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Diode Laser Hysteroscopic Metroplasty for Dysmorphic Uterus: a Pilot Study

  • Infertility: Original Article
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Abstract

This paper aims to study the efficacy and safety of diode laser hysteroscopic metroplasty for dysmorphic uterus and the impact on reproductive outcomes. This is a retrospective, single-center pilot study with prospective follow-up. The study was performed at a university-affiliated, tertiary hospital. From February 2018 to February 2020, all nulliparous women with a 3D ultrasound diagnosis of T-shaped or Y-shaped dysmorphic uterus and diagnosis of infertility, recurrent implantation failure, or recurrent pregnancy losses were referred for hysteroscopic metroplasty. Diode laser hysteroscopic metroplasty was performed under general anesthesia in an ambulatory setting. Main outcome measures included operative time, complications, hysteroscopic appearance of the cavity in a follow-up hysteroscopy, and reproductive outcomes in terms of pregnancy and live birth. A total of 25 infertile women with mean duration of infertility of 56.6 ± 36.1 months underwent hysteroscopic metroplasty. No complications were reported, and subsequent 3D ultrasound and follow-up hysteroscopic appearance were satisfactory in all cases. Maximum follow-up was 32 months (mean ± standard deviation 11.5 ± 9.2 months). Fifteen nulliparous women returned for fertility treatments in our institute, among whom nine conceived (60% pregnancy rate). The rate of deliveries and ongoing pregnancies (pregnancies beyond 24 weeks of gestation) was 78% (7/9), with six successful liveborn deliveries at 36-38 weeks and one ongoing pregnancy. One had spontaneous abortion at week 19 and one had a spontaneous abortion at week 7. Hysteroscopic metroplasty in an ambulatory setting, using diode laser, is a safe and effective procedure, improving reproductive outcomes in cases of T-shaped or Y-shaped uterus.

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Acknowledgements

We thank our senior technicians, Dalit Kamar-Shafan and Karina Yohananov, who are experts in the field of gynecological 3D-US and performed all 3D-US assessments.

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Author notes

  1. Asaf Bilgory

    Present address: Department of Obstetrics and Gynecology, Hillel Yaffe Medical Center, Hadera, Israel

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Hillel Yaffe Medical Center, Hadera, Israel

    Einat Shalom-Paz, Yuval Atzmon, Nardin Aslih, Yasmin Shibli, Daniela Estrada & Sergio Haimovich

  2. Affiliated to the Ruth and Bruce Rappaport School of Medicine, The Technion-Institute of Technology, Haifa, Israel

    Asaf Bilgory, Einat Shalom-Paz, Yuval Atzmon, Nardin Aslih, Yasmin Shibli, Daniela Estrada & Sergio Haimovich

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  1. Asaf Bilgory
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Asaf Bilgory, Einat Shalom-Paz, and Sergio Haimovich. The first draft of the manuscript was written by Asaf Bilgory and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Asaf Bilgory.

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Ethics Approval

The study was conducted according to the Declaration of Helsinki (1975) and Good Clinical Practice guidelines and was approved by the Hillel Yaffe Medical Center Institutional Review Board (approval number 0009-20-HYMC). Patients or the public were not involved in the design, conduct, reporting, or dissemination of our research.

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Informed consent to participate was not applicable due to the nature of the study.

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Informed consent to participate was not applicable due to the nature of the study.

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The authors declare no competing interests.

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Bilgory, A., Shalom-Paz, E., Atzmon, Y. et al. Diode Laser Hysteroscopic Metroplasty for Dysmorphic Uterus: a Pilot Study. Reprod. Sci. 29, 506–512 (2022). https://doi.org/10.1007/s43032-021-00607-1

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  • DOI: https://doi.org/10.1007/s43032-021-00607-1

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