Asherman's syndrome classification
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Editor(s)-in-Chief: C. Michael Gibson, M.S.,M.D. [1] Phone:617-632-7753; Canan S Fornusek, Ph.D.; Associate Editor-In-Chief: M.Umer Tariq [2]
Overview
Classification of IUA
As severity of the condition correlates with prognosis, classification of IUA is useful for choosing the treatment method and providing a prognosis relating to fertility outcome following treatment. Several classification systems have been proposed for Asherman’s syndrome, although none of them is currently endorsed universally. The older systems were based on hysterosalpingography findings however with the advent of hysteroscopy modern classification systems are based on hysteroscopic diagnosis of adhesions. Those of the American Fertility Society [1] , the European Society for Hysteroscopy [2]and Nasr's proposed system [3] are the most complex, taking into account several criteria. There is variation between criteria used in these systems but they include type of adhesions, location, extent of the uterine cavity affected, clinical symptoms, menstrual characteristics or history, and/or obstetric history. The precision in these systems may make them difficult to apply in practice because the boundaries between grade subtypes are sometimes subtle. None of these classification systems have been validated by clinical studies, and research reporting treatment outcomes often lack details on exact IUA grades in patients. This adds to the difficulties in comparing study outcomes in patients treated for Asherman's syndrome.
References
- ↑ American Fertility Society (1988). "The American Fertility Society classification of adnexal adhesions, distal tubal occlusions secondary to tubal ligation, tubal pregnancy, mullerian anomalies and intrauterine adhesions". Fertil Steril. 49 (6): 944–55. PMID 3371491.
- ↑ {{cite journal |author=Wamsteker K, DeBlok SJ |title=Diagnostic hysteroscopy: technique and documentation. |journal=Endoscopic surgery for gynecologist New York:Lippincott Williams & Wilkins Publishers |pages=263-76 |year=1995
- ↑ Nasr AL, AL-Inany HG, Thabet SM, Aboulghar M (2000). "A clinicohysteroscopic scoring system of intrauterine adhesions". Gynecol Obstet Invest. 50 (3): 178–81.