Factors affecting reproductive outcome of hysteroscopic adhesiolysis for Asherman's syndrome.
OBJECTIVE
To evaluate the outcome of hysteroscopic adhesiolysis in women with Asherman's syndrome.


METHODS
Retrospective clinical study.


METHODS
Hysteroscopic center of Fuxing Hospital in Beijing, China.


METHODS
Patients with Asherman's syndrome who presented with a history of infertility or recurrent pregnancy loss were included in the study.


METHODS
The adhesions were divided hysteroscopically by electrode needle or loop under direct vision. A second look hysteroscopy was performed after 3 months.


METHODS
The menstrual pattern, the time interval to conceive, and the reproductive outcome were recorded.


RESULTS
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%).


CONCLUSIONS
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.
Hysteroscopic Center, Fuxing Hospital Affiliate of Capital University of Medical Sciences, Beijing, China. yudanny2006@yahoo.com.cn
Dan
D
Yu
Tin-Chiu
TC
Li
Enlan
E
Xia
Xiaowu
X
Huang
Yuhuan
Y
Liu
Xuebing
X
Peng
D000026:Abortion, Habitual / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery; D000328:Adult; D005260:Female; D005306:Fertilization; D006175:Gynatresia / Q000150:complications / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D015907:Hysteroscopy / Q000009:adverse effects; D007247:Infertility, Female / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery; D008597:Menstrual Cycle; D011247:Pregnancy; D011256:Pregnancy Outcome; D018873:Pregnancy Rate; D012008:Recurrence; D012098:Reproduction; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013997:Time Factors; D000267:Tissue Adhesions; D016896:Treatment Outcome; D014591:Uterine Diseases / Q000150:complications / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*