Significance of intrauterine adhesions detected hysteroscopically in eumenorrheic infertile women and role of antecedent curettage in their formation.

The increasing use of hysteroscopy as a diagnostic tool in the infertile woman has shown that intrauterine adhesions are of more concern, especially in eumenorrheic women, than previously was recognized. Their significance is not yet clear. This study was designed to compare the incidence of such lesions detected hysteroscopically in 235 women with otherwise unexplained infertility with their incidence in a group of 31 potentially fertile women. The outcome after treatment was recorded. The effect of curettage in the production of these adhesions was examined. The incidence of adhesions in the infertile group was considerably greater than in the potentially fertile group (p less than 0.05). A 50% pregnancy rate was achieved by lysis of adhesions. An antecedent history of curettage was associated with a significantly higher incidence of adhesion formation than that found in noncuretted patients (p less than 0.0005).