关键词: 宫腔镜, 妊娠结局, 子宫疾病, 黏连, 不育, 女（雌）性

Abstract: Objective：To analyze the efficacy and the reproductive outcome of hysteroscopic adhesiolysis. Methods：A total of 40 patients diagnosed with intrauterine adhesion received hysteroscopic adhesiolysis in The Sixth Affiliated Hospital of Sun Yat-Sen University from January 2014 to December 2016. The thickness of the endometrium and the reproductive outcome were observed. Results：Among the 40 patients (25 with moderate IUA, and 15 with severe IUA) who underwent hysteroscopic adhesiolysis, 19 cases use the bipolar electrode knife cutting adhesion, while 21 cases using micro-scissors. The reproductive outcome of 40 women underwent 64 assisted reproductive technology cycles were observed. The mean endometrial thickness and thin endometrium rate of the bipolar electrode knife group were 7.0 (6.0~9.3) mm and 46.9%, while 8.0 (7.0~9.8) mm and 31.3% in the micro-scissors group, no statistical significance was found between the two groups (P＞0.05). The implantation rate, conception rate, live birth rate, miscarriage rate and ongoing rate after hysteroscopic adhesiolysis in the bipolar electrode knife group were 46.9%, 37.5%, 18.8%, 6.3% and 12.5%, respectively, while in the micro-scissors group were 34.4%, 28.1%, 12.5%, 3.1% and 12.5%, respectively (P＞0.05). The average conception time of bipolar electrode knife group was 7.5 (4.0~12.0) months longer than the micro-scissors group 3.0 (3.0~8.5) months, the difference reached statistical significance (P＜0.05). Conclusions：Hysteroscopic adhesiolysis is an effective and safe option for IUA patients that can improve the reproductive outcome, different methods of operation does not affect the reproductive outcome.

Key words:  Hysteroscopes, Uterine diseases, Adhesions, Infertility, female