Submucous fibroids and infertility: Effect of hysteroscopic myomectomy and factors influencing outcome

摘要

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.MATERIALS AND 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.CONCLUSION:Hysteroscopic myomectomy is a safe procedure to enhance fertility especially in cases with unexplained infertility.