Successful pregnancies in women with diffuse uterine leiomyomatosis after hysteroscopic management  Chih-Feng Yen, M.D., Chyi-Long Lee, M.D., Chin-Jung Wang, M.D., Yung-Kuei Soong, M.D., M.Phil., Aydin Arici, M.D.  Fertility and Sterility  Volume 88, Issue 6, Pages 1667-1673 (December 2007) DOI: 10.1016/j.fertnstert.2007.01.100 Copyright © 2007 American Society for Reproductive Medicine Terms and Conditions

Figure 1 The sonogram (A) and the hysteroscopic picture (B) revealed a diffuse dissemination of small uterine leiomyoma in patient 1. After the first extensive HM, adhesions were noted with emergence of residual submucosal myomata (C), despite postoperative hormonal treatment. With repeated hysteroscopic adhesiolysis, mild synechia persisted (D); however, the patient conceived thereafter. After the delivery, small submucosal myomas (≤0.8 cm) at the anterior fundus (E, view at the right hemicavity) and synechia at the left cornus (F, view at the left hemicavity) were still noted; even so, spontaneous conception occurred again in 1 year. M = myoma, Ad = adhesion. Fertility and Sterility 2007 88, 1667-1673DOI: (10.1016/j.fertnstert.2007.01.100) Copyright © 2007 American Society for Reproductive Medicine Terms and Conditions

Figure 2 (A) A recurrence of multiple myomas was noted on patient 2. (B) After HM, several intracavitary bumps were noted over intramural myomas. (C) However, the patient thereafter conceived spontaneously, with gestation in a uterus in which >10 intramural myomas measuring 1.0–2.5 cm in diameter were noted, some of them located immediately adjacent to the endometrium. M = myoma, GS = gestational sac. Fertility and Sterility 2007 88, 1667-1673DOI: (10.1016/j.fertnstert.2007.01.100) Copyright © 2007 American Society for Reproductive Medicine Terms and Conditions

Figure 3 (A) Patient 3 underwent an early intervention of postoperative hysteroscopy 1 month after the initial HM; only membranous adhesion bands were revealed and lysed. (B) Three months later, without any treatment, the cavity looked nearly normal. (C) Spontaneous conception occurred in the presence of multiple intramural myomas, each measuring <1 cm in diameter. M = myoma, GS = gestational sac. Fertility and Sterility 2007 88, 1667-1673DOI: (10.1016/j.fertnstert.2007.01.100) Copyright © 2007 American Society for Reproductive Medicine Terms and Conditions