Alternativas terapéuticas para el manejo del síndrome de Asherman

Abstract

Asherman's syndrome represents a health problem, because it causes gynecological alterations that affect the menstrual cycle and reproductive function. Currently, the hysteroscopy used to remove adhesions fails to recover the endometrial anatomy, so the percentage of recurrences is high, and the pregnancy rate is low, therefore, adjuvant methods are needed to avoid or reduce these recurrences and improve the receptivity. The objective of this bibliographic review was to describe the main adjuvant therapeutic alternatives used in the postoperative management of recurrences of Asherman's Syndrome. For this, a search was made in the Google Scholar, PubMed and Springer databases, a total of 898 articles were found, those that had other study variables such as: abortion, infertility, pregnancy, those that did not have a text were excluded. complete and those whose publication date was before 2017, in the end 32 articles were selected. Results: estrogens in combination with progesterone at low doses help improve endometrial function, on the other hand, the IUD with hyaluronic acid represents the best option for a good endometrial repair. Conclusion: the use of solid barriers combined with gels and hormonal therapy constitutes the most effective alternative in the treatment of recurrences of Asherman's syn drome, and advances in stem cell therapy guarantee total recovery, but there are still limitations that prevent their use.