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Archives of Gynecology and Obstetrics

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01-02-2010 | Original Article

Reproductive outcome following hysteroscopic adhesiolysis in patients with infertility due to Asherman’s syndrome

Authors: K. K. Roy, Jinee Baruah, Jai Bhagwan Sharma, Sunesh Kumar, Garima Kachawa, Neeta Singh

Published in: Archives of Gynecology and Obstetrics | Issue 2/2010

Abstract

Objectives

To evaluate the outcome of hysteroscopic adhesiolysis in patients with infertility due to Asherman’s syndrome.

Materials and methods

This was a retrospective clinical analysis of 89 patients who underwent hysteroscopic adhesiolysis by monopolar electrode knife. A second-look office hysteroscopy was performed in all cases after 2 months. On second-look hysteroscopy, 12 patients showed reformation of adhesions and needed a repeat procedure.

Results

The mean age of the patient was 28.4 years. In the majority (64%) of patients, the possible cause of Asherman’s syndrome was previous curettage on gravid uterus. The overall conception rate was 40.4% after hysteroscopic adhesiolysis. The mean conception time after surgery was 12.8 months. There was no conception in patients who needed repeat adhesiolysis. The conception rate was higher (58%) in mild Asherman’s syndrome compared to 30% conception rate in moderate and 33.3% conception rate in severe cases. There was no significant association between conception rate and preoperative menstrual pattern. There was significant higher likelihood of conception rate (44.3%) in those who continued to have improved menstrual pattern compared to only 10% likelihood of conception in those who continued to have amenorrhea after adhesiolysis. The live birth rate was 86.1% and miscarriage rate was 11.1%. Cumulative pregnancy rate showed that 97.2% patients conceived within 24 months. There was increased incidence (43.8%) of cesarean section. Four (12.5%) patients had postpartum hemorrhage for adherent placenta.

Conclusion

Hysteroscopic adhesiolysis for Asherman’s syndrome is a safe and effective method of choice for restoring menstrual function and fertility.

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Title: Reproductive outcome following hysteroscopic adhesiolysis in patients with infertility due to Asherman’s syndrome
Authors: K. K. Roy
Jinee Baruah
Jai Bhagwan Sharma
Sunesh Kumar
Garima Kachawa
Neeta Singh
Publication date: 01-02-2010
Publisher: Springer-Verlag
Published in: Archives of Gynecology and Obstetrics / Issue 2/2010
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI: https://doi.org/10.1007/s00404-009-1117-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Reproductive outcome following hysteroscopic adhesiolysis in patients with infertility due to Asherman’s syndrome

Abstract

Objectives

Materials and methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Materials and methods

Results

Conclusion

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