The Reproductive Outcome in patients having Primary Infertility or Recurrent Miscarriages after performing Hysteroscopic Septal Resection

Abstract

Objective: To assess the reproductive outcome after hysteroscopicseptal resection in women with unexplained infertility or recurrent miscarriage.Design: Prospective clinical trial.Setting: Zagazig university hospitals, Egypt.Patients: 47 patients (20 patients with primary infertility and 27 patients with recurrent miscarriage diagnosed to have uterine septum)Intervention: Hysteroscopicseptal resection.Main Outcome Measures: Pregnancy rate and its outcome (miscarriage, preterm birth, term birth and live-birth rates).Results: There was significant improvement in reproductive outcome in patients with primary infertility and uterine septum after hysteroscopicmetroplasty; pregnancy rate was 55% (11 pregnancies out of 20 patients). Abortion and preterm labor rates were low (5 and 10% respectively) while term delivery and live-birth rates were high (40 and 45% respectively).Also, there was significant improvement in the reproductive outcome in patients with recurrent pregnancy loss, there was highly significant reduction in the abortion rate to 11.1% (p=0.00) after hysteroscopicmetroplasty but there was non-significant reduction in preterm birth from 11.1% to 7.4% (p=0.63). There was highly significant rise in term delivery rate that increased from 3.8% to 51.9% (p=0.00007) and highly significant increase in live-birth rate from 7.4% to 55.6% (p=0.0001).Conclusion: Performing hysteroscopicmetroplasty could markedly improve the reproductive outcome in patients having recurrent miscarriage in the form of reduction in abortion rate and increase in term delivery and live-birth rates. There was also significant improvement in pregnancy rate among patients with unexplained primary infertility.