuxing Hospital Affiliate of Capital University of Medical Sciences, Beijing, China. yudanny2006@yahoo.com.cn
Objective:
To evaluate the outcome of hysteroscopic adhesiolysis in women with Asherman's syndrome.
Design:
Retrospective clinical study.
Setting:
Hysteroscopic center of Fuxing Hospital in Beijing, China.
Patient(S):
Patients with Asherman's syndrome who presented with a history of infertility or recurrent pregnancy loss were included in the study.
Intervention(S):
The adhesions were divided hysteroscopically by electrode needle or loop under direct vision. A second look hysteroscopy was performed after 3 months.
Main Outcome Measure(S):
The menstrual pattern, the time interval to conceive, and the reproductive outcome were recorded.
Result(S):
A total of 109 operative procedures were performed in 85 cases. Uterine perforation occurred on one occasion (0.9%). After hysteroscopic adhesiolysis, the chances of conception in women who remained amenorrheic (2 out of 11; 18.2%) were significantly lower than those who continued to have menses (37 out of 74; 50%). At second look hysteroscopy, the conception rate in women who had reformation of intrauterine adhesions (2 out of 17; 11.8%) was significantly lower than that of women who had a normal cavity (26 out of 44; 59.1%).
Conclusion(S):
The outcome of hysteroscopic adhesiolysis for Asherman's syndrome is significantly affected by recurrence of intrauterine adhesions. Further research in Asherman's syndrome should be directed toward reduction of adhesion reformation with a view to improving outcome.
