Analysis Of Factors Related To Reproductive Outcome After Separation Of Intrauterine Adhesions By Heos Cold Scissors

Objective:Through collecting clinical data,get the effect of HEOS cold scissors in separating intrauterine adhesions,and analyze the factors related to reproductive outcome after separation of intrauterine adhesions by HEOS cold scissors,so as to provide a basis for judging whether the reproductive outcome of patients with intrauterine adhesions with fertility requirements is good or not after using HEOS cold scissors in the future.Methods:The clinical data of patients with intrauterine adhesions treated by HEOS cold scissors from May 2013 to October 2017 in the Department of Gynecology of Zhongda Hospital affiliated to Southeast University were retrospectively analyzed,including age,course of disease,degree of adhesions,anti-adhesions measures,and follow up their menstruation and reproductive outcomes by telephone.Using SPSS18.0 statistical software,univariate and multivariate logistic regression analysis was carried out on the related factors that may affect reproductive outcomes.Results:General information: A total of 158 patients with intrauterine adhesions were enrolled in this study.The average age was(31.32 + 4.30).The menstrual improvement rate was 80.3%,the total pregnancy rate was 60.1%,and the live birth rate was 55.8%.Postoperative review: The rate of re-adhesion was 14.3% in patients with mild adhesions,28.6% in patients with moderate adhesions and 65.2% in patients with severe adhesions 1-3 months after hysteroscopy.There was a significant difference between the degree of adhesions and the rate of re-adhesions after hysteroscopy(P <0.05).The relationship between various factors and reproductive outcome: course ofdisease,postoperative period,adhesion scope,adhesion type,adhesion degree and recurrence were significantly related to the pregnancy(P<0.05);age,times of uterine cavity operations,preoperative period,electricity cutting,anti-adhesion measures had no statistical significance with preoperative reproductive outcome(P>0.05);recurrence was the independent parameter related to the reproductive outcome.The relationship between electricity cutting and recurrence: 18 cases had electricity cutting before HEOS cold scissors separation of intrauterine adhesions,and13 cases recurrence(72.2%),140 cases had no electricity cutting separation of adhesions,and 45 cases had recurrence(32.1%).There was statistical significance between electricity cutting and recurrence(P<0.05).Conclusions:Separation of intrauterine adhesions by HEOS cold scissors can significantly improve the postoperative menstrual status of patients,as well as improve pregnancy rate and live birth rate.HEOS cold scissors is effective in treating mild and moderate adhesions,but it is not very effective in treating severe adhesions.Course of disease,postoperative period,adhesion scope,adhesion type,adhesion degree and recurrence were main factors affecting reproductive outcome after separation of intrauterine adhesion by HEOS cold scissors.Separation of intrauterine adhesions by electricity cutting may increase the incidence of recurrence.HEOS cold scissors as a kind of operation method with little damage to endometrium and uterine cavity environment,may be the primary choice for fertility-desiring patients with intrauterine adhesion.