T-shaped uterus: what has been done, what should be done.

Abstract

T-shaped uterus is a uterine malformation which has been suggested to be associated with poor reproductive performance. Over the years, different diagnostic methods have been used to determine the anatomical status of the female genital tract and to recognize any anomalies and the 3D-ultrasound is now considered the gold standard in diagnosing uterine anomalies. The importance of a correct diagnosis of the T-shaped uterus relates to the impact that such malformation has on female fertility. Although, to date, the prevalence does not seem to be so high, the fertility of the woman is reported to be somehow compromised by this uterine dysmorphism. Correcting the abnormal uterine morphology could be the main goal in order to optimize reproductive outcomes. To date, hysteroscopic correction of T-shaped uterus may be considered in patients with infertility, recurrent miscarriages or recurrent IVF failure. However, the absence of randomized controlled trials, multicentric data and the difficulty to state that metroplasty was the reason for improved outcome, make the data available inconclusive. More studies, led by an objective diagnosis, are urgently needed to understand the real impact of T-shaped uterus on the reproductive life of women and its effective prevalence in the population of infertile women.