Results of infertility treatment using ART methods in patients who underwent myomectomy: risk factors for repeated unsuccessful ART programs

GYNECOLOGY ◽  
2020 ◽  
Vol 22 (6) ◽  
pp. 44-49
Author(s):  
Irena F. Kozachenko ◽  
Veronika Y. Smolnikova ◽  
Leila V. Adamyan
Keyword(s):  
Risk Factors ◽  
Uterine Fibroids ◽  
Uterine Cavity ◽  
Art Programs ◽  
Hysteroscopic Myomectomy ◽  
Surgical Interventions ◽  
Results Of Treatment ◽  
Art Program ◽  
Adverse Pregnancy

Aim. To evaluate the results of treatment of patients with uterine fibroids and infertility with ineffective art programs in the anamnesis and to identify possible risk factors for repeated art failures. Materials and methods. 510 patients with uterine fibroids and infertility were examined and surgically treated prior to the ART program. Myomectomy was performed using various approaches: laparoscopic access in 250 patients, laparotomic access in 70 patients, hysteroscopic myomectomy in 100 patients, and combined access (laparoscopic and hysteroscopic) in 90 women. Results. Primary infertility was observed in 38.0%, secondary in 62.0% of patients. The average duration of infertility was 4.41.9 years. ART had in history 54.5% of patients. During the follow-up period up to 2 years, 24.3% of women had recurrent uterine fibroids. After carrying out of surgical treatment and the following ART pregnancy was achieved in 44.3% of patients. Pregnancies ended in childbirth in 58.8% of cases, which exceeded the total share (41.6%) of adverse pregnancy outcomes (ectopic pregnancy, abortions, spontaneous miscarriages at various times) by 1.4 times. Conclusion. Risk factors for repeated ART failures in patients who have undergone myomectomy are: age over 40 years; duration of infertility for more than 5 years and the presence of 3 or more ineffective IVF attempts in the history; the presence of previous surgical interventions such as uterine artery embolization and FUS-ablation; the presence of submucous fibroids, a dominant node located close to the uterine cavity and myoma with signs of blood supply disorders; the combination of uterine fibroids with external genital endometriosis and chronic endometritis.

scholarly journals Experience of the use of anti-adhesive barrier based on sodium hyaluronate and carboxymethylcellulose in gynecological surgery

2019 ◽  
pp. 149-153
Author(s):  
A. S. Molotkov ◽  
E. N. Popov ◽  
A. O. Ivanova ◽  
E. V. Kazantseva
Keyword(s):  
Postoperative Period ◽  
Abdominal Cavity ◽  
Uterine Fibroids ◽  
Sodium Hyaluronate ◽  
Uterine Cavity ◽  
Early Postoperative Period ◽  
Gynecological Surgery ◽  
Surgical Interventions ◽  
And Control

The article presents our experience in the use of anti-adhesive barrier based on hyaluronic acid and carboxymethylcellulose in gynecological surgery. The study included 63 patients who underwent removal of polyps, uterine fibroids, intrauterine synechiae, removal of ovarian cysts. At the end of operations an anti-adhesive gel was introduced into the uterine cavity and into the abdominal cavity to prevent adhesions. Efficacy and safety were assessed in the early postoperative period and with a further sixmonth follow-up of patients. It is noted that the introduction of the gel does not lead to the development of hyperthermic reactions, and in the postoperative period in patients there is no increase in the level of leukocytes (6.3 ± 0.2 x 109/L before the operation and 5.8 ± 0.5 x 109/L in postoperative period). In 89.7% of patients after surgical interventions, normalization of the menstrual cycle was noted, in 23% of patients with infertility, pregnancy was noted. When carrying out ultrasound of the pelvic organs and control hysteroscopy (in 7 cases), no evidence of the occurrence of adhesions was obtained.

scholarly journals Prevalence, incidence and associated risk factors of STIs during pregnancy in South Africa

2020 ◽  
pp. sextrans-2020-054631
Author(s):  
Dorothy Chiwoniso Nyemba ◽  
Andrew Medina-Marino ◽  
Remco P H Peters ◽  
Jeffrey D Klausner ◽  
Phuti Ngwepe ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pregnant Women ◽  
Birth Outcomes ◽  
Syndromic Management ◽  
Younger Age ◽  
Pregnancy And Birth Outcomes ◽  
Adverse Pregnancy ◽  
Associated Risk Factors ◽  
Pregnancy And Birth

