Live Birth following Laparoscopy Assisted Hysteroscopic Adhesiolysis in Asherman's Syndrome: A case report

Abstract

Asherman’s syndrome is defined as the formation of intrauterine adhesions following damage to the endometrium, most frequently after uterine procedures or intrauterine infection. These adhesions may impair normal endometrial function, resulting in menstrual abnormalities, infertility, and failure of implantation. We report the case of a 37 years old woman who presented with secondary amenorrhea for seven years after undergoing two manual vacuum aspiration procedures for spontaneous abortion. Evaluation revealed severe Asherman’s syndrome. She underwent three hysteroscopic adhesiolysis procedures, one of which was performed with laparoscopic guidance. She was diagnosed with severe Asherman’s syndrome and underwent three sessions of hysteroscopic adhesiolysis, including one procedure performed under laparoscopic guidance. Comprehensive postoperative strategies were employed to prevent adhesion recurrence and promote endometrial regeneration. The patient later conceived spontaneously and delivered a healthy neonate at term by emergency cesarean section due to oligohydramnios. This case demonstrates that careful surgical management combined with appropriate postoperative care can result in successful fertility outcomes even in advanced Asherman’s syndrome.