Research Article
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Year 2022, Volume: 5 Issue: 5, 1272 - 1275, 25.09.2022
https://doi.org/10.32322/jhsm.1133577

Abstract

References

  • Grimbizis G, Camus M, Clasen K, Tournaye H, De Munck L, Devroey P. Hysteroscopic septum resection in patients with recurrent abortions or infertility. Hum Reprod 1998; 13: 1188-93.
  • Acién P, Acién MI. The history of female genital tract malformation classifications and proposal of an updated system. Hum Reprod Update 2011; 17: 693-705.
  • Chan YY, Jayaprakasan K, Tan A, Thornton JG, Coomarasamy A, Raine‐Fenning NJ. Reproductive outcomes in women with congenital uterine anomalies: a systematic review. Ultrasound Obstet Gynecol 2011; 38: 371-82.
  • Kormanyos, Z, Molnar BG, Pal A. Removal of a residual portion of a uterine septum in women of advanced reproductive age: obstetric outcome. Hum Reprod 2006; 21: 1047-51.
  • Bendifallah S, Faivre E, Legendre G, Deffieux X, Fernandez H. Metroplasty for AFS Class V and VI septate uterus in patients with infertility or miscarriage: reproductive outcomes study. J Minim Invasive Gynecol 2013; 20: 178-84.
  • Venetis CA, Papadopoulos SP, Campo R, Gordts S, Tarlatzis BC, Grimbizis GF. Clinical implications of congenital uterine anomalies: a meta-analysis of comparative studies. Reprod Biomed Online 2014; 29: 665-83.
  • Rikken JF, Kowalik CR, Emanuel MH, et al. Septum resection for women of reproductive age with a septate uterus. Cochrane Database Syst Rev 2017; 1: CD008576.
  • Rikken JF, Leeuwis‐Fedorovich NE, Letteboer S, et al. The pathophysiology of the septate uterus: a systematic review. BJOG 2019; 126: 1192-9.
  • Valle RF. Ekpo GE. Hysteroscopic metroplasty for the septate uterus: review and meta-analysis. J Minim Invasive Gynecol 2013; 20: 22-42.
  • Rikken JF, Kowalik CR, Emanuel MH, et al. Septum resection versus expectant management in women with a septate uterus: an international multicentre open-label randomized controlled trial. Hum Reprod 2021; 36: 1260-7.
  • Practice Committee of the American Society for Reproductive Medicine. Electronic address, A.a.o. and M. Practice Committee of the American Society for Reproductive, Uterine septum: a guideline. Fertil Steril 2016; 106: 530-40.
  • Heinonen, PK, Saarikoski S, Pystynen P. Reproductive performance of women with uterine anomalies. An evaluation of 182 cases. Acta Obstet Gynecol Scand 1982; 61: 157-62.
  • Homer HA, Li TC, Cooke ID. The septate uterus: a review of management and reproductive outcome. Fertil Steril 2000; 73: 1-14.
  • Fedele L, Arcaini L, Parazzini F, Vercellini P, Di Nola G. Reproductive prognosis after hysteroscopic metroplasty in 102 women: life-table analysis. Fertil Steril 1993; 59: 768-72.
  • Perino A, Mencaglia L, Hamou J, Cittadini E. Hysteroscopy for metroplasty of uterine septa: report of 24 cases. Fertil Steril 1987; 48: 321-3.
  • Rikken JF, Verhorstert KW, Emanuel MH, et al. Septum resection in women with a septate uterus: a cohort study. Hum Reprod 2020; 35: 1578-88.
  • Chan YY, Jayaprakasan K, Zamora J, Thornton JG, Raine-Fenning N, Coomarasamy A. The prevalence of congenital uterine anomalies in unselected and high-risk populations: a systematic review. Hum Reprod Update 2011; 17: 761-71.
  • Chen HX, Lv SG, Zhang YN, et al. Effect of hysteroscopic septum resection on subsequent in vitro fertilization-intracytoplasmic sperm injection outcomes in cases of primary infertility. J Gynecol Obstet Hum Reprod 2021; 50: 1021-49.
  • Fox NS, Connolly CT, Hill MB, Klahr RA, Zafman KB, Rebarber A. Pregnancy outcomes in viable pregnancies with a septate uterus compared with viable pregnancies after hysteroscopic uterine septum resection. Am J Obstet Gynecol MFM 2019; 1: 136-43.
  • Krishnan M, Narice BF, Ola B, Metwally M, Does hysteroscopic resection of uterine septum improve reproductive outcomes: a systematic review and meta-analysis. Arch Gynecol Obstet 2021; 303: 1131-42.
  • Chen SQ, Deng N, Jiang HY, Li JB, Lu S, Yao SZ. Management and reproductive outcome of complete septate uterus with duplicated cervix and vaginal septum: review of 21 cases. Arch Gynecol Obstet 2013; 287: 709-14.
  • Carrera M, Millan FP, Alcázar JL, et al. Effect of hysteroscopic metroplasty on reproductive outcomes in women with septate uterus: systematic review and meta-analysis. J Minim Invasive Gynecol 2022; 29: 465-75.
  • Group SI, Checa MA, Bellver J, et al. Hysteroscopic septum resection and reproductive medicine: A SWOT analysis. Reprod Biomed Online 2018; 37: 709-15.
  • Tang J, Jiang L, Zhang J, Xiao S, Li X, Zhou J. Effect of hyteroscopic uterine septum resection on pregnancy outcomes. J Gynecol Obstet Hum Reprod 2022; 51: 102275.

