Women with Asherman's syndrome who have confirmed intrauterine adhesions but decline surgical intervention, yet wish to conceive, require a clearly structured, non-operative management approach tailored to this specific situation.
Intrauterine adhesions (IUAs) confirmed — patient does not wish surgical intervention; conception is desired. This patient profile calls for a defined management path that respects the patient's preference while keeping reproductive goals in view.
The structured protocol centres on expectant management. The complete guidance — including specific considerations, monitoring, and follow-up parameters — is set out in the full protocol below.
Resumption of menstruation and subsequent pregnancy. Reaching these goals may require a prolonged interval from the time of diagnosis, making a clear, evidence-based plan from the outset important.
For women with IUAs who do not wish any intervention but still want to conceive, expectant management may result in subsequent pregnancy, however the time interval may be prolonged.
The limited data supporting a role for expectant management, published in 1982, demonstrated resumption of menstruation in as many as 78% within 7 years from diagnosis of IUAs and pregnancy in 45.5% of women.
DOI: 10.1016/j.jmig.2016.11.008
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