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Submucous Fibroids and Infertility

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Reproductive Surgery in Assisted Conception

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Abstract

Submucous fibroids present one of the most challenging pathologies in reproductive surgery. Concomitant use of 2D/3D US and hysteroscopy provides the most efficient and fast information for the size, localization and penetrance of the submucous myoma in relation to the endometrial cavity and myometrium. MRI provides the highest accuracy and reproducibility concerning fibroids, however, due its cost is used only for difficult and complicated cases. Small fibroids upto 1.5 cm can be operated by mechanical hysteroscopy, however in larger ones bipolar resectoscopy is preferable. Preoperative GnRHa are indicated for myomas >4 cm for 1–2 months, in order to reduce myoma volume and ease surgery, treat menorrhagia, thin the endometrium and elevate Hb. New technological advances such as hysteroscopic morcelators and shavers with automatic chip aspiration seem to be efficient, safe and faster, however large and RCTs are not still available.

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Authors and Affiliations

  1. Department of Obstetrics and Gynaecology, St Georges Medical School Nicosia University, Aretaeio Hospital, Andrea Avraaminde Str 55-57, Nicosia, 2024, Cyprus

    Vasilios Tanos MD, PhD

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  1. Vasilios Tanos MD, PhD
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Correspondence to Vasilios Tanos MD, PhD .

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Editors and Affiliations

  1. Reproductive Medicine and Surgery, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom

    Mostafa Metwally

  2. Obstetrics and Gynaecology, Chinese University of Hong Kong, Hong Kong, China

    Tin-Chiu Li

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Tanos, V. (2015). Submucous Fibroids and Infertility. In: Metwally, M., Li, TC. (eds) Reproductive Surgery in Assisted Conception. Springer, London. https://doi.org/10.1007/978-1-4471-4953-8_9

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  • DOI: https://doi.org/10.1007/978-1-4471-4953-8_9

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-4952-1

  • Online ISBN: 978-1-4471-4953-8

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