Reproductive results after hysteroscopic metroplasty using a monopolar resectoscope in women with reproductive disorders

Abstract

The role of different methods of hysteroscopic metroplasty in women with reproductive failure against the background of a septate uterus is not fully determined. The purpose of the study was to evaluate the effectiveness of reproductive function restoration after dissection and removal of the uterine membrane using a monopolar resectoscope in women with infertility and miscarriages. Material and methods. 65 patients with a septate uterus and reproductive failure were under observation: 34 women underwent hysteroscopic monopolar dissection of the uterine membrane and 31 patients underwent hysteroscopic monopolar resection of the uterine septum. Results. Metroplasty technique (dissection or resection) with the use of a monopolar resectoscope in women with a septate uterus did not affect the onset of pregnancy, the number of miscarriages and premature births, but term deliveries and live births were probably 1.69 times more likely to occur when the tissue of the uterine septum was removed compared to similar indicators during its dissection (OR 0.34 [0.12-0.93]), in women with initial miscarriages - 1.96 times, respectively (OR 0.16 [0.03-0.73]). The technique of performing metroplasty (dissection or resection) using a monopolar resectoscope in women with initial infertility in the conducted study did not have a statistically significant difference in terms of the effect on reproductive indicators. Conclusions. Removal of the uterine septum using a monopolar resectoscope in women with miscarriages has advantages in restoring reproductive function compared to the dissection technique. The technique of monopolar metroplasty in women with infertility probably does not affect the reproductive results.