Postoperative reproductive results of infertile patients with intrauterine adhesions: A retrospective analysis

Abstract

Objective To explore the reproductive outcomes after hysteroscopic separation of intrauterine adhesions (IUA) in infertile patients due to IUA. Methods This retrospective study enrolled patients with fertility requirements and infertility due to IUA. Data were collected from the hospital medical records and by follow-up by telephone. The impact on pregnancy and pregnancy outcome of preoperative adhesion, menstrual conditions before and after surgery and postoperative re-adhesion was analysed. Results A total of 106 patients (median age, 28 years) were enrolled in the study. There was a significant correlation between preoperative menstrual patterns and pregnancy rate. There were 56 pregnancies (pregnancy rate 52.83%) after the operation. Patients with improved menstruation after the operation had a significantly higher pregnancy rate (pregnancy rate 56.25%; 45 of 80 patients) compared with the patients that did not experience any improvement in their postoperative menstrual status (pregnancy rate 21.43%; three of 14 patients). Of the 56 pregnancies, 40 (71.43%) resulted in live births and six (10.71%) patients had miscarriages. A total of 54 of 56 patients (96.43%) became pregnant within 2 years. Conclusion Pregnancy after intrauterine adhesion separation has a high rate of miscarriage and obstetric complications, so close monitoring of the patient is required.

Animal models of the placenta accreta spectrum: current status and further perspectives

“…Dilation & curettage (DC) is a surgery generally considered to be relatively safe, but it is still associated with some long-term complications. The most well-known complication is intrauterine adhesions, also known as Asherman syndrome, which may lead to menstrual disorders and fertility problems ( 69 ). Previous studies have shown that the uterus of Sprague Dawley (SD) rats presents a series of abnormal changes when intrauterine adhesions occur, such as a decreased number of endometrial glands, increased deposition of collagen and fiber deposition, and disorganized morphology and structure of the myometrium ( 70 , 71 ).…”

Intrauterine adhesions: from pathogenesis to effective coping technologies

“…Аномалии полости матки, в том числе ВМС (как дефект паттерна «эндометрий -миометрий») нарушают субэндометриальную перистальтику и, как следствие, служат причиной имплантационных неудач [57]. Аномальная волновая активность эндометрия затрудняет или вовсе препятствует миграции сперматозоидов, а в случае оплодотворения нарушает транспорт зиготы [58].…”