Intrauterine adhesions and fertility: results of hysteroscopic treatment

Objective To assess the efficacy of hysteroscopic surgery in infertile women presenting with uterine synechiae. Design A retrospctive audit of 52 patients. Setting University hospital. Subjects A total of 52 patients presenting with intrauterine adhesions in a context of reproductive dysfunction: infertility, 29 cases; recurrent abortions, 23 cases. Interventions Operative hysteroscopy including section with scissors, lesion division, and electrosection. Results There were 34 pregnancies in 28 patients, with 24 term deliveries and 10 abortions. Conclusion Operative hysteroscopy should be considered as the primary treatment for patients with intrauterine adhesions. Hysteroscopy allows selectivity, reproducibility with little morbidity, and preserves the surrounding endometrium. After several unsuccessful procedures, abdominal surgery could be proposed.