Fertility Outcomes After Hysteroscopic Morcellation of Intrauterine Leiomyomas and Polyps

Abstract

Objective: To assess fertility outcomes in infertile women after hysteroscopic morcellation of intrauterine lesions.

Study design: Retrospective case series from 2 U.S. fertility clinics. Women with intrauterine pathology and infertility (≥6 months' duration if age ≥35, or ≥12 months' duration if age <35) or recurrent pregnancy loss underwent hysteroscopic morcellation of intrauterine lesions. Main outcome mea- sures were postoperative pregnancies, live births, and procedure-related adverse events through 6 months.

Results: Of 101 women screened, 62 satisfied inclusion criteria and 44 (71%) conceived, resulting in 39 live births. Women who conceived were 37.1±4.6 years old (range, 28.0-46.8) at intervention; mean treatment-to-pregnancy interval was 8.4? 7.0 months (range, 1-32). Body mass index was lower in women who conceived (24.94.4 kg/M2 versus women who remained infertile (28.9±04 kg/IM2, p=0.0362). Of 67 lesions in women who conceived, fibroids, polyps, and adhesions comprised 21%, 70%, and 9%, respectively. Mean respective fibroid and polyp sizes in women who conceived were 2.1±1.3 and 1.4±0.8 cm, respectively, similar to those in women who did not conceive. Fibroids were 74% type 0 and 26% type 1. Lesion area eradication was 95.8±9.9% for fibroids and 100% for polyps. No serious/severe adverse events occurred.

Conclusion: Morcellation of intrauterine pathologies in subfertile women undergoing fertility therapy safely supports postopera- tive pregnancy and live birth.