title: Efficacy of hysteroscopic cervical resection for cervical stenosis.
abstract: OBJECTIVE
  Cervical stenosis can be an impediment to embryo transfer (ET) and intrauterine insemination (IUI). We propose a technique of hysteroscopic cervical resection to overcome cervical stenosis.
  
  
  METHODS
  Prospective clinical study (Canadian Task Force classification III).
  
  
  METHODS
  Private general hospital.
  
  
  METHODS
  Forty-three infertile women in whom trial ET or IUI had failed with 3 available catheters.
  
  
  METHODS
  The procedure was performed with a hysteroscope under ultrasound guidance. Starting from the external os, the loop electrode gradually resected protrusions and cervical tissue until the hysteroscope could enter the uterine cavity. Repeat trial ET/IUI was performed 1 month later. The women who became pregnant underwent sonographic measurement of the cervical length and dilatation in the second and third trimesters.
  
  
  RESULTS
  Excluding 13 patients in whom the sound could pass through the cervical canal after anesthesia, 30 patients were included for analysis. The procedure failed in 1 patient (3.3%). The mean operation time was 18.0 (±7.4) minutes. Repeat trial ET/IUI was successful in all patients. There were 5 twin pregnancies and 9 singleton pregnancies after IUI or ET. From the 5 women with twin pregnancies; 2 underwent premature delivery at 34 weeks; and 3 underwent elective cesarean delivery at 35, 36, and 37 weeks, respectively. From the 9 women with singleton pregnancies, 1 underwent cesarean section at 36 weeks because of preeclampsia, and the other 8 delivered at term.
  
  
  CONCLUSIONS
  Hysteroscopic cervical resection is a safe and effective treatment for cervical stenosis.
authors.affiliation: Department of Obstetrics and Gynecology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan; School of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan; Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Yu-Hung
authors.initials: YH
authors.lastname: Lin
authors.forename: Jiann-Loung
authors.initials: JL
authors.lastname: Hwang
authors.forename: Lee-Wen
authors.initials: LW
authors.lastname: Huang
authors.forename: Kok-Min
authors.initials: KM
authors.lastname: Seow
authors.forename: Hen-Ju
authors.initials: HJ
authors.lastname: Chen
authors.forename: Chii-Ruey
authors.initials: CR
authors.lastname: Tzeng
mesh_terms: D000328:Adult; D002584:Cervix Uteri / Q000601:surgery*; D003251:Constriction, Pathologic / Q000601:surgery; D004624:Embryo Transfer; D005260:Female; D006801:Humans; D015907:Hysteroscopy / Q000379:methods*; D007247:Infertility, Female / Q000601:surgery*; D011247:Pregnancy; D011256:Pregnancy Outcome; D002577:Uterine Cervical Diseases / Q000601:surgery*
keywords: Cervical stenosis; Hysteroscope