Intrauterine adhesions: What is the pregnancy rate after hysteroscopic management?

Perrine Capmas (1, 2, 3) , Andreï Mihalache (3) , Laura Duminil (3) , Lat Soriya Hor (3) , Anne Gaëlle Pourcelot (3) , H. Fernandez (1, 3, 2)

1 CESP - Centre de recherche en épidémiologie et santé des populations
2 Université Paris-Saclay, Faculté de Médecine, 94270 Le Kremlin-Bicêtre, France
3 AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre)

Objective: To evaluate the rate of pregnancy following hysteroscopic management of intrauterine adhesions. Design: Retrospective study. Setting: From June 2009 to December 2014 in a teaching hospital. Patients: Women treated by operative hysteroscopy for intrauterine adhesions. Intervention: Operative hysteroscopy to manage intrauterine adhesions. Main outcome measure: rate of intrauterine pregnancy after hysteroscopic management of intrauterine adhesions. Results: Out of the 202 women whom benefit from hysteroscopic adhesiolysis, 112(55%) had an effective pregnancy desire. Among them, an intrauterine pregnancy was obtained for 58 women (52%) with a trend to a lower rate for type IV and Vb intrauterine adhesions management (40.5%, p = 0.09). Pregnancy rates were similar for women undergoing one or more procedures. Conclusion: Hysteroscopic management of intrauterine adhesions seems useful as it leads to a pregnancy rate of 52%. However, this rate is lower in case of type IV and Vb intrauterine adhesions. Repeated procedures don't seem to lead to less pregnancy; however, a more powerful prospective study should be performed to answer this specific question.

Keywords: Fertility; Intrauterine adhesions; Operative hysteroscopy

Domains: Gynecology and obstetrics

Perrine Capmas, Andreï Mihalache, Laura Duminil, Lat Soriya Hor, Anne Gaëlle Pourcelot, et al.. Intrauterine adhesions: What is the pregnancy rate after hysteroscopic management?. Journal of Gynecology Obstetrics and Human Reproduction, 2020, 49 (7), ⟨10.1016/j.jogoh.2020.101797⟩. ⟨hal-03032345⟩