Live births after Asherman syndrome treatment

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.

Keywords: Asherman syndrome; hysteroscopy; live birth rate; pregnancy.