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Hum. Reprod. Advance Access originally published online on January 12, 2006
Human Reproduction 2006 21(4):1047-1051; doi:10.1093/humrep/dei438
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© The Author 2006. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Removal of a residual portion of a uterine septum in women of advanced reproductive age: obstetric outcome

Zsolt Kormányos1, Béla G. Molnár and Attila Pál

Department of Obstetrics and Gynaecology, Faculty of General Medicine, Albert Szent-Györgyi Medical and Pharmacological Centre, University of Szeged, Szeged, Hungary

1 To whom correspondence should be addressed at: Department of Obstetrics and Gynaecology, University of Szeged, Semmelweis u. 1., H-6725 Szeged, Hungary. E-mail: kormanyos{at}obgyn.szote.u-szeged.hu

BACKGROUND: To learn more about the obstetric outcome after initial septum resection and remnant septum (≤1 cm) resection. METHODS: In 94 patients with septate uteri who underwent uterine septum resection, the reproductive efficiency was analysed in a prospective observational study. The reproductive outcome was analysed after initial resection and (if required) consecutive procedures. RESULTS: A total of 94 women were enrolled in the study; all had had two or more miscarriages. The septum was completely removed during the first hysteroscopy in 58 (62%) cases. A residual septum was observed in 36 (38%) patients. Subsequent operative hysteroscopy was performed in the cases (29/36; 80.5%) involving repeated miscarriage and unsuccessful conception. The minimum observation time was 24 months. The difference in delivery rate after the first hysteroscopy between those with a normalized uterine cavity (26/58; 44.8%) and those with remnants (7/36; 19.4%) was statistically significant (P < 0.05). In fact, following the normalization of the uterine cavity, 62.1% (18/29) of the patients delivered, as compared with 19.4% of those (7/36) with a residue and Kaplan–Meyer curves revealed a statistically significant difference (P < 0.05). CONCLUSIONS: Women with a remnant uterine septum have an increased chance of successful pregnancy with an improved obstetric outcome after normalization of the uterine cavity.

Key words: hysteroscopy/infertility/metroplasty/miscarriage/remnant septum


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