THE EFFICACY OF HYSTEROSCOPIC ADHESIOLYSIS IN ASHERMAN\'S SYNDROME

To determine the prevalence of Asherman's syndrome in the south of Iran and assess the safety and efficacy of hysteroscopic adhesiolysis in restoration of menstrual function and fertility, a prospective study was done from 1997 to 1999. Among 2300 couples with infertility referring to the infertility clinic of a Shiraz University hospital, 30 patients were proven to have Asherman's syndrome by diagnostic hysterosalpingography (HSG) and then hysteroscopy. T he prevalence of this syndrome was 1.3%. Hysteroscopic adhesiolysis was performed in all 30 patients. Adhesion reformation postoperatively was absent in stage 1 patients, 15% in stage II and 66% in stage III. Normal menstrual flow was restored in all patients (100%), and 19 patients (63.3%) conceived after surgery that resulted in term infants in 15 patients (50%). Hysteroscopic adhesiolysis is. a safe and effective operation for restoring the normal menstrual pattern and fertility, and the severity of the adhesions appear to correlate best with the reproductive outcome.