Complication treatment for uterine factor infertility in Asherman’s syndrome


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Abstract

Background: The occurrence of pregnancy is extremely problematic in Asherman's syndrome. The reason can be both obliteration of the uterus and a change in its anatomy, as well as impaired endometrial cyclic transformation and receptivity and no conditions for implantation. Case report: The paper describes a clinical case of three patients with secondary infertility, secondary amenorrhea, Asherman’s syndrome, who had complication treatment: hysteroscopy; laser destruction of intrauterine synechiae, anti-adhesion gel injections into the uterine cavity, cycles of photoactive therapy using chlorophyll-containing drugs, and endometrial laser intrauterine irradiation. Optical spectroscopy was used to diagnose the morphological and functional state of the endometrium. Conclusion: Combination therapy aimed at both eliminating intrauterine synechiae and restoring endometrial functional activity allowed patients with Asherman’s syndrome to realize their reproductive function. Adequate and minimally invasive surgical treatment, administration of anti-adhesion gels into the uterine cavity, active management of patients in the postoperative period, and comprehensive measures for endometrial rehabilitation could achieve the patients to have good results in restoring their reproductive functions.

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About the authors

Thea A. Dzhibladze

I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)

Email: djiba@bk.ru
Dr. Med. Sci., Professor, Professor at the Department of Obstetrics and Gynecology No. 1, N.V. Sklifosovsky ICM

Vladimir M. Zuev

I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)

Email: vlzuev@bk.ru
Dr. Med. Sci., Professor, Professor at the Department of Obstetrics and Gynecology No. 1, NV. Sklifosovsky ICM

Anatoly I. Ishchenko

I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)

Email: 7205502@mail.ru
Dr. Med. Sci., Professor, Head of the Department of Obstetrics and Gynecology No. 1, N.V. Sklifosovsky ICM

Evgenia A. Svidinskaya

I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)

Email: svidinskaya@gmail.com
PhD, Assistant at the Department of Obstetrics and Gynecology No. 1, NV. Sklifosovsky ICM

Irina D. Khokhlova

I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)

Email: irhohlova5@gmail.com
PhD, Associate Professor, Department of Obstetrics and Gynecology No. 1, N.V. Sklifosovsky ICM

Dmitry V. Bryunin

I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)

Email: bryun777@mail.ru
Dr. Med. Sci., Head of Gynecology Department, University Clinical Hospital No. 2, Professor, Department of Obstetrics and Gynecology No. 1, NV. Sklifosovsky ICM

Marina V. Ostroumova

I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)

Email: ostroumovamarina@gmail.com
PhD, obstetrician-gynecologist, Clinical and Diagnostic Department No.i, University Clinical Hospital No. 2

Anastasia O. Putilo

I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)

Email: dr.annesterova@yandex.ru
PhD Student, Department of Obstetrics and Gynecology No. 1, N.V. Sklifosovsky ICM

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