Management after hysteroscopic metroplasty: with or without intrauterine device (IUD) insertion and estrogen administration

Abstract

OBJECTIVE: To investigate effects of intrauterine device (IUD) and estrogen, both separately and in combination after hysteroscopic metroplasty. DESIGN: Prospective randomized controlled study. MATERIALS AND METHODS: A hundred patients who were diagnosed with a uterine septum at the Department of Reproductive Endocrinology in our hospital, enrolled in this study were assigned into four groups. Patients in Group I did not receive any treatment, while those in Group II were treated with cyclical hormone replacement therapy (HRT). Patients in Group III had an IUD inserted, while those in Group IV had IUD inserted combined with HRT. All patients were re-evaluated for uterine cavity adhesions by office hysteroscopy. All new pregnancies occurring during this period were recorded. RESULTS: Intrauterine adhesion development rates for the untreated, IUD + HRT and the IUD groups were 5.3%, 12% and 10.5%, respectively. None of the patients in the HRT group had any intrauterine adhesions. There was no statistically significant difference between the groups in terms of intrauterine adhesions. The difference between groups regarding ongoing pregnancies was statistically not significant. CONCLUSIONS: This study demonstrated any added benefit of postoperative IUD and/or HRT use in the prevention of intrauterine adhesions or ongoing pregnancies after hysteroscopic metroplasty.