Patient-reported menstrual and obstetric outcomes following hysteroscopic adhesiolysis for Asherman syndrome

Reproductive Surgery

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VOLUME 2, ISSUE 1, P118-125, MARCH 01, 2021

Authors:

Blanca Morales, M.D., Peter Movilla, M.D., Joyce Wang, B.A., Jennifer Wang, M.S., Alexandria Williams, M.D., Tammy Chen, B.S., M.P.H., Himabindu Reddy, M.D., Jovana Tavcar, M.D., Megan Loring, M.D., Stephanie Morris, M.D., Keith Isaacson, M.D.

Abstract:

Objective

Review the menstrual and obstetric outcomes among Asherman syndrome patients when stratified by disease severity.


Design

Retrospective cohort study.


Setting

A community teaching hospital affiliated with a large academic medical center.


Patients

A total of 355 Asherman syndrome patients stratified by March classification who underwent hysteroscopic adhesiolysis.


Interventions

Telephone survey, analyzed with multivariable analysis.


Main Outcome Measures

Return of menstruation. Pregnancy, miscarriage, and live birth rate.


Results

A total of 355 patients underwent hysteroscopic adhesiolysis. Of these, 150 (42.3%) patients completed the telephone survey with a mean follow-up of 2.21 years. Additionally, 40.7% had mild, 52.7% had moderate, and 6.6% had severe disease. Furthermore, 25.3% of patients reported amenorrhea at presentation, with mild disease patients having the highest rate of returning menstruation (93.8%) following treatment. The cumulative pregnancy rate was 81.9%, and the cumulative live birth rate was 51.2%, with no statistical differences identified by the classification group.


Conclusion

Asherman syndrome disease severity predicted returning menstruation but not pregnancy or live birth rate.

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.