Human Reproduction, Vol 12, 2277-2281, Copyright © 1997 by Oxford University Press
F Raga, C Bauset, J Remohi, F Bonilla-Musoles, C Simon and A Pellicer
This retrospective longitudinal study was undertaken in order to determine
the incidence and reproductive impact of uterine malformations on women
desiring to conceive during their reproductive years. A total of 3181
patients in whom the morphology of the uterus was ascertained by
hysterosalpingography (HSG) and laparoscopy/laparotomy during the years
1980-1995 was included in the study. The population analysed included
fertile, infertile and sterile patients. The overall frequency of uterine
malformations was 4.0%. Infertile patients (6.3%) had a significantly (P
< 0.05) higher incidence of Mullerian anomalies, in comparison with
fertile (3.8%) and sterile (2.4%) women. Septate (33.6%) and arcuate
(32.8%) uteri were the most common malformations observed. Each
malformation was individually analysed in fertile and infertile patients,
in order to ascertain its actual reproductive impact. The performance of
the unicornuate and didelphys uteri was similar with a chance of having a
living child of 37-40%. The reproductive potential of the bicornuate uterus
showed a live birth rate of 62.5% and the septate uterus showed a live
birth rate of 62%. In all these abnormalities, early miscarriages (25-38%)
and preterm deliveries (25-47%) were quite common. The arcuate uterus
presented a live birth rate of 82.7%. It is concluded that uterine
anomalies are relatively frequent in fertile women, and more frequent in
infertile patients. Nevertheless, fertile patients with normal reproductive
performance do exist, and Mullerian defects can permit an absolutely normal
obstetric outcome. The reproductive performance of the unicornuate and
didelphys uteri was poor, while that of the septate and bicornuate uteri
was better than expected. The arcuate uterus had no impact on reproduction.
ARTICLES
Reproductive impact of congenital Mullerian anomalies
Instituto Valenciano de Infertilidad, Hospital Clinico Universitario, Valencia, Spain.
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