Abstract

Objectives: We aimed to evaluate the reproductive outcomes of infertile patients who had undergone operative hysteroscopy (HS) with the diagnoses of uterine septum, endometrial polyp, submucous myoma, and intrauterine adhesion.
Methods: This retrospective study included 334 patients who had been diagnosed with primary and secondary infertility, aged between 18–35 years and diagnosed with uterine septum (group 1), endometrial polyp (group 2), submucous myoma (group 3), and intrauterine adhesion (group 4) by hysterosalpingography or office HS and who were treated via hysteroscopic operation between January 2009 and January 2013. Pregnancy results were obtained from the patients’ files and hospital database; when this was not possible, the patients were queried by phone calls. Groups were then compared in terms of characteristics, prognoses, and pregnancy outcomes.
Results: The cumulative pregnancy rate was 58.7% in infertile patients who underwent operative HS due to intrauterine pathology. The mean length of time from operation to conception was 10.8±9.6 months in all groups. Mean age, infertility duration, infertility type, and smoking status were statistically different among the groups (p<0.05). Following surgery, 95 (66.4%) of 143 patients in group 1 conceived and 57 (60%) of these pregnancies resulted in term birth. There were 64 (54.2%) pregnancies in group 2 and 34 (53.1%) resulted in term birth. Sixteen (47.1%) patients conceived in group 3, and 6 (37.5%) of them had term birth. Twenty-one (53.8%) patients conceived in group 4. Twelve out of 21 patients (57.1%) had term birth. The most common mode of delivery was cesarean section in all groups.
Conclusion: Thus, operative HS increases pregnancy rates in patients with intrauterine pathology. In future, large-scale prospective studies should be carried out to reveal the effects of the hysteroscopic method and compare this approach with other methods in order to achieve better pregnancy outcomes in infertile women with an intrauterine pathology.