INTRAUTERINE ADHESIONS (ASHERMAN SYNDROME): CURRENT PERSPECTIVES ON ETIOLOGY, DIAGNOSIS, PREVENTION, AND TREATMENT (LITERATURE REVIEW)

Intrauterine adhesions (Asherman syndrome) are recognized as one of the major causes of secondary infer­tility, menstrual disorders, and recurrent pregnancy loss. Despite more than seventy years of research into this con­dition, a unified standardized approach to its diagnosis, prevention, and treatment has not yet been established. This literature review summarizes current evidence on the etiology and pathogenesis of intrauterine adhesions, methods of diagnosis, and classification systems. It also analyzes existing strategies for the primary and secondary prevention of adhesion recurrence, including barrier agents, intrauterine devices, and hormonal therapy. Particular attention is given to a promising therapeutic approach involving cell-based technologies using autologous bone marrow-derived and menstrual-derived stem cells. The review was prepared based on an analysis of the clinical guidelines of the Society of Obstetricians and Gynaecologists of Canada (SOGC, 2010), the joint practice guidelines of the American Association of Gynecologic Laparoscopists (AAGL) and the European Society for Gynaecological Endoscopy (ESGE, 2017), as well as the original clinical study on menstrual stromal cell transplantation conducted by Tan et al. (2016).