Reproductive outcome following hysteroscopic myomectomy in patients with infertility and recurrent abortions.
OBJECTIVE
To evaluate the outcome of hysteroscopic myomectomy in patients with infertility and recurrent abortions.


METHODS
This was a retrospective clinical analysis of 186 patients who underwent hysteroscopic myomectomy by monopolar electrode loop. A second-look diagnostic hysteroscopy was performed in all cases within 2 months. The mean follow-up period was 36.5 months.


RESULTS
The mean age of the patients was 28.4 years. The presenting clinical complaint was primary infertility in 31% (62/200) patients, secondary infertility in 10% (20/200) patients, recurrent abortions in 50.5% (101/200) and preterm deliveries in 8.5% (17/200) patients. Final reproductive outcome was assessed for 186 patients, after excluding patients with other confounding factors, interfering in pregnancy outcome. There was a significant difference in reduction of number of miscarriages and increase in term deliveries while the number of preterm deliveries remained almost the same. Fifty-eight out of 82 infertile patients (70.7%) conceived after hysteroscopic myomectomy. The take home baby rate was increased from 16.2 to 74%. There was an increased incidence (35.6%) of cesarean section recorded in mode of delivery.


CONCLUSIONS
Hysteroscopic myomectomy is a safe and effective method for improving the obstetric outcome in women with infertility and recurrent abortions and associated submucous fibroids.
Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India. drkkroy2003@gmail.com
Kallol Kumar
KK
Roy
Shilpa
S
Singla
Jinee
J
Baruah
Jai Bhagwan
JB
Sharma
Sunesh
S
Kumar
Neeta
N
Singh
D000026:Abortion, Habitual / Q000517:prevention & control / Q000601:surgery / Q000628:therapy*; D000328:Adult; D005260:Female; D006801:Humans; D015907:Hysteroscopy / Q000379:methods* / Q000592:standards; D007247:Infertility, Female / Q000517:prevention & control / Q000601:surgery / Q000628:therapy*; D007889:Leiomyoma / Q000601:surgery*; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies