A modern view at the treatment and prophylactics of intrauterous synechias in the uterine form of infertility

The aim of the present study was to develop techniques for minim ally invasive treatment and prophylactics of intrauterine synechias in women of the reproductive age having uterine infertility. The work was done at the Department of Obstetrics and Gynecology No. 1 in the First Moscow State Medical University named after Sechenov. 86 patients of reproductive age with intrauterine synechias and infertility aged 23-45 were divided into 3 groups. All patients were examined and treated. Patients from the first group had hysteroscopy, laser destruction of intrauterine synechias and anti-adhesive gel injections; in the second group, women had hysteroscopy and laser destruction of adhesions; in the third group, patients had instrumental destruction of synechias with Hegar's dilators and curettes. In the postoperative period, all patients were prescribed angioprotective, anti-inflammatory and hormone therapy. If patients had a marked adhesive process, they were prescribed laser therapy and physiotherapy. In 3-6 months after the described manipulations, patients had a diagnostic hysteroscopy. All patients with recurrent intrauterine synechias were prescribed a repeated hysteroscopy, laser destruction of intrauterine synechias and anti-adhesive gel injections. As it has been shown, little-traumatic techniques and prophylactics of intrauterine synechias with laser surgery and anti-adhesive gel to patients with uterine infertility helped to restore the uterine cavity with the followed pregnancy in 52% of women from the first group, while in the second and third groups pregnancy developed in 25% and 16.7%, respectively.

бесплодие, лазерная деструкция, внутриматочные синехии, infertility, laser destruction, intrauterine synechia

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