| Abstract: | Objective To observe the clinical efficacy and pregnancy outcome of hysteroscopic cold knife system in patients with moderate and severe intrauterine adhesions who planned to undergo assisted reproduction. Methods Patients with moderate and severe intrauterine adhesions who planned to undergo assisted reproduction were retrospectively analyzed and divided into cold knife group and electric energy group according to different surgical methods. The basic data and surgical data of all patients were collected, and the pregnancy outcomes of patients were followed up. Results （1） A total of 120 patients were collected in this experiment, including 60 patients in cold knife group and 60 patients in electric energy group. There were no significant differences in operation time, intraoperative blood loss, intraoperative complications, postoperative pregnancy rate and live birth rate between the two groups （P > 0.05）. In the cold knife group, the proportion of the uterine cavity shape and endometrium restored to the condition of transplantation after two operations was 63.3%; Electrical energy group accounted for 43.3%. The median gestational month of the cold knife group was 2.5 months, which was 1 month earlier than that of the electric energy group. （2） To the extent to which caused by intrauterine adhesions, cold knife group, patients with severe caused by intrauterine adhesions in operative time and intraoperative blood loss and postoperative pregnancy rate and live-birth rate no statistical difference （P > 0.05） electrical energy group of uterine cavity adhesion of surgery in patients with severe bleeding amount of time and have more moderate caused by intrauterine adhesions, and statistically significant （P < 0.005）. In the electrical energy group, only 7.7% of the patients with severe adhesions who achieved transplantation conditions after two operations were the lowest among all groups. Conclusions For the patients with moderate and severe intrauterine adhesions who need embryo transfer, the hysteroscopic cold knife system is safe and effective, and the number of operations to break down the adhesions to meet the intimal conditions of embryo transfer is less than that of electric energy instruments. For the pregnancy rate after transplantation, the method of operation and the degree of intrauterine adhesion did not affect the pregnancy rate and live birth rate. |