ObjectiveSTIs during pregnancy increase adverse pregnancy and birth outcomes and may increase HIV risk. STI syndromic management is standard of care in South Africa. Our study evaluated the prevalence and incidence of STIs in pregnant women and the associated risk factors.MethodsWe combined data from two prospective observational studies of pregnant women enrolled while attending their first antenatal clinic (ANC) visit in Tshwane District and Cape Town. Women ≥18 years were tested at first ANC visit and at their first postpartum visit for Chlamydia trachomatis, Neisseria gonorrhoeae and Trichomonas vaginalis using Xpert assays (Cepheid, USA). We evaluated the prevalence and incidence of STI and the associated risk factors using multivariable regression models.ResultsWe enrolled 669 pregnant women, 64% (n=427) from Tshwane District and 36% (n=242) from Cape Town; 80% (n=534) were women living with HIV (WLHIV) and 20% (n=135) without HIV. At enrolment, 37% (n=250) were diagnosed with at least one STI, of which 76% (n=190) were asymptomatic. STI prevalence was 40% (n=213) in WLHIV and 27% (n=37) in women without HIV (p=0.01). Baseline STI infection was associated with younger age (OR=0.95 per year, 95% CI 0.92 to 0.98), higher gestational age (adjusted OR (aOR)=1.03 per week, 95% CI 1.00 to 1.05), single relationship status (aOR=1.53, 95% CI 1.09 to 2.15) and HIV status (aOR=1.86, 95% CI 1.17 to 2.95). Of 419 participants with no STI at baseline, 21 had an incident STI during follow-up, with a mean follow-up time of 140 days. The incidence rate of STI during pregnancy and early post partum was 15 infections per 100 women-years (95% CI 9 to 23). Younger age was associated with STI incidence.ConclusionOur study shows high prevalence and incidence of STIs in pregnancy, especially in WLHIV, demonstrating the need for STI screening in ANC to prevent adverse pregnancy and birth outcomes. Most STI cases were asymptomatic and would have gone untreated with syndromic management. Aetiological STI screening is urgently needed to reduce the burden of STIs in pregnancy.

P-748 Diode laser hysteroscopic metroplasty for dysmorphic uterus: a pilot study

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
A Bilgory ◽  
E Shalom - Paz ◽  
Y Atzmon ◽  
N Aslih ◽  
D Estrada ◽  
...  
Keyword(s):  
Pilot Study ◽  
Diode Laser ◽  
Medical Center ◽  
Uterine Cavity ◽  
Reproductive Outcomes ◽  
Excessive Bleeding ◽  
Nulliparous Women ◽  
Tertiary Center ◽  
Adverse Pregnancy

Abstract Study question Whether diode laser hysteroscopic metroplasty for dysmorphic uterus is a safe and efficacious procedure and its effect on reproductive outcomes. Summary answer Diode laser hysteroscopic metroplasty is a safe and effective procedure for infertile women with dysmorphic uterus with comparable results to those reported in the literature. What is known already A T-shaped uterine anomaly is categorized by the ESHRE/ESGE consensus as dysmorphic uterus class U1a, characterized by an abnormal hypoplastic uterine cavity. A Y-shaped uterus is a dysmorphic uterus with a fundal subseptum. Dysmorphic uteri are associated with infertility, recurrent implantation failure (RIF), recurrent pregnancy loss (RPL), and adverse pregnancy outcomes. According to several studies, it seems that hysteroscopic metroplasty may improve the chances of conception and live birth. Previous studies described the procedure using bipolar systems, monopolar needle or scissors. The purpose is to achieve a uterine cavity of normal shape and volume by cutting the thickened lateral walls. Study design, size, duration This was a retrospective pilot study with a prospective follow-up. We retrospectively evaluated all cases operated between February 2018 to February 2020, at Hillel Yaffe Medical Center, Hadera, Israel. Reproductive outcomes for women who underwent the procedure were followed until September 2020. Pregnancies that were ongoing on September 2020 were followed until January 31st 2021. Participants/materials, setting, methods Nulliparous women with a diagnosis of infertility or RPL, who were diagnosed with dysmorphic uterus by three-dimensional ultrasound (3D-US) and underwent diode laser hysteroscopic metroplasty were included. All the metroplasties were done in one tertiary center by the same specialist. Reproductive outcomes were evaluated retrospectively and prospectively for a total follow-up time of 32 months. Reproductive performances before and after metroplasty were compared where possible. Main results and the role of chance Twenty-five women underwent diode laser hysteroscopic metroplasty for dysmorphic uterus in our institute. No perforations, excessive bleeding, or other complications were encountered during the procedures. Follow-up hysteroscopy and 3D-US were satisfactory in all cases 2 months after the metroplasty. A total of 15 nulliparous women returned to fertility treatments afterwards, among whom 9 conceived (60% pregnancy rate). Their infertility period before the procedure was 56.6 ± 36.1 months. The duration between the metroplasty to pregnancy was 5.2 ± 3.5 months. The rate of deliveries and ongoing pregnancies (pregnancies beyond 20 weeks of gestation) was 78% (7/9), with five successful liveborn deliveries and two ongoing pregnancies. All deliveries were between 36-37 weeks. The 10 women who were not treated by our infertility unit were contacted, among whom 6 discontinued their attempt to conceive. The other 4 conceived; three of them spontaneously. Among those 4 women,the rate of deliveries and ongoing pregnancies was 75%, with one term delivery and two ongoing pregnancies. Limitations, reasons for caution First, we included both T-shaped and Y-shaped uteri as both represent close versions of dysmorphic uteri, but in fact they differ. The subseptum might interfere with reproduction in a different mechanism. Second, the small and heterogeneous sample as well as the short duration of follow-up limit the conclusions. Wider implications of the findings We present the first application of diode laser in hysteroscopic metroplasty for dysmorphic uteri. This technique seems promising and our results are comparable with other series using different cutting devices. Only larger controlled trials with a longer follow-up can confirm the safety, efficacy, and impact on reproductive outcomes. Trial registration number Not Applicable

