Complication treatment for uterine factor infertility in Asherman’s syndrome
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.Dzhibladze T.A., Zuev V.M., Ishchenko A.I., Svidinskaya E.A., Khokhlova I.D., Bryunin D.V., Ostroumova M.V., Putilo A.O.
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 andfunctional 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 ofpatients in the postoperative period, and comprehensive measures for endometrial rehabilitation could achieve the patients to have good results in restoring their reproductive functions.
Keywords
Asherman’s syndrome
intrauterine surgery
pregnancy
References
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Received 07.12.2021
Accepted 26.01.2022
About the Authors
Thea A. Dzhibladze, Dr. Med. Sci., Professor, Professor at the Department of Obstetrics and Gynecology No. 1, N.V. Sklifosovsky ICM, Sechenov University, +7(499) 248-69-56, djiba@bk.ru, https://orcid.org/0000-0003-1540-5628, 119991, Russia, Moscow, Trubetskaya str., 8-2.Vladimir M. Zuev, Dr. Med. Sci., Professor, Professor at the Department of Obstetrics and Gynecology No. 1, N.V. Sklifosovsky ICM, Sechenov University,
Phone: +7(499)248-69-56, vlzuev@bk.ru, https://orcid.org/0000-0001-8715-2020, 119991, Russia, Moscow, Trubetskaya str., 8-2.
Anatoly I. Ischenko, Dr. Med. Sci., Professor, Head of the Department of Obstetrics and Gynecology No. 1, N.V. Sklifosovsky ICM, Sechenov University, +7(499)248-69-56, 7205502@mailru, https://orcid.org/0000-0001-5733-953x, 119991, Russia, Moscow, Trubetskaya str., 8-2.
Evgenia A. Svidinskaya, PhD, Assistant at the Department of Obstetrics and Gynecology No. 1, N.V. Sklifosovsky ICM, Sechenov University, +7(495)609-14-00, svidinskaya@gmail.com, https://orcid.org/0000-0002-2368-1932, 119991, Russia, Moscow, Trubetskaya str., 8-2.
Irina D. Khokhlova, PhD, Associate Professor, Department of Obstetrics and Gynecology No. 1, N.V. Sklifosovsky ICM, Sechenov University, +7(499)248-69-56, irhohlova5@gmail.com, https://orcid.org/0000-0001-8547-6750, 119991, Russia, Moscow, Trubetskaya str., 8-2.
Dmitry V. Brunin, Dr. Med. Sci., Head of Gynecology Department, University Clinical Hospital No. 2, Professor, Department of Obstetrics and Gynecology No. 1, N.V. Sklifosovsky ICM, Sechenov University, +7(499)248-74-55, bryun777@mail.ru, https://orcid.org/0000-0002-5969-4217, 119991, Russia, Moscow, Trubetskaya str., 8-2.
Marina V. Ostroumova, PhD, obstetrician-gynecologist, Clinical and Diagnostic Department No.1, University Clinical Hospital No. 2, Sechenov University, +7(499)248-74-55, ostroumovamarina@gmail.com, 119991, Russia, Moscow, Trubetskaya str., 8-2.
Anastasia O. Putilo, PhD Student, Department of Obstetrics and Gynecology No. 1, N.V. Sklifosovsky ICM, Sechenov University, +7(499)248-74-55, dr.annesterova@yandex.ru, https://orcid.org/0000-0002-2137-7283, 119991, Russia, Moscow, Trubetskaya str., 8-2.
Authors’ contributions: Dzhibladze T.A., Ishchenko A.I., Zuev V.M. - concept and design of the investigation; Putilo A.O., Svidinskaya E.A., Ostroumova M.V. - material collection and processing, Khokhlova I.D., Dzhibladze T.A. - writing the text; Bryunin D.V. - editing.
Conflicts of interest: The authors declare that there are no conflicts of interest.
Funding: The investigation has not been supported.
Ethical Approval: The investigation has been approved by the Ethics Committee of the I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University).
Patients’ Consent for Publication: All patients provided informed consent for the publication of their data and associated images.
For citation: Dzhibladze T.A., Zuev V.M., Ishchenko A.I., Svidinskaya E.A.,
Khokhlova I.D., Bryunin D.V., Ostroumova M.V., Putilo A.O.
Complication treatment for uterine factor infertility in Asherman’s syndrome.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2022; 3: 165-169 (in Russian)
https://dx.doi.org/10.18565/aig.2022.3.165-169
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