Résumé
Background: Intrauterine adhesions (IUAs) or synechiae consist of partial or total (Asherman's syndrome) apposition of the walls of the uterus and are the most common complications after operative hysteroscopy in patients of reproductive age. Occurrence rates can range from 4% to 45%. These adhesions cause several complications, including obstetrical complications. Objective: The aim of this research was to develop a model of intrauterine adhesions (IUA) in rabbits undergoing uterine curettage and study the impact on fertility. Materials and Methods: This study involved 40 uterine horns in 20 New Zealand white rabbits who were randomly divided into two groups. The 10 rabbits in Group 1 (n = 20 horns) underwent dual uterine-horn mechanical damage on days 1 and day 10, via abdominal insertion and abrasion of the mucosa with a 3-mm curette. The 10 rabbits in group 2 (n = 20 horns) served as controls who did not undergo curettage. All 20 rabbits were allowed to mate with male New Zealand rabbits 30 days after the surgical damage was performed, and, at 21 days, the female rabbits were subjected to ultrasound testing to confirm the pregnancies. Laparotomy and was also performed on all of the rabbits. The number of embryos was recorded for each group. Hysteroscopy was performed at 30 days to look for the presence of IUAs. Results: In group 1, 35 pregnancies were noted with an average of 1.58 (0-7) uterine pregnancies versus 64 in group 2 with an average of 2.05 uterine pregnancies (0-6; p = 0.004). Three rabbits died during hysteroscopy. Conclusions: Curettage seems have consequences that affect fertility. Beyond objectifying the impact of tubal adhesions on fertility, this pilot study, if it is extended to a larger cohort could help to understand IUA-formation mechanisms better.