Simplified therapy for Asherman's syndrome

Objective: To evaluate a technique that converts a blind hysteroscopic procedu Design: Open noncomparative clinical study. Setting: Tertiary care center. Patient(s): Six women with Asherman's syndrome; five with complete and one with incomplete obliteration of the uterine cavity. Intervention(s): The patients underwent recreation of the uterine cavity by the hysteroscopic-laparoscopic technique described to establish the correct dissection plane. Main Outcome Measure(s): The ability to reestablish the uterine cavity; postoperative resumption of menses and fertility. Result(s): In all patients, the cavity of the uterus was restored; menses resumed in all women who were previously amenorrheic; and 5 women conceived, of whom four had live births and one a missed abortion. At hysteroscopy, two women incurred perforations and in another hemorrhage occurred. Conclusion(s): This technique appears to be effective and safe for the reconstruction of a functional endometrial cavity in women with Asherman's syndrome. (C) 1997 by American Society for Reproductive Medicine.