Author: HSIEN-AN PAN MD.PHD. (This article is also published in Zhonghua Daily)

 

Ms. Mu, aged 29, has been married for two years and has been unable to conceive. After having two abortions before marriage, her menstrual flow decreased significantly, but she still had regular periods until six months ago when her menstrual flow became very light and she experienced severe dysmenorrhea. After undergoing a uterine tubal perfusion test, it was discovered that she has uterine adhesions. The doctor recommended a hysteroscopy procedure. Ms. Mu is anxious about the potential risks of the surgery and is unsure if it could be dangerous for her.

 

With the increasing openness in society, premarital sexual activities have become more socially acceptable. However, it is regrettable that a significant number of young men and women still lack sufficient knowledge about contraception. As a result, after every festive season, there is a surge in the number of abortions.

 

Artificial abortion naturally becomes the quickest solution. However, one must not underestimate the significance of this minor surgical procedure. It still requires an experienced gynecologist to perform it in order to avoid unnecessary side effects. One of the most common consequences observed after multiple artificial abortion surgeries is a significant reduction or even absence of menstrual blood flow, sometimes accompanied by the occurrence of dysmenorrhea.

 

If these symptoms occur, there may be suspicion of uterine adhesions, and a uterine tubal patency test, such as a hysterosalpingogram, is necessary for an accurate diagnosis. If the examination confirms the presence of adhesions, the next step would involve the physician arranging a hysteroscopy examination and treatment for the patient. Hysteroscopy is a surgical procedure performed on the patient under general or regional anesthesia. Using specialized instruments, the physician enters the uterine cavity through the cervix to locate and remove the adhesions.

 

After the surgery, it is essential to restore the original shape of the uterine cavity as much as possible. Therefore, it should be performed by a highly experienced physician who can closely monitor the patient's response to prevent complications such as water intoxication and hyponatremia. Even after the removal of adhesions within the uterine cavity, there is a high possibility of reformation in the short term. Therefore, it is common practice to insert a contraceptive device into the uterine cavity after the surgery to prevent adhesions from recurring. Additionally, hormonal therapy is used to promote rapid growth of the functional endometrium. After three months, the contraceptive device is removed.

 

Uterine adhesions indeed cause infertility in many individuals. Therefore, when the above-mentioned symptoms arise, it is important to undergo a thorough examination and treatment as early as possible. Generally, the earlier the treatment is administered, the higher the chances of successful pregnancy in the future. Delaying treatment due to hesitation or reluctance can jeopardize the opportunity to conceive and may result in missed chances of parenthood.