Dynamics of indicators of hemostatic system as prognostic criteria consequences of ART programs

2016 ◽  
pp. 165-170
Author(s):  
S. Zhuk ◽  
◽  
V. Vorobey-Vykhivska ◽  
Keyword(s):  
Risk Factors ◽  
Key Words ◽  
Infertility Treatment ◽  
Reproductive Technology ◽  
Hypercoagulable State ◽  
Dynamic Monitoring ◽  
Art Programs ◽  
Prognostic Criteria ◽  
Hemostatic System ◽  
Art Program

The article deals with the insurense of haemostatic system on the ART result. The objective: of the study was to establish the relationships between the state of hemostasis in dynamics during the ART program and its results. Patients and methods. The study involved 130 women who underwent infertility treatment through IVF. The dynamics of hemostasis indicators for ART programs is investigated. Results. The trend to a hypercoagulable state in women with failed attempts of IVF is fined. Risk factors ART failure due to hemostasis disorders is established. Conclusions. The evolution of the hemostatic system is an important prognostic criteria on the outcome of ART programs. The lack of signs of a hypercoagulable state can be considered a prerequisite for pregnancy. Dynamic monitoring of hemostasis within ART programs will take timely measures on correction of the hemostatic system and to some extent influence the effects of treatment. Key words: infertility, hemostasis, assisted reproductive technology.

scholarly journals Office Hysteroscopic Laser Enucleation of Submucous Myomas without Mass Extraction: A Case Series Study

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Sergio Haimovich ◽  
Maite López-Yarto ◽  
Julio Urresta Ávila ◽  
Alejandro Saavedra Tascón ◽  
José L. Hernández ◽  
...  
Keyword(s):  
Therapeutic Option ◽  
Case Series ◽  
Uterine Cavity ◽  
Hysteroscopic Myomectomy ◽  
Submucous Myoma ◽  
Case Series Study ◽  
Laser Enucleation ◽  
A Prospective Study ◽  
Series Study

Background and Objectives. A new two-step hysteroscopic myomectomy carried out in the office setting and without anesthesia was feasible for the excision of submucous myomas. The objective of this study was to assess whether removal of submucous myomas from the uterine cavity after hysteroscopic laser enucleation is necessary.Methods. Between June 2009 and April 2013, all outpatients with symptomatic myomatosis (bleeding, pelvic pain, and infertility) assessed ultrasonographically were eligible to participate in a prospective study. All patients underwent office hysteroscopic enucleation of submucous myomas. Enucleated myomas were left in the uterine cavity. Neither anesthesia nor antibiotic prophylaxis was used.Results. Sixty-one women (mean age: 47.3 years) were included. Regardless of hysteroscopic localization and grading, all myomas were enucleated. The mean (standard deviation, SD) diameter of the myoma as measured by the ultrasound scan was 22.6 (8.5) mm. In 29 cases (47.5%), the diameter of the resected myoma was >20 mm and in 10 cases (16.4%) >30 mm. After a mean follow-up of 68.2 (16.5) days, none of the patients showed a residual myoma inside the uterine cavity.Conclusions. The present results indicate that leaving laser-enucleated submucous myoma in the uterine cavity is a feasible and safe therapeutic option.

