Hysteroscopic treatment of intrauterine adhesions is safe and effective in the restoration of normal menstruation and fertility

Abstract

Objective: To assess the safety and efficacy of hysteroscopic adhesiolysis in patients with recurrent pregnancy loss and infertility.

Design: Retrospective case report series.

Setting: The obstetrics and gynecology clinic of a medical school.

Patient(s): Forty women with recurrent pregnancy loss or infertility resulting from intrauterine adhesions.

Intervention(s): Hysteroscopic adhesiolysis in patients with recurrent pregnancy loss and infertility.

Main outcome measure(s): Postoperative adhesion formation, intraoperative complication, conceivement after surgery, pregnancy rate, and pregnancies resulted in term or viable preterm infants.

Result(s): Most patients with minimal or moderate adhesions were free of adhesions when compared with postoperative control subjects. However, adhesion re-formation was noted in 60% of the patients who initially had severe adhesions. Normal menstrual flow was restored in 81% of the patients. All the patients who had recurrent pregnancy loss conceived after treatment, and 71% of the pregnancies resulted in a term or viable preterm infant. Of the 16 infertile patients treated, 10 (63%) conceived and 6 (37%) were delivered of viable infants.

Conclusion(s): Hysteroscopic adhesiolysis is a safe and effective procedure for restoring the normal menstrual pattern and fertility. The initial severity of the adhesions appears to correlate best with the reproductive outcome.