Management and reproductive outcome of complete septate uterus with duplicated cervix and vaginal septum: review of 21 cases

Chen, Shuqin; Deng, Ni; Jiang, Hongye; Li, JinBo; Lu, San; Yao, Shuzhong

doi:10.1007/s00404-012-2622-x

Cited by 16 publications

(17 citation statements)

References 16 publications

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“…Clinical pregnancy rate (Fig. 5): For the analysis of clinical pregnancy rate, a pooled analysis was performed on six studies with a total of 358 patients who had hysteroscopic septum resection and 203 patients who were managed without septum resection [25][26][27][29][30][31]. One study was excluded from the meta-analysis [28] as the index pregnancy could not be determined from the results provided.…”

Section: Synthesis Of Resultsmentioning

confidence: 99%

“…Spontaneous miscarriage (Fig. 6): All seven studies looked at spontaneous miscarriage with 258 women having had the hysteroscopic septum resection compared with 184 women who did not [25][26][27][28][29][30][31]. The analysis found a significantly lower miscarriage rate in women who had hysteroscopic septum resection (OR 0.25, 95% CI 0.07-0.88) compared to those who had opted for conservative management.…”

Section: Synthesis Of Resultsmentioning

confidence: 99%

“…The reasons of exclusion include other uterine anomalies (n = 6), outcome comparison between septate uterus and normal uterus (n = 6), other techniques for septum resection apart from hysteroscopic resection (n = 4). A total of seven studies [25][26][27][28][29][30][31] involving 659 women, 407 who had hysteroscopic septum resection and 252 who did not, were included in the meta-analysis (Fig. 1; Table 1).…”

Section: Systematic Review and Characteristics Of Included Studiesmentioning

confidence: 99%

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Does hysteroscopic resection of uterine septum improve reproductive outcomes: a systematic review and meta-analysis

Krishnan

Narice

Ola

et al. 2021

Arch Gynecol Obstet

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Purpose Uterine septum in women with subfertility or previous poor reproductive outcomes presents a clinical dilemma. Hysteroscopic septum resection has been previously associated with adverse reproductive outcomes but the evidence remains inconclusive. We aimed to thoroughly and systematically appraise relevant evidence on the impact of hysteroscopically resecting the uterine septum on this cohort of women. Methods AMED, BNI, CINAHL, EMBASE, EMCARE, Medline, PsychInfo, PubMed, Cochrane register of controlled trials, Cochrane database of systematic reviews and CINAHL were assessed to April 2020, with no language restriction. Only randomised control trials and comparative studies which evaluated outcomes in women with uterine septum and a history of subfertility and/or poor reproductive outcomes treated by hysteroscopic septum resection against control were included. The primary endpoint was live birth rate, whereas clinical pregnancy, miscarriage, preterm birth and malpresentation rates were secondary outcomes. Results Seven studies involving 407 women with hysteroscopic septum resection and 252 with conservative management were included in the meta-analysis. Hysteroscopic septum resection was associated with a lower rate of miscarriage (OR 0.25, 95% CI 0.07–0.88) compared with untreated women. No significant effect was seen on live birth, clinical pregnancy rate or preterm delivery. However, there were fewer malpresentations during labour in the treated group (OR 0.22, 95% CI 0.06–0.73). Conclusion Our review found no significant effect of hysteroscopic resection on live birth. However, given the limited evidence available, high-quality randomised controlled trials are recommended before any conclusive clinical guidance can be drawn.

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Section: Synthesis Of Resultsmentioning

confidence: 99%

Section: Synthesis Of Resultsmentioning

confidence: 99%

Section: Systematic Review and Characteristics Of Included Studiesmentioning

confidence: 99%

See 1 more Smart Citation

Does hysteroscopic resection of uterine septum improve reproductive outcomes: a systematic review and meta-analysis

Krishnan

Narice

Ola

et al. 2021

Arch Gynecol Obstet

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“…Uterine septum causes various obstetric complications such as infertility, miscarriage, abnormal fetal position and premature birth ( Grimbizis et al, 2001 ). In patients with dyspareunia, spontaneous miscarriage and infertility, surgical intervention may be beneficial ( Chen et al, 2013 ). The septate uterus is classified into two types: complete type and incomplete type ( The American Fertility Society, 1988 ).…”

