ASHERMAN SYNDROME TREATMENT METHODS TO RESTORE REPRODUCTIVE FUNCTION

Abstract

Abstract. Asherman syndrome includes menstrual and childbearing disorders caused by the presence of intrauterine adhesions. Infertility and hypomenorrhea were found to be the most frequent clinical manifestations of Asherman syndrome (55.1% and 32.1% of cases). Diagnosis is difficult because the syndrome cannot be detected by standard methods of examination. In most cases, treatment leads to the recurrence of the disease, which is an aggravating factor for reproduction. The aim of the work is to identify optimal methods of Asherman syndrome treatment on the basis of scientific literature. The scientific literature on the restoration of reproductive function in women with Asherman syndrome was studied. An analytical review of clinical cases and a comparative analysis of the latest methods of treating this syndrome with solid and semi-solid barriers to form an artificial layer between the uterine walls and reduce adhesive changes, as well as hormonal treatment, intrauterine and anti-spastic gel based on hyaluronic acid gel was performed. The standard treatment of intrauterine adhesions is to dissect them, called hysteroscopic adhesiolysis, to restore the integrity of the uterine cavity and to further prevent their formation. Damage to the uterine tissue after hysteroscopic adhesiolysis can also cause new recurrences. To date, the introduction of multiple solid and semi-solid barriers to form an artificial layer between the uterine walls and reduce adhesion changes has been proposed. Intrauterine synechias and, as an extremely severe variant, Asherman syndrome are a multicomponent problem that requires a comprehensive approach. The prognosis depends on the degree of severity and etiology of Asherman syndrome. The following algorithm for the management of women with Asherman syndrome is possible: diagnostic module, sparing intrauterine surgery with subsequent insertion of antispastic barriers into the uterine cavity, postoperative rehabilitation aimed.