Objective To investigate factors affecting reproductive prognosis in patients with moderate to severe uterine adhesions after Hysteroscopic Cold Knife Separation.Methods A total of 215 patients with moderate to severe intrauterine adhesions,who were diagnosed in Wenzhou People's Hospital between May 2017 and May 2019,were selected and underwent comprehensive treatment based on hysteroscopic cold knife separation surgery.The relevant clinical indicators before and after the operation were counted,and the reproductive outcomes within 3 years after the operation were followed up.Results The overall pregnancy rate in 215 patients with moderate-to-severe IUA was 66.98%,with a live birth rate of 50.23%.Of these,206 pregnancies were naturally conceived,resulting in 139 pregnancies.The rate of improvement in IUA grading after treatment was 89.8%.Univariate analysis revealed statistically significant differences in pregnancy rates among various factors,including age,disease duration,number of miscarriages,pre-treatment endometrial thickness,and post-treatment endometrial thickness(P<0.05).Multivariate logistic regression analysis showed that age,course of disease,endometrial thickness before treatment,and improvement of IUA grade were independent factors affecting pregnancy in patients with moderate to severe IUA(P<0.05).Conclusion Age,course of disease,endometrial thickness before treatment,and improvement of IUA grade are important factors affecting the reproductive outcome of patients with moderate to severe intrauterine adhesions.
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