Luis Alonso Pacheco1, Antonio Simone Laganà2, Simone Garzon3, Arantxa Pérez Garrido1, Alberto Flores Gornés1, Fabio Ghezzi3. 1. Centro Gutenberg, Málaga, Spain. 2. Department of Obstetrics and Gynecology, "Filippo Del Ponte" Hospital, University of Insubria, Varese, Italy. Electronic address: antoniosimone.lagana@uninsubria.it. 3. Department of Obstetrics and Gynecology, "Filippo Del Ponte" Hospital, University of Insubria, Varese, Italy.
Abstract
OBJECTIVE: To evaluate the effectiveness of hysteroscopic outpatient metroplasty in women with T-shaped uterus and primary reproductive failure. STUDY DESIGN: Prospective cohort study including nulliparous women with primary unexplained infertility, repeated in vitro fertilization (IVF) failure or recurrent spontaneous miscarriage and T-shaped uterus anomaly not diethylstilbestrol-related, diagnosed by 3D ultrasound and diagnostic hysteroscopy. Between January 2015 and December 2017, hysteroscopic metroplasty was performed in outpatient settings with a 5-mm diameter hysteroscope and 5-Fr operative scissors. After 3 months, expectant management was proposed to women with unexplained couple infertility or recurrent spontaneous miscarriages, and IVF treatment was proposed after 6 months without natural conception or immediately to couple with repeated IVF failure. Minimum follow-up was planned for 1 year. RESULTS: A total of 63 women were included, and only 60 tried to conceive after metroplasty. Hysteroscopic procedures were performed without complications. Clinical pregnancy rate after metroplasty was 83.3% (n = 50/60) (p < 0.001), and the live birth rate was 63.3% (n = 38/60) (p < 0.001). Cesarean section rate was 26.3%. No pregnancy complications potentially related to uterine surgery were reported. The abortion rate was 12% (n = 6/50) (p < 0.001). CONCLUSION: In women with primary reproductive failure and T-shaped uterus, hysteroscopic metroplasty seems to be effective to improve reproductive outcomes.
OBJECTIVE: To evaluate the effectiveness of hysteroscopic outpatient metroplasty in women with T-shaped uterus and primary reproductive failure. STUDY DESIGN: Prospective cohort study including nulliparous women with primary unexplained infertility, repeated in vitro fertilization (IVF) failure or recurrent spontaneous miscarriage and T-shaped uterus anomaly not diethylstilbestrol-related, diagnosed by 3D ultrasound and diagnostic hysteroscopy. Between January 2015 and December 2017, hysteroscopic metroplasty was performed in outpatient settings with a 5-mm diameter hysteroscope and 5-Fr operative scissors. After 3 months, expectant management was proposed to women with unexplained couple infertility or recurrent spontaneous miscarriages, and IVF treatment was proposed after 6 months without natural conception or immediately to couple with repeated IVF failure. Minimum follow-up was planned for 1 year. RESULTS: A total of 63 women were included, and only 60 tried to conceive after metroplasty. Hysteroscopic procedures were performed without complications. Clinical pregnancy rate after metroplasty was 83.3% (n = 50/60) (p < 0.001), and the live birth rate was 63.3% (n = 38/60) (p < 0.001). Cesarean section rate was 26.3%. No pregnancy complications potentially related to uterine surgery were reported. The abortion rate was 12% (n = 6/50) (p < 0.001). CONCLUSION: In women with primary reproductive failure and T-shaped uterus, hysteroscopic metroplasty seems to be effective to improve reproductive outcomes.
Authors: Luis Alonso Pacheco; Carmina Bermejo López; José Carugno; Pedro Azumendi Gómez; Pilar Martinez-Ten; Antonio Simone Laganà; Simone Garzon Journal: Arch Gynecol Obstet Date: 2021-07-25 Impact factor: 2.344
Authors: Fortunato Genovese; Federica Di Guardo; Morena Maria Monteleone; Valentina D'Urso; Francesco Maria Colaleo; Vito Leanza; Marco Palumbo Journal: Int J Fertil Steril Date: 2021-03-11