子宮内腫瘤に対し子宮鏡手術を行いadenomyomaと診断され、術後自然妊娠に至った不妊症の一例

抄録

Introduction: Adenomyosis of the uterus can potentially give rise to pathologic processes causing infertility. We report the case of one previously infertile woman who achieved pregnancy after hysteroscopic resection of an endometrial tumor, diagnosed histopathologically as adenomyoma.

Case: A 35-year-old woman with a history of infertility and an intra-uterine tumor visited our hospital for hysteroscopic resection. Despite receiving 9 cycles of ovulation-inducing medications and artificial insemination using her husband's sperms plus ovulation-inducing agents for 3 additional cycles, she failed to achieve pregnancy. She was diagnosed with a tumor of the endometrium and underwent dilation and curettage. However, she was still unable to achieve pregnancy after 2 cycles of artificial insemination, one with and one without ovulation-inducing agents. Subsequently, she was brought to our hospital. We suspected an atypical polypoidal adenomyoma or submucosal myoma of the uterus on hysteroscopy and proceeded to perform hysteroscopic resection. The histopathological diagnosis was intra-uterine adenomyoma. The patient achieved a natural pregnancy 2 months after the surgery. Her pregnancy was uncomplicated.

Conclusion: In our study, we present the case of a previously infertile woman who achieved a natural pregnancy after hysteroscopic resection of an endometrial tumor, diagnosed histopathologically as adenomyoma. Our case demonstrates the utility of hysteroscopy and hysteroscopic resection in the diagnosis and treatment of unexplained infertility.