Abstract：Objective To introduce an integrated therapy for women with moderate and severe intrauterine adhesion (IUA) and evaluate its reproductive outcome.Methods Seventy-five patients with IUA who had expected fertility and received an integrated therapy were retrospectively studied. The correlation of menstrual pattern, adhesion degree and adhesion reformation with the conception rate were analyzed.Results The mean age of these patients was (32.1±5.1) years old. The improvement rate of menstrual pattern was 78.7 %. The overall conception rate was 61.3 %. The conception rate was 76.6% for those with moderate IUA and 35.7% for severe cases of IUA (P<0.05). Logistic regression analysis showed that the preoperative adhesion degree and postoperative menstrual pattern were independent risk factors for pregnancy. The adhesion reformation rates during the second and third hysteroscopy were both 50%. There was significant difference in the adhesion reformation rate between moderate and severe cases of intrauterine adhesion(P<0.05). There were three (2.7%) cases of TURP syndrome during operation, which were quickly discovered and rescued.Conclusions The adhesion degree and menstrual pattern are independent risk factors for pregnancy, This integrated therapy can ensure better clinical effect for moderate and severe IUA patients, especially in restoring menstrual function and fertility.
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