Submucous fibroids and infertility: Effect of hysteroscopic myomectomy and factors influencing outcome

BACKGROUND Submucosal myomas are associated with infertility and may be treated by hysteroscopic resection. OBJECTIVE The aim of this retrospective study was to analyze 37 subfertile patients who unnderwent hysteroscopic myomectomy in a tertiary care center with particular regard to their postprocedure reproductive outcome. MATERIALS AND METHODS The entire patient group (n = 37) underwent the procedure between March 2004 and March 2010. The submucosal myomas were type 0 (n = 27), type 1 (n = 8), and type 2 (n = 2). The mean myoma size was 2.1 cm; mean duration of the procedure was 54 mins and mean follow-up was 26 ± 10 months. 22 patients had one or more associated infertility factors. RESULTS The complication rate was 5.4%. 11 patients (29.7%) conceived after the procedure. The pregnancy rate was better when myoma was the exclusive etiology of infertility (40%), when the myoma was completely intracavitary (33.3%), when the lesion was ≥ 30 mm in size (50%), and there were no associated intramural fibroids. CONCLUSION Hysteroscopic myomectomy is a safe procedure to enhance fertility especially in cases with unexplained infertility.