title: Effectiveness of hysteroscopic repair of uterine lesions in reproductive outcome.
abstract: BACKGROUND
  Small intrauterine lesions such as septum, adhesion, polyp, and submucous myoma may be of greater significance in causing implantation failure, poor reproductive performance and abnormal uterine bleeding. We studied effectiveness of therapeutic intervention through operative hysteroscopy in improvement of pregnancy outcome and cessation of abnormal uterine bleeding (AUB) in women with pregnancy and fertility problems.
  
  
  METHODS
  This prospective cohort study was performed between 2003- 2009 on 65 patients with primary or secondary infertility, recurrent abortion and structural uterine lesions reported in sonography or hysterosalpingography. After hysteroscopic metroplasty, myomectomy, adhesiolysis and polypectomy under laparoscopic guide, we evaluated reproductive outcome, early and late complications, one year after surgery.
  
  
  RESULTS
  Among all patients with recurrent abortion, 6 patients (75%) complete their pregnancy successfully. Our results showed that pregnancy rate after metroplasty was 58%. Reproductive outcome was poor after myomectomy and adhesiolysis. Abnormal uterine bleeding was improved in 62% of patients.
  
  
  CONCLUSIONS
  Structural uterine lesions has been assumed to cause infertility, while several studies have shown very poor reproductive performance with high miscarriage and low term delivery rates when malformation is not treated. We show improvement in conceptional outcome and in patient's chief complaints after hysteroscopy surgery of these anomalies.
authors.affiliation: Department of Obstetrics and Gynecology, School of Medicine, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Atta Allah
authors.initials: AA
authors.lastname: Ghahiry
authors.affiliation: Department of Obstetrics and Gynecology, School of Medicine, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Elahe
authors.initials: E
authors.lastname: Refaei Aliabadi
authors.affiliation: Department of Obstetrics and Gynecology, School of Medicine, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Ali Akbar
authors.initials: AA
authors.lastname: Taherian
authors.affiliation: Department of Obstetrics and Gynecology, School of Medicine, Hormozgan University of Medical Sciences, Bandarabas, Iran.
authors.forename: Aida
authors.initials: A
authors.lastname: Najafian
authors.affiliation: Research Office of Shahid Beheshti Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Mojdeh
authors.initials: M
authors.lastname: Ghasemi
keywords: Abnormal Uterine Bleeding; Adhesion; Hysteroscopy; Infertility; Myomectomy; Uterus
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