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

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