Factors affecting reproductive outcome of hysteroscopic adhesiolysis for Asherman's syndrome

Yu, Dan; Li, Tin‐Chiu; Xia, Enlan; Huang, Xiaowu; Liu, Yuhuan; Xue-bing, Peng

doi:10.1016/j.fertnstert.2007.03.070

Cited by 155 publications

(138 citation statements)

References 19 publications

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“…In literature an improvement in the menstrual flow was observed in patients post-adhesiolysis ranging from 52.4 to 74.2 % [15,16]. However, in our series the improvement in menstrual function was only 22.5 % (9 of 40) women, which was far less compared to what has been reported in literature.…”

Section: Discussioncontrasting

confidence: 86%

“…However, with dense adhesions there was no significant change in the endometrial thickness and blood flow and the reproductive outcome still remained dismal with only 5 (12.5 %) women achieving a pregnancy and none of the women who conceived had any evidence of tuberculosis. In one of the series the authors have reported a cumulative pregnancy rate of 59 % within a year and 87.2 % within 2 years of hysteroscopic adhesiolysis [16]. The average endometrial thickness attained on day 21 postadhesiolysis in these women was 6.6 mm.…”

Section: Discussionmentioning

confidence: 91%

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Changes in endometrial receptivity in women with Asherman’s syndrome undergoing hysteroscopic adhesiolysis

Malhotra

Bahadur

Kalaivani

et al. 2012

Arch Gynecol Obstet

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Section: Discussioncontrasting

confidence: 86%

Section: Discussionmentioning

confidence: 91%

Changes in endometrial receptivity in women with Asherman’s syndrome undergoing hysteroscopic adhesiolysis

Malhotra

Bahadur

Kalaivani

et al. 2012

Arch Gynecol Obstet

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“…In that study, the chances of conception after hysteroscopic adhesiolysis in women who remained amenorrheic were significantly lower than those who continued to have menses and the conception rate in women who had reformation of intrauterine adhesions (2 out of 17; 11.8%) was significantly lower than that of women who had a normal cavity (26 out of 44; 59.1%). 23 Similar results have been shown in a study by Roy et al, who found here was significant higher likelihood of conception rate (44.3%) in those who continued to have improved menstrual pattern compared to only 10% likelihood of conception in those who continued to have amenorrhea after adhesiolysis. 24 From these results, we can deduct that education and continuing investigation of the fertility and conception rate should be performed to patients who have underwent hysteroscopic adhesiolysis.…”

Section: Investigation and Continuing Educationsupporting

confidence: 90%

The management of Asherman syndrome in gynecology

Hadisaputra¹,

Handoko²

2013

Med J Indones

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AbstrakSindrom Asherman adalah penyakit yang ditandai dengan terbentuknya perlekatan di rongga uterus. Kondisi AbstractAsherman syndrome is an acquired condition characterized by the formation of adhesions in the uterine cavity. This condition is often caused by trauma to the endometrium, which mostly happens after currettage or post-partum, and can produce several complications such as menstrual disturbances, infertility, or recurrent abortion. The management of Asherman syndrome requires complete actions which can be summarized with the acronym PRACTICE, consisting of prevention, anticipation, comprehensive therapy, timely surveillance of subsequent pregnancies, investigation and continuing education. The prevention and anticipation aspects can be performed through reduction of invasive methods of therapy such as currettage, prophylactic therapy for adhesions such as antibiotics and post-estrogen therapy for high risk patients, and the use of instruments that do less damage to the uterine walls. The comprehensive therapy that become the method of choice is operative lysis using hysteroscopy, which provides direct visualization of the adhesion. To prevent reccurrence, especially to patients planning to have subsequent pregnancies, timely surveillance of the next pregnancies for high risk patients should be performed at hospital, with complete work-ups. Lastly, evaluation of operative results and continuing education to explain prognoses to the patient should be also performed. (Med J Indones. 2013;22:121-6)

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“…We suggest further well-designed prospective studies to uniformly follow patients diagnosed with RPOC. Second look hysteroscopy may be employed following the removal of RPOC to detect and treat intra uterine adhesions [16]. In cases of postpartum RPOC, we advise proper sonographic evaluation of the placenta, and preparation of the delivery setting.…”

Section: Discussionmentioning

confidence: 99%

Pregnancies Following Hysteroscopic Removal of Retained Products of Conception after Delivery Versus Abortion

Herman

Kogan

Tairy

et al. 2018

Gynecol Obstet Invest

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Aim: To compare clinical variables, sonographic findings and pregnancy outcomes following the hysteroscopic removal of retained products of conception (RPOC) after delivery and abortion. Methods: This is a retrospective cohort of operative hysteroscopies performed between 2011 and 2015 for suspected RPOC, during which trophoblastic tissue was obtained. Patient demographics, clinical presentation, sonographic evaluation, subsequent infertility and pregnancy outcomes were compared between post-delivery (n = 85) and post-abortion (n = 93) cases. Results: The main presenting symptom in both study groups was vaginal bleeding. On sonographic evaluation, maximal endometrial thickness was significantly higher in the post-delivery group, while irregularity and increased flow were more common in the post-abortion group. There was a similar rate of deliveries following hysteroscopy in both groups with 40% in the post-delivery group and 39.7% in the post-abortion group. Deliveries in the post-delivery group were characterized by a higher rate of abnormal placentation – 30.5% – including low lying placenta and placenta accreta. A significant rate of vaginal deliveries in both groups entailed manual removal of the placenta or exploration of the uterine cavity (23.5 and 10.5%, p = 0.20). Conclusion: Pregnancies following RPOC after delivery entail a higher rate of abnormal placentation.

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Factors affecting reproductive outcome of hysteroscopic adhesiolysis for Asherman's syndrome

Cited by 155 publications

References 19 publications

Changes in endometrial receptivity in women with Asherman’s syndrome undergoing hysteroscopic adhesiolysis

Changes in endometrial receptivity in women with Asherman’s syndrome undergoing hysteroscopic adhesiolysis

The management of Asherman syndrome in gynecology

Pregnancies Following Hysteroscopic Removal of Retained Products of Conception after Delivery Versus Abortion

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