Therapeutic hysteroscopy in infertility.

Hysteroscopic treatment was provided for 122 of 139 women complaining of primary or secondary infertility. Hysteroscopy revealed intrauterine lesions and the following treatments were carried out: lysis of intrauterine adhesions (61), removal of large endometrial polyps (47), removal of submucous leiomyomas (4), removal of embedded fragmented IUD (4), division of uterine septa (3) and treatment of other unusual conditions (3). The reproductive outcome included 46 term pregnancies, 28 following the division of intrauterine adhesions, 11 after the removal of endometrial polyps, 2 after correction of a septate uterus, one after removal of a pedunculated intrauterine leiomyoma, and 4 after removal of different foreign bodies. There were 8 spontaneous first trimester abortions, and 1 ectopic pregnancy. Removal of the lesion and restoration of a symmetric uterine cavity was successful in 119 patients; only 3 failures occurred, in patients with severe Asherman's syndrome.