Uterine synechiae: variations in severity and some conditions which may be conducive to severe adhesions

Considerable variability in the severity of Asherman's syndrome was observed, and a high incidence of other gynecological disorders was discovered, mainly by endoscopy, in patients with intrauterine synechiae. Fifty-seven cases were reviewed in an attempt (1) to discover factors contributing to severity, (2) to examine possible relationships between other pelvic pathologies and the development of synechiae, and, subsequently, (3) to revise methods of treatment. Thirty-nine women underwent some form of pelvic visualization; twenty-seven (69%) were found to have other gynecological disorders. Forty-six patients had had a recent D & C. Signs of pituitary hypogonadotropism appeared in five of the 17 women with severe adhesions, suggesting that severity of adhesions developed after D & C may be increased in the presence of a concurrently existing hypoestrogenic state.