Does uterine septum resection improve IVF treatment success?

Year 2022, Volume: 5 Issue: 5, 1272 - 1275, 25.09.2022
https://doi.org/10.32322/jhsm.1133577

Abstract

Aim: Uterine septum is the most common type of congenital uterine malformation. The septum has also been suggested as a potential cause of infertility. The role of the septum in infertility and whether the septum can be resected is debatable. We aimed to reveal the results of assisted reproductive techniques in patients with septate uterus according to whether or not resection is performed.
Material and Method: 7790 patients were scanned retrospectively. 110 patients with the uterine septum and unexplained infertility were included in the study. Patients who underwent uterine septum resection were recorded. The clinical pregnancies of patients were compared according to whether or not resection was performed. In addition, patients with complete septum were evaluated according to whether or not resection was performed, and their clinical pregnancies were evaluated.
Results: It was revealed that 79 of the patients with uterine septum underwent septum resection operation. It was determined that 31 patients were not treated. Clinical pregnancy rates were found to be statistically significantly higher in the expectant management group (p=0.02). In addition, comparing the clinical pregnancy rates of the resection and expectant management groups in patients with a complete septum, no significant difference was found between the groups (p=0.134).
Conclusion: In our study, the success of treatment with assisted reproductive techniques did not change after septum resection. Although uterine septum resection is a simple and safe method, it has disadvantages such as the development of adhesions and rupture in the uterus. There is insufficient evidence to perform septum resection in patients with uterine septum prior to infertility treatment.

