Uterine adhesion: Is luteal phase prior to follicular phase in uterine adhesiolysis?

To compare the patients’ outcomes of Asherman syndrome who underwent uterine adhesiolysis in luteal phase or follicular phase. A retrospective cohort study. A tertiary hospital in China. Four hundred sixty-four women suffered intrauterine adhesion who underwent monopolar adhesiolysis from March 2014 to March 2017 were analyzed. One hundred seventy-eight patients underwent operations in follicular phase (OFP) and 286 underwent operations in luteal phase (OLP). Hormone therapy was accompanied with an intrauterine device and a second-look hysteroscopy was performed postoperatively. Endometrial thickness in women was analyzed by a transvaginal 3-dimensional ultrasound examination. Re-adhesion was confirmed by a second-look hysteroscopy 3 months after hysteroscopic adhesiolysis. Pregnancy rate was acquired by questionnaires 3 months after a second-look hysteroscopy. OLP has advantages with thicker luteal endometrium (P = .001), higher pregnancy rates (P < .001), and lower re-adhesion rates (P = 0015) compared to these values of OFP. For Asherman syndrome, our study showed that OLP is more feasible than OFP in intrauterine adhesiolysis.