Presenting Three Case Reports of Congenital Vaginal and Complete Uterine Septum with Double Cervix (U2bC2V1) with Different Reproductive Outcomes: Is There a Need for Surgical Treatment?

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Congenital uterine anomalies (CUAs) consist of structural disorders of the female genital tract arising as a result of abnormal fusion or resorption of the Müllerian ducts. The prevalence of CUAs is 5.5% in the general population, 8.0% in infertile women, and 13.3% in women with a history of miscarriage. Here, we present three cases of women with complex genital tract anomalies, including cervical duplication and vaginal septum with different reproductive outcomes. A complete uterine septum with double functional cervix may have a wide spectrum of reproductive outcomes: from completely normal conception and pregnancy to infertility and recurrent pregnancy losses. In these cases, we advised patients to complete their evaluation by undergoing hysteroscopy, to provide reliable information for the anatomical status of the cervix, tubal ostia, and, especially, the uterine cavity. In cases of infertility or recurrent miscarriages, the dilemma is whether to proceed with the resection of the uterine septum in combination with the resection of vaginal one. We suggest that among women with this type of CUAs, surgical treatment should be offered. Further evidence from larger population studies is needed as the risks of surgical treatment cannot be disregarded.