[Reproductive outcome of hysteroscopic lysis of intrauterine adhesions].

OBJECTIVE

To analyze the reproductive outcome in women undergoing hysteroscopic lysis of intrauterine adhesions, according to their localization and severity.

STUDY DESIGN

Retrospective study.

MATERIALS AND METHODS

Fifty-three patients affected by intrauterine adhesions of different degree, subdivided according to localization and morphologic aspect: three isthmic, thirteen marginal, fourteen central, moreover twenty were complex and three complete. All the interventions were performed by means of the resectoscope.

RESULTS

Hysteroscopic surgery restored an acceptable menstrual cycle in almost all the patients affected by intrauterine isolated adhesions, in 52% of women affected by complex incomplete adhesions, and in none of the three patients with entirely obliterated cavity. Concerning fertility, while in isolated, isthmic, central or marginal synechias we observed a pregnancy rate of 73.3% (22 out of 30) with a pregnancy rate to term respectively of 63.3% (19 out of 30 cases) and of 86.3% (19 out of 22 total pregnancies), in case of complex but not complete adhesions we reported, on 20 cases, 5 pregnancies (25%) with only two gone to term. We had no pregnancy in three cases of complex synechias.

CONCLUSIONS

The basic parameter to define the functional and reproductive prognosis of the hysteroscopic lysis of intrauterine adhesions is not the menstrual profile or the histological characteristic of the lesions, but rather their extension.