Öz
Objectives: We aimed to evaluate the reproductive outcomes of infertile patients who had undergone operative hysteroscopy (HS) with the diagnoses of uterine septum, endometrial polyp, submucous myoma, and intrauterine adhesion.Methods: This retrospective study included 334 patients who had been diagnosed with primary and secondary infertility, aged between 18–35 years and diagnosed with uterine septum (group 1), endometrial polyp (group 2), submucous myoma (group 3), and intrauterine adhesion (group 4) by hysterosalpingography or office HS and who were treated via hysteroscopic operation between January 2009 and January 2013. Pregnancy results were obtained from the patients’ files and hospital database; when this was not possible, the patients were queried by phone calls. Groups were then compared in terms of characteristics, prognoses, and pregnancy outcomes.Results: The cumulative pregnancy rate was 58.7% in infertile patients who underwent operative HS due to intrauterine pathology. The mean length of time from operation to conception was 10.8±9.6 months in all groups. Mean age, infertility duration, infertility type, and smoking status were statistically different among the groups (p<0.05). Following surgery, 95 (66.4%) of 143 patients in group 1 conceived and 57 (60%) of these pregnancies resulted in term birth. There were 64 (54.2%) pregnancies in group 2 and 34 (53.1%) resulted in term birth. Sixteen (47.1%) patients conceived in group 3, and 6 (37.5%) of them had term birth. Twenty-one (53.8%) patients conceived in group 4. Twelve out of 21 patients (57.1%) had term birth. The most common mode of delivery was cesarean section in all groups. Conclusion: Thus, operative HS increases pregnancy rates in patients with intrauterine pathology. In future, large-scale prospective studies should be carried out to reveal the effects of the hysteroscopic method and compare this approach with other methods in order to achieve better pregnancy outcomes in infertile women with an intrauterine pathology. J Clin Exp Invest 2015; 6 (1): 52-58
Anahtar Kelimeler
Kaynakça
- 1. Boyar HI, Female infertility and endocrinological diseases. Dicle Med J 2013;40:700-703.
- 2. Wallach EE. The uterine factor in infertility. Fertil Steril 1972;23:138-158.
- 3. Pantalenoi D. On Endoscopic examination of the cavity of the womb. Med Pres Circ 1869;8:26.
- 4. Rackow BW, Arici A. Reproductive performance of women with müllerian anomalies. Curr Opin Obstet Gynecol 2007;19:229-237.
- 5. Varasteh NN, Neuwirth RS, Levin B, Keltz MD. Pregnant rates after hysteroscopic poypectomy and myomectomy in infertile women. Obstet Gynecol 1999;94:168-171.
- 6. Sanders B. Uterine factors and infertility. Journal of Rep Med 2006;51:169-176.
- 7. Pace S, Stentella P, Catania R, et al. Endoscopic treatment of intrauterine adhesions. Clin Exp Obstet Gynecol 2003;30:26–28.
- 8. Homer HA, Li TC, Cooke ID. The septate uterus: a review of management and reproductive outcome. Fertil Steril 2000;73:1-14.
- 9. Lin PC, Bhatnagar KP, Nettleton GS, Nakajima ST. Female genital anomalies affecting reproduction. Fertil Steril 2002; 78:899-915.
- 10. Pabuccu R, Gomel V. Reproductive outcome after hysteroscopic metroplasty in women with septate uterus and otherwise unexplained infertility. Fertil Steril 2004;81:1675-1678.
- 11. Daly DC, Maier D, Soto AC. Hysteroscopic metroplasty: six years’ experience. Obstet Gynecol 1989;73:201-205.
- 12. Grimbizis GF, Camus M, Tarlatzis BC, et al. Clinical implications of uterine malformations and hysteroscopic treatment results. Hum Reprod Update 2001;7:161-174.
- 13. Raga F, Bauset C, Remohi J. Reproductive impact of congenital mullerian anomalies. Hum Reprod 1997;12:2277-228 . 14. Heinonen PK. Complete septate uterus with longitudinal vaginal septum. Fertil Steril 2006;85:700-705.
- 15. Bendifallah S, Faivre E, Legendre G, et al. J Minim Invasive Gynecol 2013;20:178-184.
