[Fertility after hysteroscopic treatment of intra-uterine adhesions].
OBJECTIVE
The main aim of the study was to evaluate the efficacy of hysteroscopy in the treatment of intra-uterine adhesions with infertility.


METHODS
This retrospective study of patients with uterine synechias treated exclusively hysteroscopically included 120 cases: 109 of them (90.8%) low fertility patients, 110 (91.7%) with menstrual disorders and 2 (1.7%) with no others symptoms. Mean age was 34 years (range: 21-45 years). Operative hysteroscopy was performed in 155 cases including electrosection in 124 cases (80%) and a collapse in 31 cases (20%). A single endoscopic procedure was performed in 96 patients, 2 procedures in 17 patients, 3 in 3 patients and 4 in 4 patients. Mean follow-up was 26.8 months (range: 6-52 months).


RESULTS
Good anatomic results were achieved in 116 patients (96.7%) after 1, 2 or 3 hysteroscopic procedures. We obtained good results in 58.2% of the patients with menstrual disorders. One pregnancy was achieved in 49 of patients (44.9%) including: 35 childbirth, 13 abortions and 1 molar pregnancy.


CONCLUSIONS
Hysteroscopy, easy procedure, allowing reproducible treatment with low morbidity should be proposed as first intention treatment in all cases with synechia. Fertility prognosis is tightly related to the gravity of synechia and its topography.
Kdous
M
M
Service de gynécologie-obstétrique et médecine de la reproduction, hôpital Aziza-Othmana, 1000 Tunis, Tunisie. kdousm@excite.com
Hachicha
R
R
Zhiou
F
F
Ferchiou
M
M
Chaker
A
A
Meriah
S
S
D000328:Adult; D005260:Female; D006801:Humans; D015907:Hysteroscopy / Q000379:methods*; D007247:Infertility, Female / Q000209:etiology / Q000601:surgery*; D008875:Middle Aged; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D000267:Tissue Adhesions / Q000150:complications / Q000601:surgery; D016896:Treatment Outcome; D014591:Uterine Diseases / Q000150:complications / Q000601:surgery*