Reproductive outcome following hysteroscopic myomectomy in patients with infertility and recurrent abortions.

OBJECTIVES

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

MATERIALS AND

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.

CONCLUSION

Hysteroscopic myomectomy is a safe and effective method for improving the obstetric outcome in women with infertility and recurrent abortions and associated submucous fibroids.