Section: Introductionmentioning

confidence: 99%

New Ambulatory Hysteroscopic Septoplasty using Ballooning in a Woman with Complete Septate Uterus: A Case Report

Cho¹,

Won²,

Kim³

et al. 2018

Dev Reprod

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A 40-year-old G1 P0 L0 A1 woman was referred to our clinic with 6-year history of infertility. Before visiting the clinic, she had 3 cycles of In-Vitro Fertilization (IVF) procedures (2 cycles of Controlled Ovarian Stimulation-IVF and 1 cycle of frozen-thawed Embryo Transfer (ET)) at other clinic. She had medical history of abortion at early gestation following FET (frozen-thawed-ET). The patient had complete type of septate uterus, double cervix and longitudinal vaginal septum. Vaginal septotomy was done first and 1 month later, hysteroscopic septoplasty was followed using ballooning filled with dye. After septoplasty, we inserted ballooning and left for several days to compress septal endometrium on the septectomy area. All procedures were done in the ambulatory operating room without laparoscopy or admission. 3 months later, she had in vitro fertilization-embryo transfer (IVF-ET) and FET procedures in our clinic. She had successful pregnancy and now is at 22 weeks of gestation. New ambulatory septoplasty using dye-filled ballooning is easy, safe and minimally invasive surgery for treatment of complete septate uterus.

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“…The postoperative hormone therapy using estrogen and terminal progesterone is controversial because their efficacy has not been demonstrated in well-designed, prospective, randomized studies. They utilized hormone replacement therapy (HRT) and/ or temporary splints such as the intrauterine device (IUD) to maintain the uterine cavity distended to denuding endometrial cavity to prevent septal fusion ( 24 - 28 ). Nonetheless, They also suggested artificial stimulation of endometrial growth postoperatively may assist in the overall healing process by artificially enhancing endometrial growth by use of estrogen and subsequent shedding by use of terminal progesterone, paving the way to normal endometrial growth and subsequent spontaneous ovulation ( 5 , 29 , 30 ).…”

Section: Introductionmentioning

confidence: 99%

Reproductive Outcome Following Hysteroscopic Treatment of Uterine Septum

2014

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Background:Septate uterus is the most common uterine anomaly and a cause for miscarriage and infertility. Existing data suggested a better reproductive outcome of uterine septum following hysteroscopic septum resection.Objective:Current study was administered to share our experience in hystroscopic septum resection for reproductive outcome following hysteroscopic treatment of uterine septum and specifically focusing on different treatment protocols after hysteroscopic septum resection.Methods& materials:This study was a cross-sectional study based on secondary data that was obtained from medical records of infertile women who had undergone transvaginal hysteroscopy and used different treatment protocols after hysteroscopic correction of uterine septum in Infertility and Reproductive Health Research Center between April 2005 and February 2014.Results:The total number of infertile women underwent hysteroscopy uterine septoplasty was 106. The hysteroscopy septoplasty resulted in an overall pregnancy rate of 67% and a live birth 57.5%. Pregnancy rate for patients who had not male infertility was 92.1%. The chi-square test did not reveal any statistically significant difference in side affect, pregnancy, live birth, abortion, preterm deliveries, and term deliveries rate between these patients either with consistent hormone therapy plus IUD insertion or with alternate hormone therapy plus IUD after hysteroscopic metroplasty.Conclusion:The findings of the present study indicated hysteroscopic septum resection to remove a uterine septum in women with infertility is safe and may be an efficacious procedure. Treatment following hysteroscopic septum resection, either the consistent or the alternate protocol is both beneficial to improve pregnancy rate.

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Management and reproductive outcome of complete septate uterus with duplicated cervix and vaginal septum: review of 21 cases

Abstract: The uterine septum may not necessarily be transected for patients who have complete septate uterus with duplicated cervix and vaginal septum, and meanwhile have no a history of poor reproductive outcome.

Cited by 16 publications

References 16 publications

Does hysteroscopic resection of uterine septum improve reproductive outcomes: a systematic review and meta-analysis

Does hysteroscopic resection of uterine septum improve reproductive outcomes: a systematic review and meta-analysis

New Ambulatory Hysteroscopic Septoplasty using Ballooning in a Woman with Complete Septate Uterus: A Case Report

Reproductive Outcome Following Hysteroscopic Treatment of Uterine Septum

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