Abstract
Objective:The correlation between dysmorphic uterus and infertility still remains enigmatic. We evaluated the reproductive outcomes of metroplasty via office hysteroscopy in unexplained infertile women with dysmorphic uteri.Materials and Methods:In this retrospective cohort study, metroplasty via office hysteroscopy using a bipolar system was performed to 272 women with unexplained infertility with dysmorphic uteri from January 2013 to January 2016. Of all the patients, 162 had primary infertility, and 110 had secondary infertility.Results:In the primary infertility group, the clinical pregnancy rate was 45.68% (74/162) and the live birth rate was 38.9% (63/162), and in the secondary infertility group, the clinical pregnancy rate was 55.45% (61/110) and the live birth rate was 49% (54/110) after metroplasty. In the secondary infertility group, the miscarriage rate and especially the ectopic pregnancy rate declined dramatically [from 84.5% (93/110) to 9.8% (6/61) and from 15.5% (17/110) to 1.6% (1/61), respectively] (p<0.01).Conclusion:Reproductive outcome can be impaired by Müllerian anomalies, hence, infertile women with dysmorphic uteri should undergo hysteroscopy to improve reproductive outcomes. Our study demonstrated that office hysteroscopic metroplasty of a dysmorphic uterus might improve fertility, particularly in patients with unexplained infertility with dysmorphic uteri, which was an ignored factor previously. Office hysteroscopy is an alternative option in terms of non-invasive procedure.
Highlights
A dysmorphic uterus, which was formerly known as “T-shaped uterus” in the American Fertility Society classification of anomalies of the Müllerian duct, is denoted as a secondclass (Class U1) uterine anomaly in the European Society of Human Reproduction and Embryology (ESHRE) and the European Society for Gynaecological Endoscopy (ESGE) (ESHRE/ESGE) consensus on the classification of congenital genital tract anomalies, and it leads to poor reproductive and obstetric outcomes[1,2]
Our study demonstrated that office hysteroscopic metroplasty of a dysmorphic uterus might improve fertility, in patients with unexplained infertility with dysmorphic uteri, which was an ignored factor previously
During the 3-year study period, 685 office hysteroscopies for dysmorphic uterus were performed to 272 women with unexplained infertility by our In Vitro Fertilization (IVF) department
Summary
A dysmorphic uterus, which was formerly known as “T-shaped uterus” in the American Fertility Society classification of anomalies of the Müllerian duct, is denoted as a secondclass (Class U1) uterine anomaly in the European Society of Human Reproduction and Embryology (ESHRE) and the European Society for Gynaecological Endoscopy (ESGE) (ESHRE/ESGE) consensus on the classification of congenital genital tract anomalies, and it leads to poor reproductive and obstetric outcomes[1,2]. The prevalence of dysmorphic uterus is not yet known, the reproductive performance of a dysmorphic uterus after hysteroscopic metroplasty is poorly documented; only five trials have been reported to date[3,4,5,6,7]. The correlation between dysmorphic uterus and infertility still remains enigmatic. The poor obstetric outcomes of Müllerian anomalies are wellknown issues, their reproductive performance in terms of infertility has been relatively ignored. The aim of our study was to evaluate the effectiveness of hysteroscopic metroplasty on reproductive outcome in women with unexplained infertility with dysmorphic uteri
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