Comparison of the localization of intrauterine adhesions in pregnant and infertile women.

Objective: Intrauterine adhesion (IUA) is the formation of band-shaped fibrotic tissues in the endometrial cavity due to uterine procedures. Most adhesions remain asymptomatic and do not affect fertility or pregnancy conditions. However, they may lead to infertility and pregnancy complications in some women. This study aimed to determine which localization and type of IUA may lead to infertility.

Materials and methods: Seventy-six women with IUA were retrospectively scanned. Thirty-nine women with IUA with uterine factor-related infertility were included in the infertility group. Thirty-seven pregnant women, who had adhesions in the second-trimester ultrasonography and who had a live birth via cesarean section at term, were included in the pregnancy group. The localization of adhesions was determined as the fundus, corpus, isthmus, and cornu. Concerning the type of adhesion, the adhesions were classified as dense- and film-type adhesions.

Results: The infertility group was compared with the pregnancy group according to the type and localization of the adhesions. Fundal adhesions were significantly higher in the infertility group compared to the pregnancy group (p<0.05). The isthmic adhesions, however, were more common in the pregnancy group than in the infertility group (p<0.05). Dense-type adhesions were more common in the infertility group than in the pregnancy group (p<0.05).

Conclusion: According to the localization and types of adhesions, fundal and dense-type adhesions are among the features of uterine factor-related infertility. However, isthmus-located and film-type adhesions may not cause infertility.