Recurrent intrauterine synechiae in reproductive age. Hysteroscopic predictors

• Mekan R. Orazov
• Lyudmila M. Mikhaleva
• Sevinc Ya. Ismayilzade

Abstract

Intrauterine synechiae is a multifactorial polygenic syndrome with various forms of clinical determinants – from asymptomatic to complete/absolute infertility and complications of implantation/gestation.

The aim of the study was to identify hysteroscopic predictors of recurrence of intrauterine synechiae in patients of reproductive age.

Material and methods. A prospective cohort comparative open-label study included 63 women with primary intrauterine synechiae (median age 35 years (Q₁–Q₃: 33.07–36.27) and 64 women with recurrent intrauterine synechiae (median age 37.36 years (Q₁–Q₃: 32.54–38.84). History, anthropometric data were collected, sonographic examination of the pelvic organs and hysteroscopy of the uterine cavity were performed. Statistical analysis with calculation of odds ratio was also carried out.

Results. Significant (p<0.05) hysteroscopic predictors of recurrence of intrauterine synechiae were: endometrial atrophy/hypoplasia (OR, 4.515; 95% CI 1.396–14.638), partial/complete isthmic obliteration (OR 3.906; 95% CI 1.521–10.010), endometrial micropolyposis (OR 2.908; 95% CI 1.047–8.065), no visualization of fallopian tubes (OR 2.722; 95% CI 1.258–5.882), diffuse hyperemia of the uterine cavity (OR 2.384; 95% CI 1.060–5.348) and severe adhesive-fibrotic lesions (OR 2.153; 95% CI 1.150–4.031).

Conclusion. The results obtained indicate the leading role of chronic inflammation and endometrial fibrosis in the pathogenesis of recurrent synechiae.

Keywords:intrauterine synechiae; recurrence; hysteroscopy; predictors

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