scholarly journals Experience of application anti adgesivebarrier in the treatment of patients with Asherman’s syndrome

2016 ◽  
Vol 65 (5) ◽  
pp. 29-32
Author(s):  
Tatyana A Makarenko ◽  
Daria E Nikiforova ◽  
Inga O Ul’yanova
Keyword(s):  
Uterine Cavity ◽  
Intrauterine Adhesions ◽  
Asherman’S Syndrome ◽  
Surgical Interventions ◽  
Results Of Treatment ◽  
Group I ◽  
Extreme Degree ◽  
Group Ii ◽  
Research On Application ◽  
Prevention Of Recurrence

Relevance. Asherman’s syndrome is one of the most difficult problems in gynecologic practice, because in addition to complex clinical picture, which includes secondary amenorrhea and infertility is a significant difficulty in diagnosis and treatment. The purpose was to improve the results of treatment of Аsherman’s syndrome after conducting hysteroresectoscope adhesiolysis using anti adhesive barrier “Antiadgezin”.Materials and methods. The study included 36 patients with peritoneal process in the uterus of varying severity. Group I consisted of 20 women who are in the postoperative period in the uterine cavity was entered “Antiadgezin”, group II — 16 women with similar pathology without introducing anti adgesive barriers.Results. All women 3 months after adhesiolysis was performed a control hysteroscopy. The presence of adhesions was diagnosed in 2 (10%) patients in the first group, while adhesions were isolated delicate and easily destroyed by the sheath of a hysteroscope. In group II adhesions had recurrences in 5 (31,3%) patients (p = 0,038), and one patient was visualized “tunnel” — uterus, which is extremely unfavorable course of disease.Conclusion. Treatment of Asherman’s syndrome, as extreme degree of intrauterine adhesions, requires a comprehensive approach, which is based on prevention of recurrence of the formation of adhesions after surgical interventions. Research on application anti adgesivebarriers will continue, as intrauterine their use on the example of antiadgezin showed good results.

scholarly journals Causes and clinical picture of very early preterm birth

2021 ◽  
Vol 6 ◽  
pp. 44-49
Author(s):  
O.V. Mosendz
Keyword(s):  
Risk Factors ◽  
Preterm Birth ◽  
Uterine Fibroids ◽  
Perinatal Outcomes ◽  
Reproductive Age ◽  
Surgical Interventions ◽  
Urogenital Infections ◽  
Fetoplacental Complex ◽  
Inflammatory Processes ◽  
Early Preterm Birth

The objective: the determination of the risk factors, causes and clinical features of very early preterm birth.Materials and methods. The data of anamnesis, the course of pregnancy, childbirth and perinatal outcomes in 166 women of reproductive age with very early preterm birth at 22–27 weeks of gestation were analyzed. The fact of childbirth at these terms of pregnancy is the main criterion of inclusion. The patients were divided into two groups depending on the criteria of live birth: 1 group — 79 women, whose labor was regarded as late miscarriage (retrospective study); 2 group — 87 women with very early preterm (prospective study). Exclusion criteria: congenital malformations of the fetus. Results. The main risk factors for the development of very early preterm labor are urogenital infections (83.7 % and 78.9 % in 1 and 2 groups, respectively). A combination of pathogens was found in almost half of the subjects (43 % in 1 group, 44 % in 2 group). The patients in both groups had a complicated general and obstetric anamnesis, in particular, a significant frequency of inflammatory processes of the genital organs (50.0 % – in 1 group and 59.2 % – in 2 group), surgical interventions (50.0 % and 59.2 %, respectively), as well as hormonal disorders and related diseases (ovarian dysfunction – 27.8 % and 27.6 %, uterine fibroids – 16.4 % and 17. 2%, ovarian cysts – 11.4 % in both groups). 35.4 % of patients in 1 group and 28.7 % of patients in 2 group had a history of chronic foci of infections, pathology of the urinary system – 30.3 % and 28.7 %, respectively, of the digestive tract – 24 % and 22.98 %, hypertension – 32.9 % and 31 %. The main complications of gestation in pregnant women in both groups in the II trimester were the threat of abortion (43 % and 30 %, respectively) and dysfunction of the fetoplacental complex (22.7 % and 21.8 %). This caused fetal growth retardation in both groups – 66 % and 63 % of newborns, respectively.Conclusions. Analysis of the general and obstetric history, the presence of infectious factor in combination with extragenital pathology confirm the polyetiology of the causes that leads to very early preterm birth. Considering the main risk factors of preterm birth, a complete examination for urogenital infections in women before and during pregnancy, followed by treatment and restoration of normal vaginal biocenosis, as well as the study of fetoplacental system function from early pregnancy is neseccary.Preventive measures and timely treatment of fetoplacental disorders should prolong pregnancy for the terms in which there is the best way to improve perinatal outcomes.

