Hysteroscopic Metroplasty: Reproductive Outcome in Relation to Septum Size

Purpose: Our aim is to determine if the reproductive performance after hysteroscopic resection of partial uterine septum was related to septum size.

Methods: The retrospective and comparative cohort study was conducted in a University-affiliated Hospital. A cohort of 112 non-parous patients was treated for a partial uterine septum. The septum size was evaluated by hysteroscopy and transvaginal 3-dimensional ultrasound. The patients were stratified into two groups: group 1 (85 women) with small partial uterine septum (≤2.5 cm) and group 2 (27 women) with large partial uterine septum (>2.5 cm). They were also divided according to their obstetrics history: 39 infertile women and 73 aborters. All underwent hysteroscopic metroplasty with a resectoscope with an equatorial semicircular loop cutting 0° with monopolar energy. All septa were almost completely removed and no complications occurred.

Results: The two groups of patients with small (group 1) and large (group 2) partial uterine septum were compared in the terms of reproductive history and performance before and after surgery. In the overall population the reproductive performance after surgery is greatly improved. No significant differences in reproductive performance were evident between patients with small and large partial uterine septa. The reproductive performance was also similar in infertile patients and in aborters.

Conclusions: This study demonstrates that hysteroscopic metroplasty in cases of partial uterine septum and infertility significantly improves the reproductive performance irrespectively of septum size and that reproductive performance is independent from previous obstetrics history.