UNVEILING THE IMPACT OF INTRAUTERINE ADHESIONS ON INFERTILITY: A COMPARATIVE JOURNEY THROUGH PRIMARY AND SECONDARY INFERTILITY PATIENTS

Authors

  • Loredana TOMA ‟Grigore Popa” University of Medicine and Pharmacy Iași
  • Daniela MATEI ‟Grigore Popa” University of Medicine and Pharmacy Iași
  • Demetra SOCOLOV ‟Grigore Popa” University of Medicine and Pharmacy Iași
  • Laura RISCANU ‟Grigore Popa” University of Medicine and Pharmacy Iași
  • Sorana ANTON ‟Grigore Popa” University of Medicine and Pharmacy Iași
  • Andreea PRUTEANU “Elena Doamna” Clinical Hospital of Obstetrics and Gynecology Iasi
  • Raluca BALAN ‟Grigore Popa” University of Medicine and Pharmacy Iași
  • E. ANTON ‟Grigore Popa” University of Medicine and Pharmacy Iași
  • Roxana COVALI ‟Grigore Popa” University of Medicine and Pharmacy Iași
  • Mihaela CORLADE-ANDREI ‟Grigore Popa” University of Medicine and Pharmacy Iași
  • B. CIUNTU ‟Grigore Popa” University of Medicine and Pharmacy Iași
  • R. SOCOLOV ‟Grigore Popa” University of Medicine and Pharmacy Iași

Abstract

Intrauterine adhesions (IUAs) represent an important cause of infertility, having various effect in patients with primary and secondary infertility. The objective of the study is to evaluates the clinical, demographic, and intraoperative characteristics of patients with IUAs, focusing the correlation between hysteroscopic and laparoscopic tubal patency assessment and infertility type. Materials and methods: A retrospective descriptive study was conducted between 2016 and 2024 at two hospitals in Iasi, Romania: Clinical Hospital of Obstetrics and Gynecology “Elena Doamna” and “Cuza-Vodă”. Medical records identified 134 patients with IUAs, of whom only 102 patients met the inclusion criteria and divided in two groups: primary and secondary cohorts. All patients underwent hysteroscopic adhesiolysis to restore the anatomy of uterine cavity, with perioperative tubal patency evaluation and confirmed laparoscopically in most cases. Results: Patients with IUAs and primary infertility were younger (31.66 vs. 34.13 years; p=0.023) and predominantly aged 25-34 years, whereas IUAs patients and secondary infertility was more common in those over 35 years. Secondary infertility subjects showed higher rates of repetitive dilation and curettage (77%, p=0.001), ectopic pregnancies (6.6%, p=0.04). Hysteroscopic and laparoscopic tubal patency revealed a higher patency rate in secondary infertility cases (90.2%) compared to primary infertility cases (73.2%, p=0.038). Bilateral positive patency through the laparoscopic Dye test was more common in primary infertility cases (61% vs. 41%, p=0.029). This study highlights distinct clinical and intraoperative characteristics between primary and secondary infertility in patients with AIUs. Secondary infertility was significantly associated with higher rates of previous D&Cs, increased hysteroscopic and laparoscopic tubal patency rates and ectopic pregnancies. Conclusions: This study emphasize the importance of tailored diagnostic and therapeutic approaches to optimize outcomes for patients with IUAs and infertility.

Author Biographies

  • Loredana TOMA, ‟Grigore Popa” University of Medicine and Pharmacy Iași

    Faculty of Bioengineering,
    Department of Medical Bioscience
    “Elena Doamna” Clinical Hospital of Obstetrics and Gynecology Iasi

  • Daniela MATEI, ‟Grigore Popa” University of Medicine and Pharmacy Iași

    Faculty of Bioengineering,
    Department of Medical Bioscience

  • Demetra SOCOLOV, ‟Grigore Popa” University of Medicine and Pharmacy Iași

    Faculty of Medicine,
    Department of Mother and Child Medicine
     “Cuza-Vodă” Clinical Hospital of Obstetrics and Gynecology Iasi

  • Laura RISCANU, ‟Grigore Popa” University of Medicine and Pharmacy Iași

    Faculty of Medicine,
    Department of Morpho-functional Sciences (I)

  • Sorana ANTON, ‟Grigore Popa” University of Medicine and Pharmacy Iași

    Faculty of Medicine,
    Department of Mother and Child Medicine
    “Cuza-Vodă” Clinical Hospital of Obstetrics and Gynecology Iasi

  • Raluca BALAN, ‟Grigore Popa” University of Medicine and Pharmacy Iași

    Faculty of Medicine,
    Department of Morpho-functional Sciences (I)
     “Elena Doamna” Clinical Hospital of Obstetrics and Gynecology Iasi

  • E. ANTON, ‟Grigore Popa” University of Medicine and Pharmacy Iași

    Faculty of Medicine,
    Department of Mother and Child Medicine
    “Elena Doamna” Clinical Hospital of Obstetrics and Gynecology Iasi

  • Roxana COVALI, ‟Grigore Popa” University of Medicine and Pharmacy Iași

    Faculty of Bioengineering,
    Department of Medical Bioscience
    “Elena Doamna” Clinical Hospital of Obstetrics and Gynecology Iasi

  • Mihaela CORLADE-ANDREI, ‟Grigore Popa” University of Medicine and Pharmacy Iași

    Faculty of Medicine,
    Department of Surgery (I)

  • B. CIUNTU, ‟Grigore Popa” University of Medicine and Pharmacy Iași

    Faculty of Medicine,
    Department of Surgery (I)

  • R. SOCOLOV, ‟Grigore Popa” University of Medicine and Pharmacy Iași

    Faculty of Medicine,
    “Elena Doamna” Clinical Hospital of Obstetrics and Gynecology Iasi

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Additional Files

Published

2024-12-23