Risk factors, demographics and clinical profile of Acanthamoeba keratitis in Melbourne: an 18-year retrospective study

2017 ◽  
Vol 102 (5) ◽  
pp. 687-691 ◽  
Author(s):  
Matthew Hao Lee ◽  
Robin Geoffrey Abell ◽  
Biswadev Mitra ◽  
Merv Ferdinands ◽  
Rasik B Vajpayee
Keyword(s):  
Risk Factors ◽  
Early Recognition ◽  
Visual Outcome ◽  
Signs And Symptoms ◽  
Acanthamoeba Keratitis ◽  
Late Diagnosis ◽  
Surgical Interventions ◽  
Incidence Risk ◽  
Final Visual Outcome

PurposeTo assess incidence, risk factors, presentation and final visual outcome of patients with Acanthamoebakeratitis (AK) treated at the Royal Victorian Eye and Ear Hospital (RVEEH), Melbourne, Australia, over an 18-year period.MethodsA retrospective review of all cases of AK managed at RVEEH between January 1998 and May 2016 was performed. Data collected included age, gender, affected eye, signs and symptoms, time between symptoms and diagnosis, risk factors, presenting and final visual acuity (VA), investigations, medical treatment, surgical interventions and length of follow-up.ResultsA total of 36 eyes affected by AK in 34 patients were identified. There were 26 cases diagnosed early (<30 days) and 10 were diagnosed late (≥30 days). There were 31 (86.1%) cases associated with contact lens (CL). Signs associated with early AK included epithelial infiltrates, while signs of late AK included uveitis, ring infiltrate, endothelial plaque and corneal thinning (p<0.05). Surgical treatment was required in seven cases (19.4%). There were 29 (80.6%) cases that reported improved VA. Median best corrected final VA was worse in patients with late diagnosis (logarithm of minimal angle of resolution (logMAR) 0.5, IQR: 0.2–0.8), compared with patients with early diagnosis (logMAR 0.0, IQR: 0.0–0.3; p=0.01). Late diagnosis was associated with a prolonged disease period.ConclusionAK was an uncommon cause of severe keratitis and was associated commonly with CL. Patients with late diagnosis had worse presenting and final VAs as well as a prolonged disease period, indicating need for early recognition and management.

Prevalence, risk factors and management of ocular hypertension or glaucoma in patients with Vogt-Koyanagi-Harada disease

2020 ◽  
pp. bjophthalmol-2020-316323
Author(s):  
Peizeng Yang ◽  
Chaokui Wang ◽  
Guannan Su ◽  
Su Pan ◽  
Yang Qin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Case Series ◽  
Chinese Patients ◽  
Time Interval ◽  
Inflammatory Factor ◽  
Surgical Interventions ◽  
Treatment Data ◽  
Uveitis Attack ◽  
Posterior Synechiae

Background/aimsThis study was performed to examine the prevalence, risk factors and treatment outcome of OHT/glaucoma in Chinese patients with Vogt-Koyanagi-Harada (VKH).MethodsRetrospective non-interventional case series were conducted on a total of 2281 patients with VKH referred from April 2008 to April 2019. Of these cases, 1457 had a minimum follow-up period of 3 months and were included for this study. Medical records were reviewed for demographic, ocular and treatment data.ResultsAmong 2914 eyes of 1457 patients with VKH, 695 (23.9%) eyes of 425 patients (29.2%) developed OHT/glaucoma. The risk factors of OHT/glaucoma included initial BCVA of 20/200 or worse (OR=4.826), final best-corrected visual acuity (BCVA) of 20/50–20/100 (OR=5.341) and final BCVA of 20/200 or worse (OR=4.235), the interval between uveitis attack and referral time interval being 2 months or more (OR=3.318), more than three recurrent episodes (OR=4.177) and posterior synechiae (OR=1.785). The main possible mechanisms of OHT/glaucoma were inflammatory factor-induced open-angle OHT/glaucoma in 277 eyes (39.9%) and pupillary block arising from complete posterior synechiae in 201 eyes (28.9%). In these 695 eyes with OHT/glaucoma, normalised intraocular pressure (IOP) was achieved in 389 eyes (56.0%) following medical treatment. In the remaining 306 eyes, various surgical interventions were performed and a normalised IOP could be achieved in 249 eyes (81.4%).ConclusionOHT/glaucoma is a common complication in Chinese patients with VKH. Risk factors of OHT/glaucoma included worse acuity at first and final visits, the longer interval between uveitis attack and referral, more recurrent episodes and posterior synechiae.

