Surgical treatment of Asherman syndrome and reproductive outcome

Dan Med J. 2022 Feb 28;69(3):A09210736.

Abstract

Introduction: Asherman syndrome may be challenging to treat. This study presented the results after hysteroscopic treatment of Asherman syndrome in our clinic focusing on the reproductive outcome.

Methods: A total of 43 women were operated in the course of a five-year period. The women were post-operatively treated with hyaluronic acid gel, intrauterine device (IUD) and hormonal supplementation. A second-look minihysteroscopy and removal of the IUD were conducted seven weeks later. Data concerning the results after one or more operations were obtained from a phone interview and from the medical records.

Results: The pregnancy rate among the 38 women who wished to conceive was 82%, and the live birth rate was 63%. Among the 31 women who became pregnant, 42% achieved spontaneous pregnancy, whereas 58% became pregnant after fertility treatments. An increased risk of obstetric complications was recorded, especially related to abnormal placentation and impaired placenta function.

Conclusions: Hysteroscopic treatment of Asherman syndrome seems to be a safe procedure, but a risk possibly exists of obstetrical complications in the subsequent pregnancies. Pregnancies following hysteroscopic adhesiolysis should be considered high-risk pregnancies.

Funding: none.

Trial registration: not relevant.

MeSH terms

  • Female
  • Gynatresia* / complications
  • Gynatresia* / surgery
  • Humans
  • Hysteroscopy / adverse effects
  • Hysteroscopy / methods
  • Infertility, Female* / etiology
  • Live Birth
  • Pregnancy
  • Pregnancy Rate
  • Treatment Outcome