Intracytoplasmic sperm injection following hysteroscopic adhesiolysis in patients with moderate intrauterine adhesions

Abstract

Purpose 

The aim of this study was to assess the efficacy of hysteroscopic adhesiolysis in patients with moderate Asherman’s syndrome undergoing ICSI.

Materials and methods 

A total of 17 patients with moderate degree Asherman’s syndrome undergoing ICSI for severe male factor of infertility (group A1) and 39 patients with moderate degree Asherman’s syndrome undergoing ICSI for tubal factor of female infertility (group A2) underwent hysteroscopic adhesiolysis before ICSI. Results in the form of implantation and miscarriage rate were compared with two control groups (CA1 and CA2) with matching inclusion criteria but with normal uterine cavities.

Results 

There was no statistically significant difference in the implantation and miscarriage rate between patients in group A1 compared with patients in the control group CA1 (P=0.06453 and 0.28397, respectively) and between patients in group A2 compared with patients in the control group CA2 (P=0.05976 and 0.33978, respectively). However, there was a statistically significant difference in the overall clinical pregnancy rates of patients in group A1 compared with patients in group CA1 and patients in group A2 compared with patients in group CA2 (P=0.04139 and 0.04225, respectively).

Conclusion 

Hysteroscopic adhesiolysis in patients with moderate Asherman’s syndrome before ICSI restores the anatomy of the uterine cavity and the menstrual blood flow and optimizes the patients’ chances during ICSI, compared with patients with normal uterine cavities; however, their clinical pregnancy rates after correction may be significantly lower.