P–748 Diode laser hysteroscopic metroplasty for dysmorphic uterus: a pilot study

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
A Bilgory ◽  
E Shalo. Paz ◽  
Y Atzmon ◽  
N Aslih ◽  
D Estrada ◽  
...  
Keyword(s):  
Pilot Study ◽  
Diode Laser ◽  
Medical Center ◽  
Uterine Cavity ◽  
Reproductive Outcomes ◽  
Excessive Bleeding ◽  
Nulliparous Women ◽  
Tertiary Center ◽  
Adverse Pregnancy

Abstract Study question Whether diode laser hysteroscopic metroplasty for dysmorphic uterus is a safe and efficacious procedure and its effect on reproductive outcomes. Summary answer Diode laser hysteroscopic metroplasty is a safe and effective procedure for infertile women with dysmorphic uterus with comparable results to those reported in the literature. What is known already A T-shaped uterine anomaly is categorized by the ESHRE/ESGE consensus as dysmorphic uterus class U1a, characterized by an abnormal hypoplastic uterine cavity. A Y-shaped uterus is a dysmorphic uterus with a fundal subseptum. Dysmorphic uteri are associated with infertility, recurrent implantation failure (RIF), recurrent pregnancy loss (RPL), and adverse pregnancy outcomes. According to several studies, it seems that hysteroscopic metroplasty may improve the chances of conception and live birth. Previous studies described the procedure using bipolar systems, monopolar needle or scissors. The purpose is to achieve a uterine cavity of normal shape and volume by cutting the thickened lateral walls. Study design, size, duration This was a retrospective pilot study with a prospective follow-up. We retrospectively evaluated all cases operated between February 2018 to February 2020, at Hillel Yaffe Medical Center, Hadera, Israel. Reproductive outcomes for women who underwent the procedure were followed until September 2020. Pregnancies that were ongoing on September 2020 were followed until January 31st 2021. Participants/materials, setting, methods Nulliparous women with a diagnosis of infertility or RPL, who were diagnosed with dysmorphic uterus by three-dimensional ultrasound (3D-US) and underwent diode laser hysteroscopic metroplasty were included. All the metroplasties were done in one tertiary center by the same specialist. Reproductive outcomes were evaluated retrospectively and prospectively for a total follow-up time of 32 months. Reproductive performances before and after metroplasty were compared where possible. Main results and the role of chance Twenty-five women underwent diode laser hysteroscopic metroplasty for dysmorphic uterus in our institute. No perforations, excessive bleeding, or other complications were encountered during the procedures. Follow-up hysteroscopy and 3D-US were satisfactory in all cases 2 months after the metroplasty. A total of 15 nulliparous women returned to fertility treatments afterwards, among whom 9 conceived (60% pregnancy rate). Their infertility period before the procedure was 56.6 ± 36.1 months. The duration between the metroplasty to pregnancy was 5.2 ± 3.5 months. The rate of deliveries and ongoing pregnancies (pregnancies beyond 20 weeks of gestation) was 78% (7/9), with five successful liveborn deliveries and two ongoing pregnancies. All deliveries were between 36–37 weeks. The 10 women who were not treated by our infertility unit were contacted, among whom 6 discontinued their attempt to conceive. The other 4 conceived; three of them spontaneously. Among those 4 women,the rate of deliveries and ongoing pregnancies was 75%, with one term delivery and two ongoing pregnancies. Limitations, reasons for caution First, we included both T-shaped and Y-shaped uteri as both represent close versions of dysmorphic uteri, but in fact they differ. The subseptum might interfere with reproduction in a different mechanism. Second, the small and heterogeneous sample as well as the short duration of follow-up limit the conclusions. Wider implications of the findings: We present the first application of diode laser in hysteroscopic metroplasty for dysmorphic uteri. This technique seems promising and our results are comparable with other series using different cutting devices. Only larger controlled trials with a longer follow-up can confirm the safety, efficacy, and impact on reproductive outcomes Trial registration number Not applicable

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