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Human Reproduction, Vol. 13, No. 10, 2751-2755, October 1998
© 1998 European Society of Human Reproduction and Embryology

Hysteroscopic metroplasty in diethylstilboestrol-exposed and hypoplastic uterus: a report on 24 cases

Oliver Garbin, Jeanine Ohl, Karima Bettahar-Lebugle and Pierre Dellenbach

Department of Gynaecology, Centre Médico-Chirurgical et Obstétrical de la Sécurité Sociale (C.M.C.O.), 67300 Schiltigheim, France

Correspondence: To whom correspondence should be addressed at: Service de Gynécologie-Obstétrique, Centre Médico-Chirurgical et Obstétrical de la Sécurité Sociale, B.P. 120. 67303 Schiltigheim Cedex, France

The aim of this study was to determine the feasibility and safety of hysteroscopic metroplasty in cases of diethylstilboestrol-exposed and hypoplastic malformed uterus. Twenty-four patients were referred for primary infertility (n = 9), secondary infertility (n = 1) or infecundity (n = 14). Fifteen had been exposed to diethylstilboestrol in utero. All patients had a hypoplastic uterus and/or uterine deformity as seen by hysterosalpingography and each served as their own control. All patients underwent hysteroscopic metroplasty. Outcome measures included postoperative hysterosalpingography and the ability to conceive and to carry pregnancy to live birth. Postoperative hysterosalpingograms revealed improvement in 23 cases; the final result was considered excellent in 15 cases and 11 pregnancies occurred. The abortion rate decreased from 88% in previous pregnancies to 12.5%, and the rate of term deliveries increased from 3% to 87.5%. Ten patients were delivered after 30 weeks' gestation of healthy infants and one delivered more prematurely. Six deliveries were normal and four required a Caesarean section. We conclude that hysteroscopic metroplasty gives good results. This technique can be used in women with diethylstilboestrol-exposed or hypoplastic malformed uterus, suffering from severe infertility, recurrent pregnancy loss or implantation failures in an in-vitro fertilization programme.

Key words: diethylstilboestrol/hypoplastic uterus/hysteroscopic metroplasty/uterine deformity


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