Hysteroscopic adhesiolysis for patients with Asherman's syndrome: Menstrual and fertility outcomes

Nari Yamamoto, Reiko Takeuchi, Daisuke Izuchi, Norihito Yuge, Masahide Miyazaki, Masafumi Yasunaga, Katsuko Egashira, Yousuke Ueoka, Yoshihito Inoue

Research output: Contribution to journalArticlepeer-review

20 Citations (Scopus)


Purpose: Most patients with Asherman's syndrome present with infertility and menstrual problems. In this retrospective clinical study, we analyzed patients with Asherman's syndrome who underwent hysteroscopic adhesiolysis to examine their associated symptoms, disease etiologies, and fertility outcomes. Methods: Twenty-seven patients with Asherman's syndrome that were diagnosed using hysteroscopy were recruited. The chief complaints were infertility, hypomenorrhea, and amenorrhea. Each case of Asherman's syndrome was classified according to the American Fertility Society classification. Hysteroscopic adhesiolysis was performed in all cases and concomitant transabdominal ultrasonography was conducted in cases with extensive and dense adhesions. Results: There were no complications associated with the hysteroscopic procedure. Normal menstrual cycles resumed in all cases. Of the 16 infertile patients, 9 conceived. Three patients achieved term deliveries and one patient is currently pregnant. None of the patients had obstetric complications. Two patients had spontaneous abortions, one had an ectopic pregnancy, one had an abortion at 16 weeks' gestation due to cervical incompetence, and one had a molar pregnancy and required uterine artery embolization for uncontrolled hemorrhaging during a dilatation and curettage procedure. Conclusions: Hysteroscopic adhesiolysis with transabdominal ultrasonography is a suitable treatment method for Asherman's syndrome. Subfertile patients with Asherman's syndrome undergoing adhesiolysis should be appropriately informed about the risk of associated life-threatening complications and preterm delivery.

Original languageEnglish
Pages (from-to)159-166
Number of pages8
JournalReproductive Medicine and Biology
Issue number4
Publication statusPublished - Oct 2013
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Reproductive Medicine
  • Cell Biology


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