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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
Objective:
The following retrospective study is intended as a contribution towards determining the necessity of a hysteroscopic metroplasty in patients with primary infertility. -
Material And Methods:
21 patients with primary infertility and a septate uterus, who had undergone a hysteroscopic dissection of the septum between 1993 and 2000, were evaluated. With the help of medical records, operation reports, standardised questionnaires as well as telephone contact with the patient's doctor and/or the patient, anamneses, operation as well as postoperative development were recorded. -
Results:
All dissections of the septum occurred without complication. During follow-up (median 24.0 +/- 23.7 months), 11/21 patients became pregnant (52.4 %). Of these 11 pregnancies, 7 ended (63.3 %) at full-term, 2 (18.2 %) prematurely and one (9.1 %) as a miscarriage. One pregnancy is currently in the 3(rd) trimester. -
Conclusions:
The hysteroscopic metroplasty demonstrates a low intra- and postoperative rate of complication. Particularly the indication of a lower rate of miscarriages, possibly of an increase in the pregnancy rates, should, in our opinion, give reason to proceeding with a diagnostic hysteroscopy, especially prior to extensive sterility therapies. Where suspicion exists of a septum > 1.0 cm, this should be corrected by means of an operative hysteroscopy.