İntrauterin patoloji nedeniyle operatif histeroskopi uygulanan infertil hastalarda üreme sonuçlarının değerlendirilmesi
Öz
Amaç: Bu çalışmada uterin septum, endometrial polip, submüköz miyom ve intrauterin adezyon tanıları ile operatif histeroskopi (HS) uygulanan infertil hastaların üreme sonuçlarını değerlendirmeyi amaçladık. Yöntemler: Histerosalpinjografi veya ofis HS ile uterin septum (grup 1), endometrial polip (grup 2), submüköz miyom (grup 3) ve intrauterin adezyon (grup 4) tanısı konulan ve Ocak 2009-2013 tarihleri arasında operatif HS ile tedavi edilen 18-35 yaş arasındaki primer veya sekonder infertil 334 hasta bu retrospektif çalışmaya dahil edildi. Gebelik sonuçları hasta dosyalarından ve hastane veri tabanından, bu mümkün olmadığında ise hastalar telefon ile sorgulanarak elde edildi. Ardından gruplar klinik özellikleri, prognozları ve gebelik sonuçları açısından kar- şılaştırıldı. Bulgular: İntrauterin patoloji nedeniyle operatif HS uygulanan infertil hastalarda kümülatif gebelik oranı 58,7% idi. Tüm gruplarda operasyon-gebelik arası süre ortalama 10,8 ± 9,6 ay idi. Olguların ortalama yaşı ve infertilite süresi ile infertilite tipi ve sigara içme durumu gruplar arasında istatistiksel anlamlı olarak farklıydı (p <0,05). Ameliyat sonrasında; grup 1’de 143 hastanın 95’i (%66,4) gebe kalırken bu gebeliklerin 57 (%60) tanesi termde doğumla sonuçlandı. Gebelik oranı grup 2’de %54,2 idi ve 34 (%53,1) tanesi termde doğum yaptı. Grup 3’de 16 (%47,1) hasta gebe kaldı ve bunların 6 (%37,5)’sı termdi. Grup 4’de 21 (%53,8) hasta gebe kaldı ve 21 hastadan 12’sinin (%57,1) term doğumu vardı. Tüm gruplarda en sık doğum şekli sezaryen oldu. Sonuç: Operatif HS, intrauterin patolojisi olan hastalarda gebelik oranlarını arttırır. Geniş katılımlı prospektif çalış- malar ile intrauterin patolojisi olan infertil hastalarda daha iyi gebelik sonuçları elde edebilmek için histeroskopik yöntemin diğer tedavi seçenekleriyle karşılaştırılıp ortaya konulması gereklidir. Anahtar kelimeler: Histeroskopi, infertilite, intrauterin patoloji
Anahtar Kelimeler
Kaynakça
- 1. Boyar HI, Female infertility and endocrinological diseases. Dicle Med J 2013;40:700-703.
- 2. Wallach EE. The uterine factor in infertility. Fertil Steril 1972;23:138-158.
- 3. Pantalenoi D. On Endoscopic examination of the cavity of the womb. Med Pres Circ 1869;8:26.
- 4. Rackow BW, Arici A. Reproductive performance of women with müllerian anomalies. Curr Opin Obstet Gynecol 2007;19:229-237.
- 5. Varasteh NN, Neuwirth RS, Levin B, Keltz MD. Pregnant rates after hysteroscopic poypectomy and myomectomy in infertile women. Obstet Gynecol 1999;94:168-171.
- 6. Sanders B. Uterine factors and infertility. Journal of Rep Med 2006;51:169-176.
- 7. Pace S, Stentella P, Catania R, et al. Endoscopic treatment of intrauterine adhesions. Clin Exp Obstet Gynecol 2003;30:26–28.
- 8. Homer HA, Li TC, Cooke ID. The septate uterus: a review of management and reproductive outcome. Fertil Steril 2000;73:1-14.
- 9. Lin PC, Bhatnagar KP, Nettleton GS, Nakajima ST. Female genital anomalies affecting reproduction. Fertil Steril 2002; 78:899-915.
- 10. Pabuccu R, Gomel V. Reproductive outcome after hysteroscopic metroplasty in women with septate uterus and otherwise unexplained infertility. Fertil Steril 2004;81:1675-1678.
- 11. Daly DC, Maier D, Soto AC. Hysteroscopic metroplasty: six years’ experience. Obstet Gynecol 1989;73:201-205.
- 12. Grimbizis GF, Camus M, Tarlatzis BC, et al. Clinical implications of uterine malformations and hysteroscopic treatment results. Hum Reprod Update 2001;7:161-174.
- 13. Raga F, Bauset C, Remohi J. Reproductive impact of congenital mullerian anomalies. Hum Reprod 1997;12:2277-228 . 14. Heinonen PK. Complete septate uterus with longitudinal vaginal septum. Fertil Steril 2006;85:700-705.
- 15. Bendifallah S, Faivre E, Legendre G, et al. J Minim Invasive Gynecol 2013;20:178-184.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Bölüm | Araştırma Yazısı |
| Yazarlar | |
| Yayımlanma Tarihi | 10 Mayıs 2015 |
| Yayımlandığı Sayı | Yıl 2015 |