N Ahdad-Yata1, H Fernandez2, A Nazac3, M Lesavre4, A-G Pourcelot1, P Capmas5. 1. Service de gynécologie obstétrique, hôpital Bicêtre, GHU Sud, AP-HP, 78, rue du Général-Leclerc, 94270 Le Kremlin-Bicêtre, France. 2. Service de gynécologie obstétrique, hôpital Bicêtre, GHU Sud, AP-HP, 78, rue du Général-Leclerc, 94270 Le Kremlin-Bicêtre, France; U1018 CESP-Inserm, Centre de recherché en épidémiologie et santé des populations, 82, rue du Général-Leclerc, 94270 Le Kremlin-Bicêtre, France; Faculté de médecine, université Paris Sud, 63, rue Gabriel-Péri, 94270 Le Kremlin-Bicêtre, France. 3. Service de gynécologie obstétrique, hôpital Bicêtre, GHU Sud, AP-HP, 78, rue du Général-Leclerc, 94270 Le Kremlin-Bicêtre, France; Laboratoire de physique des interfaces et des couches minces, école polytechnique, 91128 Palaiseau, France. 4. Service de gynécologie obstétrique, hôpital Bicêtre, GHU Sud, AP-HP, 78, rue du Général-Leclerc, 94270 Le Kremlin-Bicêtre, France; Faculté de médecine, université Paris Sud, 63, rue Gabriel-Péri, 94270 Le Kremlin-Bicêtre, France. 5. Service de gynécologie obstétrique, hôpital Bicêtre, GHU Sud, AP-HP, 78, rue du Général-Leclerc, 94270 Le Kremlin-Bicêtre, France; U1018 CESP-Inserm, Centre de recherché en épidémiologie et santé des populations, 82, rue du Général-Leclerc, 94270 Le Kremlin-Bicêtre, France; Faculté de médecine, université Paris Sud, 63, rue Gabriel-Péri, 94270 Le Kremlin-Bicêtre, France. Electronic address: perrine.capmas@bct.aphp.fr.
Abstract
OBJECTIVES: Myoma is the most frequent benign uterine tumor and might have a negative impact on fertility. In 5 to 10% of cases, infertility is associated with myoma and in 1 to 3% myoma is the only infertility factor. Even if effect of myomectomy on fertility is controversial, benefit of hysteroscopic myomectomy for submucosal myoma on fertility has already been shown. The aim of this study is to evaluate fertility of infertile women less than 46years old after hysteroscopic resection of submucosal myoma. MATERIAL AND METHODS: This retrospective unicentric study took place in the gynecologic unit of a teaching hospital. All infertile women with a hysteroscopic myomectomy for submucosal myoma between March 2009 and May 2013 were included. A phone questionnaire was conducted to evaluate pregnancy rate, eventual medical assistance, time between submucisal resection and pregnancy and issue of pregnancies. RESULTS: Seventy-one infertile women with a hysteroscopic resection of submucosal myoma were included. Pregnancy rate was 33.8% with 50% of live births, 41.6% of miscarriages and 8.4% of late fetal losses with a mean follow-up of 28.7months. Mean time between hysteroscopic resection and pregnancy was 9.9months. A medical assistance was necessary for 6 women (25% of pregnancy). CONCLUSION: This study reports hysteroscopic resection of submucosal myoma for infertile women. The rate of pregnancy after treatment is 33.8%.
OBJECTIVES:Myoma is the most frequent benign uterine tumor and might have a negative impact on fertility. In 5 to 10% of cases, infertility is associated with myoma and in 1 to 3% myoma is the only infertility factor. Even if effect of myomectomy on fertility is controversial, benefit of hysteroscopic myomectomy for submucosal myoma on fertility has already been shown. The aim of this study is to evaluate fertility of infertile women less than 46years old after hysteroscopic resection of submucosal myoma. MATERIAL AND METHODS: This retrospective unicentric study took place in the gynecologic unit of a teaching hospital. All infertile women with a hysteroscopic myomectomy for submucosal myoma between March 2009 and May 2013 were included. A phone questionnaire was conducted to evaluate pregnancy rate, eventual medical assistance, time between submucisal resection and pregnancy and issue of pregnancies. RESULTS: Seventy-one infertile women with a hysteroscopic resection of submucosal myoma were included. Pregnancy rate was 33.8% with 50% of live births, 41.6% of miscarriages and 8.4% of late fetal losses with a mean follow-up of 28.7months. Mean time between hysteroscopic resection and pregnancy was 9.9months. A medical assistance was necessary for 6 women (25% of pregnancy). CONCLUSION: This study reports hysteroscopic resection of submucosal myoma for infertile women. The rate of pregnancy after treatment is 33.8%.