Hysteroscopic treatment of Asherman's Syndrome

Abstract

Objective: To assess achievement of hysteroscopic treatment for Asherman’s Syndrome(AS), also called ‘intrauterine adhesions(IUAs) or Intrauterine synechiae’. Method: Retrospectively,27 patients with AS were enrolled in our study at ankara liv hospital between 2017-2019 . These patients were evaluated with hysteroscopically then they had adhesiolysis at the same session. Monopolar knife was used for adesiolysis and the operation was gone on until adequate cavity enlargement was achieved. Intrauterine device (IUD) was placed in the new occurred cavity and combined hormonal therapy(high dose estrogen and progesteron) was given for two months. American Fertility Society classification was used for scoring of IUAs. After IUD was taken out, they were called and their menstrual pattern and fertility status were learned. If their symptoms were recurred they were hysteroscopically evaluated again. Results: 27 patients were hysteroscopically diagnosed as AS . 15of them had reproductive problems and other 12 patients had only menstrual abnormality. 13 patients had pregnancy related curettage, 4 patients had dilatation and curratage(D&C) for their menstrual problems. After hysteroscopic treatment, 6 of 12 patients with only menstrual abnormality had normal menstual pattern, 2 of them did not have normal period but a little bit better(from amenorrhoea to hypomenorrhoea). 8 of 15 infertile patients had positive pregnancy test(live born:6, spontaneous abortion:2). And also all these pregnant womens were seconder infertile patients. Conclusions: Hysteroscopy is the most useful technique for diagnosis and treatment for Asherman’s Syndrome. And also, hysteroscopic procedure has positive effect on pregnancy rate and menstrual regularity