Received October 25, 2021
Accepted April 30, 2022

Objective: To evaluate reproductive outcomes after hysteroscopic adhesiolysis for patients with Asherman syndrome (AS) who presented with infertility and/or subfertility. Methods: A retrospective study was conducted in Women's Specialized Hospital, King Fahad Medical City, from December 2010 to December 2018. Medical records were reviewed for all infertile women who had hysteroscopic adhesiolysis. The specific study’s main reproductive outcomes included: [1] the overall rate of conception, [2] the overall rate of conception according to the severity degree of intrauterine adhesions (IUAs), [3] the reproductive methods of achieving conception, and [4] the outcomes of the pregnancy. Reproductive methods of conception included spontaneous conception, ovulation induction (OI), intrauterine insemination (IUI), and in-vitro fertilization (IVF) with/without intracytoplasmic sperm injection (ICSI). Outcomes of pregnancy included ectopic pregnancy, miscarriage, and live birth events. Results: Forty-one patients (n=41) were analyzed. Their mean age was 32.2 ± 4.6 years. The most common menstrual pattern amongst these patients was hypomenorrhea 46.4%. All patients resumed regular menstrual cycles after the adhesiolysis procedure. The overall conception rate during 24 months follow up was 53.6%, and the overall live birth rate was 34.2%. Of the 22 patients who conceived, 12 patients (29.2%) conceived spontaneously, 2 (4.9%) with IUI, and 8 (19.5%) with IVF-ICSI. Patients with minimal IUAs had a significantly higher pregnancy rate (71.4%) than rates with moderate (47%) and severe (40%) IUA groups (two-tailed log-rank test, P=0.041). Conclusion: The spontaneous cumulative conception rate following hysteroscopic adhesiolysis was higher in patients with minimal IUAs than those with moderate and severe IUAs.