title: Reproductive Outcomes in Patients With Intrauterine Adhesions Following Hysteroscopic Adhesiolysis: Experience From the Largest Women's Hospital in China.
abstract: To analyze the reproductive outcome of hysteroscopic adhesiolysis and assess the diagnostic accuracy of transvaginal ultrasonography (TVS) in infertile women resulting from intrauterine adhesions (IUAs).
  
  
  
  Retrospective, cross-sectional study (Canadian Task Force classification II-2).
  
  
  
  University tertiary referral center.
  
  
  
  Three hundred and fifty-seven patients with mild, moderate, and severe IUAs who underwent hysteroscopic adhesiolysis between January 2012 and December 2015.
  
  
  
  Hysteroscopic adhesiolysis in the outpatient analgesic setting for infertility and IUAs.
  
  
  
  Among the 357 patients (135 with mild IUAs, 116 with moderate IUAs, and 106 with severe IUAs) who underwent hysteroscopic adhesiolysis, 334 (93.6%) experienced a completely restored uterine cavity. The reproductive outcomes of 332 women (93%) were followed for an average duration of 27 ± 9 months, and the overall conception rate after hysteroscopic adhesiolysis was 48.2%, which decreased with increased IUA severity (mild, 60.7%; moderate, 53.4%; severe, 25%). The mean time to conception following hysteroscopic adhesiolysis was 9.7 ± 3.7 months. The miscarriage rate was 9.4%, and the live birth rate was no lower than 85.6%. Eleven patients (7.9%) had postpartum hemorrhage, including 6 (4.3%) due to adherent placenta and 3 (2.1%) due to placenta accreta.
  
  
  
  Hysteroscopic adhesiolysis is a feasible and effective way to improve fertility in patients with Asherman's syndrome.
authors.affiliation: Medical Center of Diagnosis and Treatment for Cervical Diseases, Obstetrics and Gynecology Hospital, Fudan University, and Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Shanghai, China.
authors.forename: Limei
authors.initials: L
authors.lastname: Chen
authors.affiliation: Medical Center of Diagnosis and Treatment for Cervical Diseases, Obstetrics and Gynecology Hospital, Fudan University, and Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Shanghai, China.
authors.forename: Hongwei
authors.initials: H
authors.lastname: Zhang
authors.affiliation: Medical Center of Diagnosis and Treatment for Cervical Diseases, Obstetrics and Gynecology Hospital, Fudan University, and Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Shanghai, China.
authors.forename: Qing
authors.initials: Q
authors.lastname: Wang
authors.affiliation: Medical Center of Diagnosis and Treatment for Cervical Diseases, Obstetrics and Gynecology Hospital, Fudan University, and Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Shanghai, China.
authors.forename: Feng
authors.initials: F
authors.lastname: Xie
authors.affiliation: Medical Center of Diagnosis and Treatment for Cervical Diseases, Obstetrics and Gynecology Hospital, Fudan University, and Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Shanghai, China.
authors.forename: Shujun
authors.initials: S
authors.lastname: Gao
authors.affiliation: Medical Center of Diagnosis and Treatment for Cervical Diseases, Obstetrics and Gynecology Hospital, Fudan University, and Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Shanghai, China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Song
authors.affiliation: Medical Center of Diagnosis and Treatment for Cervical Diseases, Obstetrics and Gynecology Hospital, Fudan University, and Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Shanghai, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Dong
authors.affiliation: Medical Center of Diagnosis and Treatment for Cervical Diseases, Obstetrics and Gynecology Hospital, Fudan University, and Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Shanghai, China.
authors.forename: Hua
authors.initials: H
authors.lastname: Feng
authors.affiliation: Medical Center of Diagnosis and Treatment for Cervical Diseases, Obstetrics and Gynecology Hospital, Fudan University, and Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Shanghai, China. Electronic address: cndxie@163.com.
authors.forename: Kangyun
authors.initials: K
authors.lastname: Xie
authors.affiliation: Medical Center of Diagnosis and Treatment for Cervical Diseases, Obstetrics and Gynecology Hospital, Fudan University, and Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Shanghai, China. Electronic address: suilong@sh163.net.
authors.forename: Long
authors.initials: L
authors.lastname: Sui
mesh_terms: D000328:Adult; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D004210:Dissection / Q000009:adverse effects / Q000379:methods; D005260:Female; D005306:Fertilization / Q000502:physiology; D006175:Gynatresia / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000601:surgery; D006801:Humans; D015907:Hysteroscopy / Q000009:adverse effects / Q000379:methods; D007247:Infertility, Female / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D010043:Outcome and Process Assessment, Health Care; D060728:Reproductive Health / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012720:Severity of Illness Index
keywords: Asherman's syndrome; Infertility; Transvaginal ultrasound