How to Minimize Future Fertility Risks Associated with the Surgical Management of Miscarriage

Abstract

Miscarriage is a distressing event that can have a profound and lasting impact on a woman’s physical and emotional well-being. Although the causes of miscarriage are not always clear, it is estimated that up to 20% of all pregnancies end in miscarriage. After a miscarriage, women may experience a range of emotions, including grief, guilt, and anxiety. In some cases, medical intervention may be necessary to remove any remaining tissue from the uterus, prevent infection, and reduce the risk of complications. Surgical management is often recommended for incomplete or recurrent miscarriage. However, traditional surgical procedures can lead to the development of intrauterine adhesions, which can cause further complications and fertility problems. Intrauterine adhesions occur when scar tissue forms inside the uterus, usually as a result of damage to the uterine lining. This can cause the walls of the uterus to stick together, making it difficult for a fertilized egg to implant and grow, and potentially leading to infertility. To minimize the risk of intrauterine adhesions and preserve future fertility, ultrasound-guided manual vacuum aspiration (USG-MVA) has been developed as an alternative approach to traditional surgical management of miscarriage. USG-MVA is a minimally invasive procedure that involves using a handheld syringe to remove any remaining tissue from the uterus under ultrasound guidance. The use of ultrasound guidance ensures accurate catheter placement, leading to complete evacuation of the uterine contents and minimizing discomfort by reducing the number of suction catheters passes and unnecessary endometrial damage. USG-MVA has been shown to be a safe and effective method for managing miscarriages while preserving future fertility. The procedure is effective and can be performed in an outpatient setting, reducing the need for hospitalization, and minimizing associated costs. Additionally, USG-MVA has been found to have a lower risk of intrauterine adhesions compared to traditional surgical evacuation.