Asherman's syndrome. A comparison of therapeutic methods.

The authors compared two methods of managing Asherman's syndrome. One group (nine patients) was treated with dilatation and curettage (D & C), followed by conjugated estrogens and progestin therapy. A second group (26 patients) was treated with hysteroscopic evaluation of therapy, followed by placement of an intrauterine contraceptive device (IUD) and antibiotics in addition to a D & C and hormonal therapy. Although the series was small, the pregnancy rate was higher in the second group. This is felt to be related to the hysteroscopic localization of synechiae as well as the postoperative insertion of an IUD.