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[Uterus septus with primary infertility - an operating indication?].
F Nawroth1, T Schmidt, C Freise
1Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, Universität zu Köln. Frank.Nawroth@medizin.uni-koeln.de
Zentralblatt Fur Gynakologie
|January 18, 2002
Summary
Hysteroscopic metroplasty for septate uterus in primary infertility patients shows a 52.4% pregnancy rate and low complication risk. This procedure may improve outcomes, especially for septums over 1.0 cm.
Area of Science:
- Reproductive Medicine
- Gynecologic Surgery
Background:
- Primary infertility affects numerous women.
- A septate uterus is a common uterine anomaly that can impact fertility.
- Hysteroscopic metroplasty is a surgical option for correcting uterine septums.
Purpose of the Study:
- To evaluate the necessity and efficacy of hysteroscopic metroplasty in patients with primary infertility and a septate uterus.
- To assess the pregnancy and miscarriage rates following the procedure.
Main Methods:
- Retrospective analysis of 21 patients with primary infertility and septate uterus who underwent hysteroscopic septum dissection (1993-2000).
- Data collected via medical records, operation reports, questionnaires, and patient/doctor contact.
- Evaluation of intraoperative and postoperative outcomes, including pregnancy rates and complications.
Main Results:
- All septum dissections were performed without complications.
- A total of 11 out of 21 patients (52.4%) achieved pregnancy during follow-up (median 24.0 months).
- Of the 11 pregnancies, 7 resulted in full-term delivery, 2 in premature birth, and 1 in miscarriage.
Conclusions:
- Hysteroscopic metroplasty is associated with low complication rates.
- The procedure may lead to improved pregnancy rates and reduced miscarriage rates.
- Diagnostic hysteroscopy is recommended before extensive infertility treatments, with operative hysteroscopy for septums >1.0 cm.