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Ginecología y Obstetricia de México

Federación Mexicana de Ginecología y Obstetricia, A.C.
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2012, Number 06

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Ginecol Obstet Mex 2012; 80 (06)

Future Reproductive Ability in Post-Treatment Asherman’s Syndrome Patients

Cruz OOP, Castellanos BG, Gaviño GF, Jara DJ, García VJ, Roque SAM
Full text How to cite this article

Language: Spanish
References: 10
Page: 389-393
PDF size: 192.36 Kb.


Key words:

Asherman’s Syndrome, hysteroscopy, pregnancy, post-treatment fertility, medroxyprogesterone.

ABSTRACT

Background: Hysteroscopy is the best approach for the management of Asherman syndrome with reproductive purposes, since it allows a quick diagnosis and treatment of partial or total uterine adhesions. However, there are a few studies on the reproductive outcome in patients with Asherman´s syndrome.
Objective: Evaluate the results of adherenciolisis hysteroscopy in women with Asherman’s syndrome.
Patients and methods: We performed a cohort study of thirty-nine patients diagnosed with Asherman’s syndrome and who underwent surgical hysteroscopic adherenciolisis by bipolar energy through the period from 2006 to June 2011.
Results: Thirty-nine cases were reviewed. All patients restored their menstrual cycle in the course of the first three months after surgery. The pregnancy rate after hysteroscopic treatment was 71.7% (28/39), with a son living at home in 28.2% of the cases (11/39). There was no statistical difference to achieve term pregnancy based on a cut-off point at 35 years of age. A history of menstrual pattern before hysteroscopy was associated with perinatal success. All pregnancies were achieved spontaneously within the first year after the procedure.
Conclusions: Spontaneous pregnancy is possible after hysteroscopic adherenciolisis in Asherman’s Syndrome. It confirms the viability of using bipolar energy to restore the size and shape of the uterine cavity with minimal endometrial damage and with an exclusive reproductive purpose.


REFERENCES

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  3. Yu D, Wong Y, Cheong Y, Xia E. Asherman syndrome -one century later. Fertil Steril 2008;89;759-779.

  4. Panayoditis C, Weyers S, Bosteels J, Van Herendael V. Intrauterine adhesions: has there been progress in understanding and treatment over the last 20 years? Gynecol Surg 2009;6:197-211.

  5. Fernandez H, Al-Najjar F, Chauveaud-Lambling A. Fertility after treatment of Asherman’s syndrome stage 3 and 4. J Minim Invasive Gynecol 2006;13:398-402.

  6. The American Fertility Society classifications of adnexal adhesions, distal tubal occlusion, tubal occlusion secondary to tubal ligation, tubal pregnancies, mullerian anomalies and intrauterine adhesions. Fertil Steril 1988;49:944-955.

  7. Capella S, Morsad F, Taylor S, Fernandez H. Hysteroscopic treatment of severe Asherman´s syndrome and subsequent fertility. Human Reprod 1999;14:1230-1233.

  8. Dawood A, Al Taib A, Tulandi T. Predisposing Factors and Treatment Outcome of Different Stages of Intrauterine Adhesions. J Obstet Gynaecol Can 2010;32(8):767-770.

  9. Zikopoulos KA, Kolibianakis EM, Platteau P. Live delivery rates in subfertile women with Asherman’s syndrome after hysteroscopic adhesiolysis using the resectoscope or the Versapoint system. Reprod Biomed Online 2004;8:720.

  10. Yu D, Xia E, Huang X, Peng X. Factors affecting reproductive outcome of hysteroscopia adhesiolysis for Asherman´s syndrome. Fertil Steril 2008;89:715-722.




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Ginecol Obstet Mex. 2012;80