title: Changes in endometrial receptivity in women with Asherman's syndrome undergoing hysteroscopic adhesiolysis.
abstract: OBJECTIVE
  To determine whether there is any improvement in the endometrial receptivity in infertile women with Asherman's syndrome undergoing hysteroscopic adhesiolysis.
  
  
  METHODS
  This was a prospective observational clinical analysis of 40 infertile patients who underwent hysteroscopic adhesiolysis for Asherman's syndrome in a tertiary level hospital. Endometrial thickness and blood flow impedance of the uterine spiral artery by transvaginal color pulsed Doppler ultrasound was measured post-menstrual on day 2/3 and post-menstrual on day 21 pre- and post-hysteroscopic adhesiolysis or at a randomly chosen time in patients with amenorrhea.
  
  
  RESULTS
  The age of the patients was 18-36 years (mean 29.2 years). The mean duration of infertility was 6.9 years. There were 27 (67.5 %) women with primary infertility and 13 (32.5 %) had secondary infertility. 22 (55 %) women had had genital tuberculosis in the past. A significant improvement in the endometrial thickness was observed on day 2 (p < 0.0001) and day 21 (p < 0.0001) 3 months post-adhesiolysis. The spiral artery RI was statistically significant (p < 0.04) on day 2 pre-adhesiolysis compared to post-adhesiolysis.
  
  
  CONCLUSIONS
  A significant improvement in the endometrial thickness was observed post-adhesiolysis. A high blood flow impedance of spiral artery perhaps impairs growth of the endometrium making it unsuitable for successful implantation.
authors.affiliation: Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, 3076, 3rd Floor, Teaching Block, New Delhi 110 029, India.
authors.forename: Neena
authors.initials: N
authors.lastname: Malhotra
authors.forename: Anupama
authors.initials: A
authors.lastname: Bahadur
authors.forename: Mani
authors.initials: M
authors.lastname: Kalaivani
authors.forename: Suneeta
authors.initials: S
authors.lastname: Mittal
mesh_terms: D000293:Adolescent; D000328:Adult; D004717:Endometrium / Q000098:blood supply* / Q000473:pathology*; D005260:Female; D006175:Gynatresia / Q000473:pathology* / Q000601:surgery*; D006801:Humans; D015907:Hysteroscopy / Q000379:methods*; D007247:Infertility, Female / Q000209:etiology / Q000601:surgery; D010535:Laparoscopy / Q000379:methods; D011446:Prospective Studies; D000267:Tissue Adhesions / Q000601:surgery; D016896:Treatment Outcome; D014384:Tuberculosis, Female Genital / Q000150:complications / Q000601:surgery; D018615:Ultrasonography, Doppler, Color; D055815:Young Adult