New hysteroscopic technique dramatically lowers scar risk after miscarriage surgery
A study led by surgeon Kirsten Sasaki shows that hysteroscopic morcellation results in far fewer intrauterine adhesions than the traditional dilation and curettage.
Kirsten Sasaki, a gynecologic surgeon at CCRM Fertility, published the largest cohort study to date on miscarriage-related surgery, revealing that hysteroscopic morcellation yields an adhesion rate of just 0.6% compared with the 17% reported for traditional dilation and curettage in a 2025 meta-analysis. The study examined 208 patients treated at two Illinois sites from 2019 through 2024, most of whom received care in office settings.
Unlike D&C, which relies on tactile feedback, hysteroscopic morcellation uses a camera and ultrasound guidance to remove tissue under direct view, eliminating blind scraping. The research underscores that adhesions can cause menstrual changes, infertility, and severe pregnancy complications, adding costly downstream procedures. Economic data show that D&C can cost uninsured patients $8,000-$9,000, with additional expenses for adhesion correction and related complications. Sasaki argues that broader adoption of the visualized method could reduce these health and financial burdens, especially for underserved populations who more often receive emergency D&C care.
Why it matters
The safer technique could prevent infertility and lower medical costs for women after miscarriage.
In this story
