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  • Title: A matched cohort study comparing the outcome of intrauterine adhesiolysis for Asherman's syndrome after uterine artery embolization or surgical trauma.
    Author: Song D, Liu Y, Xiao Y, Li TC, Zhou F, Xia E.
    Journal: J Minim Invasive Gynecol; 2014; 21(6):1022-8. PubMed ID: 24842805.
    Abstract:
    STUDY OBJECTIVE: To compare the outcome of hysteroscopic adhesiolysis in women who had Asherman's syndrome after uterine artery embolization (UAE) with those who had Asherman's syndrome caused by surgical trauma. DESIGN: A retrospective cohort study matched for age and intrauterine adhesion score (Canadian Task Force classification II-2). SETTING: A tertiary hysteroscopic center in a teaching hospital. PATIENTS: Nineteen women with Asherman's syndrome after UAE and 57 women with Asherman's syndrome caused by surgical trauma. INTERVENTIONS: Hysteroscopic adhesiolysis was followed by a second-look hysteroscopy 1 month later. The scoring system proposed by the American Fertility Society was used to evaluate intrauterine adhesion during hysteroscopy. MEASUREMENTS AND MAIN RESULTS: In the UAE group, only 42.1% of women experienced improvement in menstruation defined as a subjective increase in menstrual flow after surgery, which was significantly lower than that of 86.0% observed in the non-UAE group. In the UAE group, the reduction of the American Fertility Society (AFS) score after intrauterine adhesiolysis was 30%, which was significantly lower than that of 80% in the non-UAE group. The pregnancy rate and live birth rate in the UAE group (5% and 0%, respectively) were significantly lower than the corresponding rates in the non-UAE group (33% and 25%, respectively). CONCLUSION: The outcome of hysteroscopic adhesiolysis in women with Asherman's syndrome after UAE was worse than in women with Asherman's syndrome caused by surgical trauma.
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