Intrauterine adhesions (IUA): has there been progress in understanding and treatment over the last 20 years?

Gynecological Surgery

Table 3 Classifications of IUA by the European Society for Hysteroscopy (ESH), 1989

Grade	Extent of intrauterine adhesion
I	Thin or filmly adhesion
	Easily ruptured by hysteroscope sheath alone
	Cornual areas normal
II	Singular firm adhesions
	Connecting separate parts of the uterine cavity
	Visualization of both tubal ostia possible
	Cannot be ruptured by hysteroscope sheath alone
IIa	Occluding adhesions only in the region of the internal cervical os
IIa	Upper uterine cavity normal
III	Multiple firm adhesions
	Connecting separate parts of the uterine cavity
	Unilateral obliteration of ostial areas of the tubes
IIIa	Extension scarring of the uterine cavity wall with amenorrhoea or hypomenorrhoea
IIIb	Combination of III and IIIa
IV	Extensive firm adhesion with agglutination of uterine walls
IV	At least both tubal ostial areas occluded