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Chih-Feng Yen, M. D. , Chyi-Long Lee, M. D. , Chin-Jung Wang, M. D

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Presentation on theme: "Chih-Feng Yen, M. D. , Chyi-Long Lee, M. D. , Chin-Jung Wang, M. D"— Presentation transcript:

1 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 (December 2007) DOI: /j.fertnstert Copyright © 2007 American Society for Reproductive Medicine Terms and Conditions

2 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  , DOI: ( /j.fertnstert ) Copyright © 2007 American Society for Reproductive Medicine Terms and Conditions

3 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  , DOI: ( /j.fertnstert ) Copyright © 2007 American Society for Reproductive Medicine Terms and Conditions

4 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  , DOI: ( /j.fertnstert ) Copyright © 2007 American Society for Reproductive Medicine Terms and Conditions


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