VOLUME 116, ISSUE 4, P1181-1187
Authors:
Miriam M.F. Hanstede, M.D., Eva van der Meij, M.D., Ph.D., Sebastiaan Veersema, M.D., Ph.D., Mark Hans Emanuel, M.D., Ph.D.
Abstract:
Objective
To study the reproductive outcomes after surgical management of women with Asherman syndrome (AS).
Design
Cohort study.
Setting
International referral hospital for women with AS.
Patient(s)
A total of 500 women who were diagnosed with and treated for AS between January 2003 and December 2016 and followed for a minimum of 2 years.
Intervention(s)
Hysteroscopic adhesiolysis using conventional instruments with concomitant fluoroscopy as a guidance method.
Main Outcome Measure(s)
Live birth rate.
Result(s)
Of the 500 women included in the cohort, 569 pregnancies were achieved within 3 years after surgery. The miscarriage rate was 33.0%, and the live birth rate was 67.4%. Age, the causal procedure, and at least one miscarriage after adhesiolysis strongly predicted the outcome of a live birth.
Conclusion(s)
The overall take-home newborn rate was 67.4% after adhesiolysis in women with AS. Women with AS who are relatively young, with a first-trimester procedure preceding AS, and with low grades of adhesions and no miscarriage after adhesiolysis have the best chance of a newborn delivery.
