Hysteroscopic treatment of intrauterine adhesions is safe and effective in the restoration of normal menstruation and fertility

Objective: To assess the safety and efficacy of hysteroscopic adhesiolysis in patients with recurrent pregnancy loss and infertility. Design: Retrospective case report series. Setting: The obstetrics and gynecology clinic of a medical school. Patient(s): Forty women with recurrent pregnancy loss or infertility resulting from intrauterine adhesions. Intervention(s): Hysteroscopic adhesiolysis in patients with recurrent pregnancy loss and infertility. Main Outcome Measure(s): Postoperative adhesion formation, intraoperative complication, conceivement after surgery, pregnancy rate, and pregnancies resulted in term or viable preterm infants. Result(s): Most patients with minimal or moderate adhesions were free of adhesions when compared with postoperative control subjects. However, adhesion re-formation was noted in 60% of the patients who initially had severe adhesions. Normal menstrual flow was restored in 81% of the patients. All the patients who had recurrent pregnancy loss conceived after treatment, and 71% of the pregnancies resulted in a term or viable preterm infant. Of the 16 infertile patients treated, 10 (63%) conceived and 6 (37%) were delivered of viable infants. Conclusion(s): Hysteroscopic adhesiolysis is a safe and effective procedure for restoring the normal menstrual pattern and fertility. The initial severity of the adhesions appears to correlate best with the reproductive outcome. (C) 1997 by American Society for Reproductive Medicine.