Reproductive Outcome of Patients with Asherman’s Syndrome: A SAIMS Experience

Background: the purpose of the study was to evaluate menstrual and reproductive outcome in patients diagnosed with asherman’s syndrome on hysteroscopy and to assess the role of hysteroscopic adhesiolysis. methods: a prospective study was performed for patients having intrauterine adhesion at a tertiary care teaching hospital, indore, india for a period of 2 years. findings at hysteroscopy, details of adhesiolysis, changes in menstrual pattern following adhesiolysis, need for repeat procedure and fertility outcome were prospectively collected. data was analysed using spss software. a p-value of <0.05 was considered significant. results: a total of 60 patients with a mean age of 30.1±5.5 years with asherman’s syndrome were included. in 53.3% of them, no factors like post-partum curettage, uterine surgery or history of tuberculosis could be found in which the present intrauterine adhesions could be attributed to. hypomenorrhoea was the most common (53.3%) menstrual pattern in patients diagnosed with asherman’s syndrome. thirty eight out of 60 (63.33%) required second look hysteroscopy. there was a significant change in endometrial lining and echo pattern after adhesiolysis (p<0.05). 45% of patients started having normal menstrual flow after adhesiolysis which was statistically significant. a total of 16 conceptions and 10 live births were reported in the present cohort. pregnancy rate was higher in patients having mild asherman’s syndrome (53.3%) as compared to moderate (26.9%) or severe type (9.5%), (p=0.0049). it was also higher in patients having normal endometrial pattern after adhesiolysis (p=0.0005). conclusion: women who underwent hysteroscopic adhesiolysis showed significant improvement in the menstrual pattern. pregnancy rates were improved after hysteroscopic adhesiolysis.