Objective:To analyze the reproductive outcomes of moderate and severe intrauterine adhesions after transcervical resection of adhesions（TCRA）. Methods:A retrospective analysis was carried out to explore the clinical data of 506 patients with moderate or severe intrauterine adhesions who were hospitalized in Nanjing Maternity and Child Care Center from January 2011 to December2014. And they all underwent the TCRA surgery successfully for the first time. The pregnancy and live birth rates

the ratio of term birth

abortion

and premature birth

and the intrapartum complications of patients with two different adhesions degrees were separately calculated. Results:（1）This study contained 506 patients of IUA

274 moderate cases and 232 severe cases;90.51% of all cases had experienced hypomenorrhea even amenorrhea. The incidence of hypomenorrhea and secondary infertility in severe group was significantly higher than that of moderate group（P=0.000）.（2）A total of 433 cases were followed up and the follow-up rate was 85.57%.406 of them had fertility requirements（93.76%）;the total pregnancy rate was 57.64%（234/406）

and the total live birth rate was34.98%（142/406）. The pregnancy rate of 67.11%（151/225）in moderate group was significantly higher than that of 45.86%（83/181）in severe group（P=0.000）. The live birth rate of 25.97%（47/181）in severe group was significantly lower than that of 42.22%（95/225）in moderate group（P=0.01）.（3）Among all the pregnant patients

the constituent ratio of full-term birth and abortion was 46.58%and 32.05%

respectively. In severe group

the constituent ratio of full-term birth was lower than that in the moderate group

and the abortion constitution ratio was higher than that in the moderate group

but there was no statistically significant difference（P=0.466

P=0.198）. There were 178 cases of postpartum hemorrhage

placenta adhesion

placenta praevia and placenta implantation. The placenta implantation was significantly higher in severe group than in moderate group

the difference was statistically significant（P=0.045）.Conclusion:The reproductive outcome of moderate IUA is better than that of severe intrauterine adhesions.