Fertility-enhancing hysteroscopic surgery; multi-center retrospective cohort study of reproductive outcome
Abstract Introduction Hysteroscopic surgery and assisted reproduction technology are feasible ways to improve the reproductive outcome. Our aim was to study hysteroscopic septoplasty and myomectomy’s effect on infertility and reproductive performance. Methods Retrospective cohort of patients who had...
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| Format: | Article |
| Language: | English |
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BMC
2023-08-01
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| Series: | BMC Women's Health |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12905-023-02562-2 |
| _version_ | 1797556717161021440 |
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| author | Naser Al-Husban Omar Odeh Muataz AlRamahi Sara Qadri Hedaieh Al-Husban |
| author_facet | Naser Al-Husban Omar Odeh Muataz AlRamahi Sara Qadri Hedaieh Al-Husban |
| author_sort | Naser Al-Husban |
| collection | DOAJ |
| description | Abstract Introduction Hysteroscopic surgery and assisted reproduction technology are feasible ways to improve the reproductive outcome. Our aim was to study hysteroscopic septoplasty and myomectomy’s effect on infertility and reproductive performance. Methods Retrospective cohort of patients who had unexplained infertility and/or recurrent miscarriages and had myomectomy or septoplasty in the period September 2016-october 2021 with a total of 18 months’ follow up. The main outcome measures were spontaneous pregnancy, term pregnancy and miscarriage. For analysis, we used Statistical Package for Social Sciences (SPSS) version 20. Results One hundred and sixty-five patients were included. The mean age of patients was 39 years. 40 patients had septum resection and 125 patients had hysteroscopic myomectomy. A spontaneous pregnancy rate after surgery was achieved in 46 patients (27.9%). Out of the 64 patients who had failed IVF preoperatively, 32 patients (50%) had a successful IVF post-hysteroscopic surgery and there were more successful cases in the patients who had fibroid resection but this difference did not reach a statistical significance (P value 0.055). In the 79 pregnancies after surgery, preterm birth and miscarriage were seen in 10 patients (12.7%), similarly, respectively after septal or fibroid resection. Miscarriages were less post-operatively. Hysteroscopic myomectomy, compared with hysteroscopic metroplasty, was significantly associated with higher spontaneous pregnancy rate (63.0% Vs 37.0%, P value 0.018), more term pregnancies (87.5% vs. 12.5%, P value 0.001) and less miscarriage rate (40%vs 60%, P value 0.003). Pregnancy post-operatively in patients with primary infertility was more statistically significantly associated with hysteroscopic myomectomy than with hysteroscopic septoplasty (95.8% vs. 4.2%, p value 0.030). In patients who got pregnant postoperatively there was no statistically significant difference in the mode of delivery. Conclusion In carefully selected patients with unexplained infertility and recurrent miscarriage, hysteroscopic myomectomy, compared with hysteroscopic metroplasty, was significantly associated with higher spontaneous pregnancy, more term pregnancies and less miscarriage rates. More than metroplasty, hysteroscopic myomectomy led to higher spontaneous pregnancies in patients with primary infertility. Trial registration NCT05560295. |
| first_indexed | 2024-03-10T17:06:50Z |
| format | Article |
| id | doaj.art-5d9332d89d904c3899edf94118dfcf0d |
| institution | Directory Open Access Journal |
| issn | 1472-6874 |
| language | English |
| last_indexed | 2024-03-10T17:06:50Z |
| publishDate | 2023-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Women's Health |
| spelling | doaj.art-5d9332d89d904c3899edf94118dfcf0d2023-11-20T10:47:00ZengBMCBMC Women's Health1472-68742023-08-012311910.1186/s12905-023-02562-2Fertility-enhancing hysteroscopic surgery; multi-center retrospective cohort study of reproductive outcomeNaser Al-Husban0Omar Odeh1Muataz AlRamahi2Sara Qadri3Hedaieh Al-Husban4School of Medicine, The University of JordanJordan University hospitalAl-Noor Fertility CentreArab Medical CentreAl-Noor Fertility CentreAbstract Introduction Hysteroscopic surgery and assisted reproduction technology are feasible ways to improve the reproductive outcome. Our aim was to study hysteroscopic septoplasty and myomectomy’s effect on infertility and reproductive performance. Methods Retrospective cohort of patients who had unexplained infertility and/or recurrent miscarriages and had myomectomy or septoplasty in the period September 2016-october 2021 with a total of 18 months’ follow up. The main outcome measures were spontaneous pregnancy, term pregnancy and miscarriage. For analysis, we used Statistical Package for Social Sciences (SPSS) version 20. Results One hundred and sixty-five patients were included. The mean age of patients was 39 years. 40 patients had septum resection and 125 patients had hysteroscopic myomectomy. A spontaneous pregnancy rate after surgery was achieved in 46 patients (27.9%). Out of the 64 patients who had failed IVF preoperatively, 32 patients (50%) had a successful IVF post-hysteroscopic surgery and there were more successful cases in the patients who had fibroid resection but this difference did not reach a statistical significance (P value 0.055). In the 79 pregnancies after surgery, preterm birth and miscarriage were seen in 10 patients (12.7%), similarly, respectively after septal or fibroid resection. Miscarriages were less post-operatively. Hysteroscopic myomectomy, compared with hysteroscopic metroplasty, was significantly associated with higher spontaneous pregnancy rate (63.0% Vs 37.0%, P value 0.018), more term pregnancies (87.5% vs. 12.5%, P value 0.001) and less miscarriage rate (40%vs 60%, P value 0.003). Pregnancy post-operatively in patients with primary infertility was more statistically significantly associated with hysteroscopic myomectomy than with hysteroscopic septoplasty (95.8% vs. 4.2%, p value 0.030). In patients who got pregnant postoperatively there was no statistically significant difference in the mode of delivery. Conclusion In carefully selected patients with unexplained infertility and recurrent miscarriage, hysteroscopic myomectomy, compared with hysteroscopic metroplasty, was significantly associated with higher spontaneous pregnancy, more term pregnancies and less miscarriage rates. More than metroplasty, hysteroscopic myomectomy led to higher spontaneous pregnancies in patients with primary infertility. Trial registration NCT05560295.https://doi.org/10.1186/s12905-023-02562-2InfertilityHysteroscopyReproductionSeptoplasty myomectomy |
| spellingShingle | Naser Al-Husban Omar Odeh Muataz AlRamahi Sara Qadri Hedaieh Al-Husban Fertility-enhancing hysteroscopic surgery; multi-center retrospective cohort study of reproductive outcome BMC Women's Health Infertility Hysteroscopy Reproduction Septoplasty myomectomy |
| title | Fertility-enhancing hysteroscopic surgery; multi-center retrospective cohort study of reproductive outcome |
| title_full | Fertility-enhancing hysteroscopic surgery; multi-center retrospective cohort study of reproductive outcome |
| title_fullStr | Fertility-enhancing hysteroscopic surgery; multi-center retrospective cohort study of reproductive outcome |
| title_full_unstemmed | Fertility-enhancing hysteroscopic surgery; multi-center retrospective cohort study of reproductive outcome |
| title_short | Fertility-enhancing hysteroscopic surgery; multi-center retrospective cohort study of reproductive outcome |
| title_sort | fertility enhancing hysteroscopic surgery multi center retrospective cohort study of reproductive outcome |
| topic | Infertility Hysteroscopy Reproduction Septoplasty myomectomy |
| url | https://doi.org/10.1186/s12905-023-02562-2 |
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