title: Submucous fibroids and infertility: Effect of hysteroscopic myomectomy and factors influencing outcome.
abstract: BACKGROUND
  Submucosal myomas are associated with infertility and may be treated by hysteroscopic resection.
  
  
  OBJECTIVE
  The aim of this retrospective study was to analyze 37 subfertile patients who unnderwent hysteroscopic myomectomy in a tertiary care center with particular regard to their postprocedure reproductive outcome.
  
  
  METHODS
  The entire patient group (n = 37) underwent the procedure between March 2004 and March 2010. The submucosal myomas were type 0 (n = 27), type 1 (n = 8), and type 2 (n = 2). The mean myoma size was 2.1 cm; mean duration of the procedure was 54 mins and mean follow-up was 26 ± 10 months. 22 patients had one or more associated infertility factors.
  
  
  RESULTS
  The complication rate was 5.4%. 11 patients (29.7%) conceived after the procedure. The pregnancy rate was better when myoma was the exclusive etiology of infertility (40%), when the myoma was completely intracavitary (33.3%), when the lesion was ≥ 30 mm in size (50%), and there were no associated intramural fibroids.
  
  
  CONCLUSIONS
  Hysteroscopic myomectomy is a safe procedure to enhance fertility especially in cases with unexplained infertility.
authors.affiliation: Department of Minimally Invasive Surgery, KJK Hospital, Nalanchira, Chackai, Trivandrum, Kerala, India.
authors.forename: K
authors.initials: K
authors.lastname: Jayakrishnan
authors.forename: Vandana
authors.initials: V
authors.lastname: Menon
authors.forename: Divya
authors.initials: D
authors.lastname: Nambiar
keywords: Hysteroscopic myomectomy; infertility; myoma