Influence of hysteroscopic metroplasty on reproductive outcome in patients with infertility and recurrent pregnancy loss.

Introduction: Patients with congenital uterine anomalies (CUA) have decreased reproductive potential and an unfavourable reproductive outcome compared to the population with normal uterine cavity. Patients with untreated CUA have a higher abortion rate, higher foetal loss rate and decreased live birth rate. Hysteroscopic metroplasty is a standard, safe and minimally invasive method for the treatment of correctible types of congenital uterine anomalies. The aim of the study was to analyse the reproductive outcome in certain groups of patients with CUA and infertility, before and after hysteroscopic metroplasty.

Material And Methods: We analyzed 115 patients on whom 129 hysteroscopic metroplasty interventions were performed at the University Clinic of Obstetrics and Gynaecology in Skopje over a oneyear period, between 01.01.2011 and 31.12.2011. Patients and their reproductive outcome were monitored over a two-year period and the same group served as a control group, taking into account their previous reproductive history before and after metroplasty. Statistical analysis was performed using the Chi-square test and p < 0.05 was considered to be statistically significant.

Results: The most common CUA were types 5b and 6, represented by 83.3%. In a follow-up period of two years, there were 55 patients with previous foetal loss treated by hysteroscopic metroplasty, and 31 of them had pregnancies. There was a statistically significant decrease of abortion rate from 88.5% to 19.3%, and a significant increase in term delivery rate from 2.3% to 71%.

Conclusion: Hysteroscopic metroplasty significantly improves the reproductive outcome in patients with previous foetal loss.