173 © Springer Nature Singapore Pte Ltd. 2021 R. Manchanda (ed.), Intra Uterine Adhesions, https://doi.org/10.1007/978-981-33-4145-6_14 L. Alonso Pacheco (*) Gynecology Endoscopy Unit, Centro Gutenberg, Malaga, Spain Unidad de Reproducción Asistida Hospital Quirónsalud, Malaga, Spain J. Carugno · D. Timmons Department of Obstetrics, Gynecology and Reproductive Sciences, University of Miami, Miller School of Medicine, Miami, FL, USA M. G. Sanchez Unidad de Reproducción Asistida Hospital Quirónsalud, Malaga, Spain 14 Complications and Fertility Potential Following Adhesiolysis Luis Alonso Pacheco, Jose Carugno, Douglas Timmons, and Marta Garcia Sanchez 14.1 Introduction The presence of intrauterine adhesions and the association with secondary amenor- rhea were frst described by Dr. Fritsh in 1894. In 1948, Dr. Joseph G. Asherman published a series of papers describing the etiology, symptoms, imaging fndings, and fertility outcomes, and the condition has been known as Asherman’s syndrome (AS) since. Asherman’s syndrome was primarily described as an outcome of trauma to the basal layer of the endometrium, with subsequent formation of fbrotic adhe- sions leading to either partial or complete obstruction of the cervical canal or uterine cavity resulting in menstrual abnormalities, infertility, or recurrent pregnancy loss [1]. The initial defnition of AS included confrmed IUAs with clinical features of amenorrhea, infertility, or recurrent pregnancy loss; however, today the presence of IUAs regardless of additional clinical features is often referred to as AS. For many, the terminologies Asherman’s syndrome (AS), intrauterine adhesions (IUA), and intrauterine synechiae (IUS) are interchangeable. The exact prevalence of AS is diffcult to identify as a large proportion of patients have no symptoms. The last worldwide investigation found that the high- est prevalence of AS has been found in Israel, Greece, and South America [2]. AS was initially described to occur following trauma to a gravid uterus. Curettage in the postpartum period, following a spontaneous abortion or during an elective