Finis coronat opus? What comes after hysteroscopic metroplasty

Hysteroscopic metroplasty is widely regarded as the endpoint of septate uterus care, yet its impact on fertility remains uncertain and the postoperative cavity is seldom reassessed. Evidence on second-look hysteroscopy is equally scarce: mostly retrospective, rarely randomised, and not designed to isolate its reproductive effect. Re-inspection should arguably be reframed as an integral, fertility-oriented step rather than optional surveillance. Routine use in all patients is unjustified and not cost-effective, yet systematic omission may also overlook clinically relevant abnormalities. A selective, risk-stratified strategy is preferable, reserving it for the highest-risk women and triaging the rest with three-dimensional sonohysterography. Prospective, second-look-controlled trials are needed.