References

  • Grimbizis G, Camus M, Clasen K, Tournaye H, De Munck L, Devroey P. Hysteroscopic septum resection in patients with recurrent abortions or infertility. Hum Reprod 1998; 13: 1188-93.
  • Acién P, Acién MI. The history of female genital tract malformation classifications and proposal of an updated system. Hum Reprod Update 2011; 17: 693-705.
  • Chan YY, Jayaprakasan K, Tan A, Thornton JG, Coomarasamy A, Raine‐Fenning NJ. Reproductive outcomes in women with congenital uterine anomalies: a systematic review. Ultrasound Obstet Gynecol 2011; 38: 371-82.
  • Kormanyos, Z, Molnar BG, Pal A. Removal of a residual portion of a uterine septum in women of advanced reproductive age: obstetric outcome. Hum Reprod 2006; 21: 1047-51.
  • Bendifallah S, Faivre E, Legendre G, Deffieux X, Fernandez H. Metroplasty for AFS Class V and VI septate uterus in patients with infertility or miscarriage: reproductive outcomes study. J Minim Invasive Gynecol 2013; 20: 178-84.
  • Venetis CA, Papadopoulos SP, Campo R, Gordts S, Tarlatzis BC, Grimbizis GF. Clinical implications of congenital uterine anomalies: a meta-analysis of comparative studies. Reprod Biomed Online 2014; 29: 665-83.
  • Rikken JF, Kowalik CR, Emanuel MH, et al. Septum resection for women of reproductive age with a septate uterus. Cochrane Database Syst Rev 2017; 1: CD008576.
  • Rikken JF, Leeuwis‐Fedorovich NE, Letteboer S, et al. The pathophysiology of the septate uterus: a systematic review. BJOG 2019; 126: 1192-9.
  • Valle RF. Ekpo GE. Hysteroscopic metroplasty for the septate uterus: review and meta-analysis. J Minim Invasive Gynecol 2013; 20: 22-42.
  • Rikken JF, Kowalik CR, Emanuel MH, et al. Septum resection versus expectant management in women with a septate uterus: an international multicentre open-label randomized controlled trial. Hum Reprod 2021; 36: 1260-7.
  • Practice Committee of the American Society for Reproductive Medicine. Electronic address, A.a.o. and M. Practice Committee of the American Society for Reproductive, Uterine septum: a guideline. Fertil Steril 2016; 106: 530-40.
  • Heinonen, PK, Saarikoski S, Pystynen P. Reproductive performance of women with uterine anomalies. An evaluation of 182 cases. Acta Obstet Gynecol Scand 1982; 61: 157-62.
  • Homer HA, Li TC, Cooke ID. The septate uterus: a review of management and reproductive outcome. Fertil Steril 2000; 73: 1-14.
  • Fedele L, Arcaini L, Parazzini F, Vercellini P, Di Nola G. Reproductive prognosis after hysteroscopic metroplasty in 102 women: life-table analysis. Fertil Steril 1993; 59: 768-72.
  • Perino A, Mencaglia L, Hamou J, Cittadini E. Hysteroscopy for metroplasty of uterine septa: report of 24 cases. Fertil Steril 1987; 48: 321-3.
  • Rikken JF, Verhorstert KW, Emanuel MH, et al. Septum resection in women with a septate uterus: a cohort study. Hum Reprod 2020; 35: 1578-88.
  • Chan YY, Jayaprakasan K, Zamora J, Thornton JG, Raine-Fenning N, Coomarasamy A. The prevalence of congenital uterine anomalies in unselected and high-risk populations: a systematic review. Hum Reprod Update 2011; 17: 761-71.
  • Chen HX, Lv SG, Zhang YN, et al. Effect of hysteroscopic septum resection on subsequent in vitro fertilization-intracytoplasmic sperm injection outcomes in cases of primary infertility. J Gynecol Obstet Hum Reprod 2021; 50: 1021-49.
  • Fox NS, Connolly CT, Hill MB, Klahr RA, Zafman KB, Rebarber A. Pregnancy outcomes in viable pregnancies with a septate uterus compared with viable pregnancies after hysteroscopic uterine septum resection. Am J Obstet Gynecol MFM 2019; 1: 136-43.
  • Krishnan M, Narice BF, Ola B, Metwally M, Does hysteroscopic resection of uterine septum improve reproductive outcomes: a systematic review and meta-analysis. Arch Gynecol Obstet 2021; 303: 1131-42.
  • Chen SQ, Deng N, Jiang HY, Li JB, Lu S, Yao SZ. Management and reproductive outcome of complete septate uterus with duplicated cervix and vaginal septum: review of 21 cases. Arch Gynecol Obstet 2013; 287: 709-14.
  • Carrera M, Millan FP, Alcázar JL, et al. Effect of hysteroscopic metroplasty on reproductive outcomes in women with septate uterus: systematic review and meta-analysis. J Minim Invasive Gynecol 2022; 29: 465-75.
  • Group SI, Checa MA, Bellver J, et al. Hysteroscopic septum resection and reproductive medicine: A SWOT analysis. Reprod Biomed Online 2018; 37: 709-15.
  • Tang J, Jiang L, Zhang J, Xiao S, Li X, Zhou J. Effect of hyteroscopic uterine septum resection on pregnancy outcomes. J Gynecol Obstet Hum Reprod 2022; 51: 102275.
There are 24 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Original Article
Authors

Munire Funda Cevher Akdulum 0000-0003-2285-7112

Erhan Demirdağ 0000-0003-4599-3854

Seçil İrem Arık 0000-0001-9512-533X

Mehmet Erdem 0000-0003-4396-2149

Nuray Bozkurt 0000-0002-1107-9629

Mesut Oktem 0000-0002-5555-8189

İsmail Güler 0000-0002-8098-2483

Ahmet Erdem 0000-0002-1950-9670

Publication Date September 25, 2022
Published in Issue Year 2022 Volume: 5 Issue: 5

Cite

AMA Cevher Akdulum MF, Demirdağ E, Arık Sİ, Erdem M, Bozkurt N, Oktem M, Güler İ, Erdem A. Does uterine septum resection improve IVF treatment success?. J Health Sci Med / JHSM. September 2022;5(5):1272-1275. doi:10.32322/jhsm.1133577

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