We reviewed pre- and postoperative appearances of the uterine cavity o
n hysterosalpingography (HSG) in 28 patients who had hysteroscopic sur
gery. Twelve patients presented with primary infertility and 16 patien
ts with secondary infertility. The uterine abnormalities included syne
chiae (12), septa (8), submucosal fibroids (7), and polyp (1). The siz
e and number of lesions in the uterus, the extent of improvement after
surgery, and the postoperative pregnancy rate were recorded. The uter
ine cavity was restored to a normal appearance in 23 (82%) of 28 patie
nts. In patients after fibroid resection, all uterine cavities reverte
d to normal after surgery. Two patients developed adhesions after sept
al resection. Three patients with lysis of synechiae remained unchange
d or had worsened intrauterine scarring. The postoperative pregnancy r
ate was 35% (six of 17) in those patients followed for more than 6 mon
ths. One patient had a spontaneous abortion. In the six patients who b
ecame pregnant, four had secondary infertility, and all had normal or
substantial improvement in the appearance of the uterine cavity after
surgery. Perforation of the uterus occurred in one patient after resec
tion of a fibroid.