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.
To study the reproductive outcomes after surgical management of women with Asherman syndrome (AS).
International referral hospital for women with AS.
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.
Hysteroscopic adhesiolysis using conventional instruments with concomitant fluoroscopy as a guidance method.
Main Outcome Measure(s)
Live birth rate.
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.
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.