Müllerian Anomalies Prevalence Diagnosed by Hysteroscopy and Laparoscopy in Mexican Infertile Women: Results from a Cohort Study.

Enrique Reyes-Muñoz,Yenara Patricia Guevara-Gómez,Alma Villarreal-Barranca,Franziska Michaela Lohmeyer,Amerigo Vitagliano,Fela Vanesa Morales-Hernández,Deisi Alvarado-Rosales,José Romo-Yañez,Esther Iyune-Cojab,Salvatore Giovanni Vitale,Araceli Montoya-Estrada,Patricia Aguayo-González

doi:10.3390/diagnostics9040149

Abstract

Background: To evaluate the prevalence of Müllerian anomalies (MAs) in a cohort of infertile Mexican women candidates for infertility treatments (intrauterine insemination or IVF (In vitro fertilization) cycles). Methods: We performed a retrospective observational study on a cohort of consecutive women, who underwent hysteroscopy and laparoscopy as part of the basic infertility workup from 2002 to 2014, at our center. Our aim was to calculate the prevalence of MAs and each subtype. Results: A total of 4005 women were included in the study. The MA prevalence was 4.4% (95% CI; 3.8–5.1; n = 177). Among women with MAs, the prevalence of different MA types was: septate uterus 54.2% (n = 96), arcuate uterus 15.8% (n = 28), bicornuate uterus 10.7% (n = 19), unicornuate uterus 8.5% (n = 15), didelphys uterus 6.2% (n = 11) and hypoplasia/agenesis 3.4% (n = 6), unclassifiable 1.1% (n = 2). Women with MAs who achieved pregnancy were: 33.3% (n = 59). The MA associated with the highest pregnancy rate was septate uterus after hysteroscopic correction, at 38.5% (37/96). Conclusions: The prevalence of MAs among infertile Mexican women can be considered as low, but not negligible. The septate uterus is the most common MA in women with infertility.

Highlights

Normal female reproductive tract development involves specific and complex processes characterized by differentiation, migration, fusion and canalization of the Müllerian duct [1,2].Müllerian anomalies (MAs) include a group of congenital anomalies resulting from alterations in the embryonic development of the Müllerian ducts, potentially affecting the morphology of the uterus, Diagnostics 2019, 9, 149; doi:10.3390/diagnostics9040149 www.mdpi.com/journal/diagnosticsDiagnostics 2019, 9, 149 fallopian tubes, cervix and vagina
A total of 4005 infertile women were submitted for hysteroscopy and laparoscopy between January
The aim of our study was to evaluate the prevalence of MAs in a cohort of infertile Mexican women candidates for infertility treatments

Summary

Introduction

Normal female reproductive tract development involves specific and complex processes characterized by differentiation, migration, fusion and canalization of the Müllerian duct [1,2].Müllerian anomalies (MAs) include a group of congenital anomalies resulting from alterations in the embryonic development of the Müllerian ducts, potentially affecting the morphology of the uterus, Diagnostics 2019, 9, 149; doi:10.3390/diagnostics9040149 www.mdpi.com/journal/diagnosticsDiagnostics 2019, 9, 149 fallopian tubes, cervix and vagina. Normal female reproductive tract development involves specific and complex processes characterized by differentiation, migration, fusion and canalization of the Müllerian duct [1,2]. MAs can sometimes be associated with ovarian, urinary tract, skeletal, or other organ anomalies [3,4,5,6,7]. To evaluate the prevalence of Müllerian anomalies (MAs) in a cohort of infertile Mexican women candidates for infertility treatments (intrauterine insemination or IVF (In vitro fertilization) cycles). Among women with MAs, the prevalence of different MA types was: septate uterus 54.2% (n = 96), arcuate uterus 15.8% (n = 28), bicornuate uterus 10.7% (n = 19), unicornuate uterus 8.5% (n = 15), didelphys uterus 6.2% (n = 11) and hypoplasia/agenesis 3.4% (n = 6), unclassifiable 1.1% (n = 2). The MA associated with the highest pregnancy rate was septate uterus after hysteroscopic correction, at 38.5%

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