Reproductive outcome after hysteroscopic metroplasty

To evaluate the reproductive outcome after hysteroscopic metroplasty.

We analysed the reproductive outcome of 69 patients, with different degrees of septate uterus, undergoing hysteroscopic metroplasty in the outpatient infertility clinic of Naples 'Federico II' University. Of the 69 patients, 48 had a history of recurrent abortion while 21 had a primary infertility. In all cases the procedure was performed by means of the resectoscope.

In 97.1% of the cases post-operative hysterosalpingogram or hysteroscopic examination showed a normal cavity with a little fundal notch. In two cases, second surgery was needed. Of the 48 patients affected by repeated abortion, 40 became pregnant after the metroplasty whereas, to date, in the infertile group only six out 21 (29.0%) conceived. We observed a total of 46 pregnancies with two sets of twins. Of these, 31 pregnancies (67.4%) were carried to term, five (10.8%) ended in preterm delivery, six (13%) ended in spontaneous abortion and four (8.6%) are in progress. Cervical cerclage was performed on 13 women. Only one (7.6%) woman with cervical cerclage had a preterm delivery, while the preterm delivery rate in women without cerclage was 12.1%. The modality of term pregnancy deliveries was cesarean section in 48% of the cases and vaginal delivery in the 52%.

Our data analysis suggest that the correction of mullerian anomalies does not improve the pregnancy rate, but only the pregnancy outcome of the patients.