Hysteroscopic Myomectomy and Reproductive Outcome

Although hysteroscopic myomectomy as a safe and effective intervention is recommended for myoma resection, its effect on infertile patients who need the ICSI or IUI is not clearly defined. The present study was conducted aimed to evaluate the effect of hysteroscopic myomectomy on the outcome of pregnancy in in infertile patients who were candidates for IUI, ICSI, and FET cycles.

In this cohort study, 330 women underwent hysteroscopic myomectomy, of them 204 patients had history of infertility and 154 were candidates for ICSI cycles, 33 for FET cycles, and 17 for IUI cycles  at two tertiary teaching hospital and Royan institute between February 2008-February2012. Primary outcomes were chemical and clinical pregnancy rates.

Among 204 patients with a history of infertility, 116 (75.4%) had primary and 38 (24.6%) secondary infertility. In ICSI group, 129 patients had one myoma, 18 cases two myoma, 5 cases three myoma and 2 cases had five intracavitary myoma. In FET group, there were 27 cases with one and 6 cases with two intracavitary myoma. In IUI group, there were 15 cases with one and two cases with two intracavitary myoma. In the ICSI group, there were 17% clinical pregnancy, 1% missed abortion, 4% blighted ovum, and 2% chemical pregnancy. In FET group, the clinical pregnancy was detected in 28.6% of women including 7 clinical pregnancy, one blighted ovum and one chemical pregnancy. In IUI group, pregnancy failure rate was 100%.

Hysteroscopic myomectomy in addition to a safe and effective intervention for myoma resection, can improve pregnancy outcomes in infertile women.