Asherman syndrome: Audit of a single‐operator cohort of 423 cases

Background The diagnosis of Asherman syndrome, or ‘intra‐uterine adhesions’ is often overlooked when the symptoms of amenorrhea and hematometra are missing. Aims This audit reviews the clinical data of a large cohort of patients treated by a single operator. Materials and Methods From July 1998 till the end of December 2017, 423 patients with intra‐uterine adhesions were treated by a single operator. Clinical information was obtained by review of the medical files and phone interviews. Results Amenorrhea was recorded in 163/423 patients (38.5%), 225/423 (53.2%) patients did not have amenorrhea and for 35/423 (8.3%) patients the information was missing. A hematometra was documented in 19/423 (4.5%) patients. Pregnancy was achieved in 215/246 (87.4%). Patients with stage II disease did best with a pregnancy rate of 94.5% (P = 0.029). Conclusion Asherman syndrome should be considered in any woman with a history of miscarriage or postpartum curettage who then fails to conceive again.