Outcome of hysteroscopic resection of submucous myomas for infertility.

OBJECTIVE: To examine the reproductive outcome after operative hysteroscopic resection of submucous myomas in women for whom no other infertility factor was identified. DESIGN: Fifteen infertile women with submucous myomas underwent an intensive workup to exclude other causes of infertility. Operative hysteroscopy for resection of the submucous myomas was performed using a rigid 26 French resectoscope (Karl Storz GmbH & Co., Tuttlingen, Germany). SETTING: Academic tertiary referral center. RESULTS: The mean +/- SD duration of the procedure was 25.5 +/- 5.6 minutes. No operative or postoperative complications occurred and all patients were discharged within 6 hours. The follow-up period was 12.0 +/- 4.2 months (mean +/- SD). Seven women conceived (pregnancy rate of 47%) and six of them subsequently delivered at term. CONCLUSION: The results of this study indicate that operative hysteroscopy achieved a pregnancy rate comparable to myomectomy via laparotomy. These results suggest that operative hysteroscopy is the procedure of choice for the resection of submucous myomas in infertile women.

Reproductive outcome following hysteroscopic management of intrauterine septum and adhesions.

The reproductive outcome of women with repeated abortions or infertility was assessed following treatment by operative hysteroscopy for an intrauterine septum or adhesions. A prospective follow-up study (mean +/- SD, 21.1 +/- 10.3 months) of 47 patients with an intrauterine septum (36 suffering from infertility and 11 from recurrent abortions) and 36 patients with intrauterine adhesions (24 complaining of infertility and 12 of recurrent abortions) was performed. The pregnancy rate in infertile women following hysteroscopic resection of an intrauterine septum or adhesions was 53 and 48% respectively. The pregnancy wastage in women with recurrent abortions who underwent hysteroscopic resection of an intrauterine septum or adhesions decreased postoperatively from 87.5 to 44.4% and from 86.5 to 42.8% respectively. Our results suggest that hysteroscopic resection of an intrauterine septum or adhesions may benefit patients suffering from infertility or recurrent pregnancy wastage.