7378 Correction of Uterine Anomalies and Its Effect on Infertility and Recurrent Miscarriages in a Study Including 10000 Patients over 6 Years

Abstract

<h3>Study Objective</h3> use of hysteroscopic metroplasty to enhance and promote the uterine receptivity in infertile women and those who had recurrent miscarriages. <h3>Design</h3> prospective study for 6 years from 2016 including 12000 cases of primary infertility and recurrent miscarriages. <h3>Setting</h3> operative hysteroscopy both 5mm and 9mm, patient on lithotomy position under either general or spinal anaesthesia. <h3>Patients or Participants</h3> cases were selected as primary infertility for more than 2 years, recurrent IVF or ICSI failure, recurrent miscarriages who had 3D transvaginal ultrasound assessment that revealed anomalies including Narrow T shaped, tubular, subseptated and septated cavities. <h3>Interventions</h3> hysteroscopic metroplasty to reach the normal cavity shape and dimensions. If excessive raw area levonorgestril triple dose for 21 days used post operative to enhance healing and putting Foleys catheter size 10 F for 3 days post operative. <h3>Measurements and Main Results</h3> 3D transvaginal ultrasound +or - saline sono hystrography done post hysteroscopic correction by one cycle to compare the shape and dimensions with the preoperative one and to ensure absence of intrauterine adhesions. 88% of cases had successfully got pregnant and continued their pregnancy beyond 36 weeks, 6 % had preterm labour between 30-36 weeks, 2% had preterm labour 28-30 weeks and 4 % still under follow up. <h3>Conclusion</h3> correction of uterine anomalies has a strong significance on success of implantation in cases of infertility, recurrent IVF and ICSI failure and recurrent miscarriages after prober 3D transvaginal ultrasound.