Live births after Asherman syndrome treatment

The birth rate after Asherman surgery is 67.4%. Age and the causal procedure leading to Asherman syndrome are the most significant prognostic factors for this outcome.

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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.

Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders.