Can Pregnancy Occur After MyoSure?
Yes, women can become pregnant after MyoSure (hysteroscopic tissue removal system) procedure, with evidence showing a pregnancy rate of 65.12% and improved time to conception compared to traditional hysteroscopic electroresection. 1
Fertility Outcomes After MyoSure
The most recent high-quality evidence demonstrates that MyoSure not only preserves fertility but may enhance reproductive outcomes:
Pregnancy rates of 65.12% were achieved in women of reproductive age after MyoSure treatment for benign intrauterine lesions, significantly higher than the 54.55% rate with traditional electroresection (P = 0.045). 1
Time to pregnancy was significantly shorter at 13.14 ± 7.85 months compared to 16.26 ± 8.22 months with electroresection (P = 0.040). 1
Term live birth rates, premature birth rates, and abortion rates showed no significant differences between MyoSure and traditional methods, indicating comparable pregnancy safety profiles. 1
Mechanism of Fertility Preservation
MyoSure offers specific advantages that support fertility:
Reduced intrauterine adhesion formation: The American Fertility Society adhesion scores improved significantly more with MyoSure (2.90 ± 1.29 points) compared to electroresection (1.31 ± 0.89 points, P = 0.025). 1 This is critical because intrauterine adhesions are a major cause of infertility after hysteroscopic procedures.
Shorter operative times minimize endometrial trauma for type 0 and type I myomas, endometrial polyps, and retained products of conception. 1
Important Clinical Considerations
Lesion Type Matters
Type 0 and Type I submucosal fibroids: MyoSure demonstrates clear advantages with faster operative times and excellent fertility outcomes. 1
Type II myomas (>50% intramural component): MyoSure has limitations with lower complete resection rates compared to electroresection. 1 For these lesions, traditional electroresection or laparoscopic myomectomy may be more appropriate. 2
Supporting Evidence from Broader Hysteroscopic Myomectomy Data
The fertility benefits of hysteroscopic removal of submucosal fibroids are well-established:
Pregnancy rates of 85% after hysteroscopic myomectomy with live birth rates of 65% have been reported in retrospective studies. 2
Submucosal fibroids have the most detrimental effect on fertility with pregnancy rates of only 10% and implantation rates of 4.3% when left untreated. 2
Hysteroscopic myomectomy is the treatment of choice for submucosal fibroids to improve conception and pregnancy rates. 2
Post-Procedure Recommendations
Timing of conception attempts: While the evidence doesn't specify a mandatory waiting period after MyoSure, the improved adhesion scores and shorter operative times suggest earlier attempts may be reasonable compared to traditional methods. 1
Follow-up evaluation: Second-look hysteroscopy can assess for intrauterine adhesions, though MyoSure demonstrates significantly better adhesion outcomes than electroresection. 1
Critical Pitfall to Avoid
Do not assume MyoSure is appropriate for all fibroid types. For type II myomas with significant intramural components (>50%), comprehensive pre-procedure evaluation is required, and alternative approaches such as laparoscopic myomectomy should be considered. 1 2 The complete resection rate is lower with MyoSure for these lesions, which could compromise fertility outcomes.