Hysteroscopic treatment of septate uterus with Neodymium-YAG laser.
OBJECTIVE
To determine the effectiveness of Neodymium-YAG (Nd-YAG) laser for hysteroscopic transection of the septate uterus to improve pregnancy outcome.


METHODS
Patients treated for recurrent pregnancy loss and/or infertility were evaluated for before versus after treatment pregnancy outcomes.


METHODS
All patients were referred to a University Reproductive Endocrine and Infertility practice from 1986 through 1990.


METHODS
Nineteen patients underwent hysteroscopic transection of uterine septa after exclusion of other factors that may cause recurrent fetal wastages and/or infertility. They were allowed to conceive 8 weeks after surgery after a postoperative hysterosalpingogram. Fourteen women attempted conception during a time span of 11 to 42 months; 3 patients declined to conceive, and 2 were lost to follow-up.


METHODS
Hysteroscopic transection of the uterine septum with a Nd-YAG laser was performed in all patients. The Nd-YAG laser delivered via a 600-microns bare fiber or an 800-microns sculpted fiber through operative hysteroscopy.


METHODS
To evaluate the success and complications of this new laser technique.


RESULTS
(1) Thirteen patients conceived; 10 delivered a live infant at term; (2) 87% of the postoperative pregnancies were considered successful as compared with 11% preoperative; (3) complications included a small perforation of the uterus (no treatment needed) and development of uterine adhesions (1 case only).


CONCLUSIONS
Hysteroscopic metroplasty with the Nd-YAG laser is a valuable alternative new technique for the treatment of uterine septum.
Choe
J K
JK
Department of Obstetrics and Gynecology, University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School, Camden.
Baggish
M S
MS
D000022:Abortion, Spontaneous; D000328:Adult; D005260:Female; D005313:Fetal Death; D006801:Humans; D015907:Hysteroscopy; D007231:Infant, Newborn; D007234:Infant, Premature; D007247:Infertility, Female / Q000601:surgery; D053685:Laser Therapy; D011247:Pregnancy; D011256:Pregnancy Outcome; D014599:Uterus / Q000601:surgery*