Reproductive outcomes following management of intrauterine pathologies by hysteroscopic resection: a systematic review
CANSAGE ePoster Library. Fras T. 09/27/19; 275250; eP-117
Tatiana Fras
Tatiana Fras
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Objective: To examine the reproductive outcomes following hysteroscopic morcellation and resection in the management of intrauterine pathologies.Study methods: A systematic literature review was conducted using the Cochrane Library, EMBASE, and MEDLINE databases from their respective inception dates to July 2018. Keywords included hysteroscopy, resection, morcellation, fertility, pregnancy, and birth. Prospective and retrospective studies examining reproductive outcomes following hysteroscopic management of intrauterine pathologies, including but not limited to intrauterine adhesions, retained products of conception, fibroids and polyps were included. Data was extracted by two independent reviewers. Results: The literature search yielded a total of 659 studies, of which 10 studies met inclusion criteria. Theses were all observational studies; and included a total of 972 women. A variety of techniques including hysteroscopic scissors, monopolar loop, and morcellation were used. Study period ranged from 1978 to 2016. Five studies examined fertility outcomes following hysteroscopic management of intrauterine adhesions, 4 looked at fibroids, 1 related to polyps and 1 on retained products of conception. Clinical pregnancy rates following treatment ranged between 44.9 to 100%, whereas live birth rates ranged from 32.1 to 89%. Conclusion: Hysteroscopic resection is a safe and effective method in the management of intrauterine pathologies, all the while preserving high rates of fertility following treatment.
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