ObjectiveTo evaluate reproductive outcomes after hysteroscopic adhesiolysis for
patients with Asherman syndrome (AS) who presented with infertility and/or
subfertility.MethodsA retrospective study was conducted in the Women’s Specialized Hospital, King
Fahad Medical City, from December 2010 to December 2018. The medical records
were reviewed for all infertile women who had hysteroscopic adhesiolysis.
The specific study’s main reproductive outcomes included: [1] the overall
rate of conception, [2] the overall rate of conception according to the
severity degree of intrauterine adhesions (IUAs), [3] the reproductive
methods for achieving conception, and [4] pregnancy outcomes. Reproductive
methods for conception included spontaneous conception, ovulation induction
(OI), intrauterine insemination (IUI), and in-vitro fertilization (IVF)
with/without intracytoplasmic sperm injection (ICSI). Outcomes of pregnancy
included ectopic pregnancy, miscarriage, and live birth events.ResultsForty-one patients (n=41) were analyzed. Their mean age was 32.2±4.6
years. The most common menstrual pattern amongst these patients was
hypomenorrhea 46.4%. All patients resumed regular menstrual cycles after the
adhesiolysis procedure. The overall conception rate during the 24 months
follow up was 53.6%, and the overall live birth rate was 34.2%. Of the 22
patients who conceived, 12 patients (29.2%) conceived spontaneously, 2
(4.9%) with IUI, and 8 (19.5%) with IVF-ICSI. The patients with minimal IUAs
had a significantly higher pregnancy rate (71.4%) when compared to those
with moderate (47%) and severe (40%) IUA (two-tailed log-rank test,p=0.041).ConclusionsThe spontaneous cumulative conception rate following hysteroscopic
adhesiolysis was higher in patients with minimal IUAs than those with
moderate and severe IUAs.