Reproductive outcomes after hysteroscopic metroplasy for women with dysmorphic uterus and recurrent implantation failure

Keywords:

dysmorphic uterus, hysteroscopy, metroplasty, pregnancy rate, reproductive outcome, RIF, recurrent implantation failure


Published online: Feb 20 2019

J. Ferro1, E. Labarta2, C. Saenz3, P. Montoya3, J. Remohi4

Director of Surgery of Instituito Valenciano de Infertilidad “IVI”, Plaza de la Policía Local, 3. 46015. Valencia, Spain;
2 Especialist in Reproductive Medicine of Instituito Valenciano de Infertilidad “IVI”;
Fellows in Reproductive Medicine of Instituito Valenciano de Infertilidad “IVI”.
Director of Instituto Valenciano de Infertilidad “IVI.

Abstract

Background: The aim of this study was to assess the reproductive outcomes of women with recurrent implantation failure (RIF) after hysteroscopic metroplasty for dysmorphic uteri.
Methods: This retrospective observational study included 190 women with a diagnosis of RIF. These patients were eligible for hysteroscopic metroplasty for dysmorphic uteri, including T-shaped uteri, between January 2008 and September 2015 at the Instituto Valenciano de Infertilidad (IVI) in Valencia, Spain.
Results: The total clinical pregnancy rate, the live birth rate, and the abortion rate were 80.0% (152/190), 77.9% (147/190) and 8.9%, respectively. At 12 months, the clinical pregnancy rate was 76.3% (145/190) and at 6 months 50.5% (96/190). After the metroplasty, approximately 76% of all gravidities, were achieved during the first 12 months of follow-up. Within the first IVF cycle, pregnancy and live birth rates were 77.8% and 86.1%, respectively. The mean time to pregnancy was 6.5 months.
Conclusions: This study demonstrates that hysteroscopic metroplasty improves pregnancy and live birth rates for women with a history of recurrent implantation failure and dysmorphic uterus. However, conclusions must be taken carefully as this is an observational study. A prospective, randomized and controlled study is necessary to support these results.