Beneficial Effect of Hysteroscopic Metroplasty on the Reproductive Outcome in a ‘T-Shaped’ Uterus

Abstract

Eight women (aged 27-43) with reproductive dysfunction who were diagnosed by hysterosalpingogram and hysteroscopy as having a ‘T-shaped’ uterus were operated on using fiberoptic hysteroscopic guidance; the uterine side walls were incised until a normal uterine cavity was achieved. The women’s gynecologic and obstetric records were compared before and after the operation. In all the 8 women the operation was without complications and resulted in a satisfactory uterine cavity. Before the operative procedure, the women had had 10 spontaneous abortions and 1 ectopic pregnancy. The postoperative performance available for 7 of the 8 women showed 4 term pregnancies in 3 women, 1 ectopic pregnancy, and no abortions. Our study suggests that hysteroscopic metroplasty in women with a T-shaped uterus improves the reproductive outcome, mainly in women with repeated abortions. We conclude that women with a T-shaped uterus who want to improve their reproductive function should be encouraged to undergo hysteroscopic metroplasty.

Term Delivery Rate after Hysteroscopic Metroplasty in Patients with Recurrent Spontaneous Abortion and T-Shaped, Arcuate and Septate Uterus

“…For T-shaped uterus, metroplasty was performed according to the description and technique of Katz et al [11] and the uterine side walls were incised until a normal uterine cavity was achieved.…”

“…In a series of 8 cases, Katz et al [11 ]in 1996 concluded that hysteroscopic metroplasty in women with a T-shaped uterus improves the reproductive outcome, and women with this anomaly who want to improve their reproductive function should be encouraged to undergo hysteroscopic metroplasty.…”

Reproductive performance after hysteroscopic metroplasty in the hypoplastic uterus: a study of 29 cases

“…Their results showed a successful outcome of term deliveries in three out of six women with recurrent miscarriages, and no success in two women with primary infertility. In the same way, Katz et al 7 published a study concerning eight women with a 'T-shaped' uterus. The post-operative performance available for seven of the eight women showed four term pregnancies and one ectopic pregnancy in three women with secondary infertility.…”

“…Different methods and instruments for the hysteroscopic metroplasty have been used, including scissors 6 and a resectoscope with a monopolar hook 7,8 . The choice of the technique seems to depend on operating time, cost of instrumentation and rate of complication.…”

Pelvic Imaging in Reproductive Endocrinology

“…Several authors have proposed surgical correction (metroplasty) of uterine anomalies related to DES exposure, including T-shaped distortion 49 or simple overall reduction of uterine size. 50 Although authors reporting on small series recount positive impressions about the impact of surgery on subsequent reproductive outcome, 51 the efficacy of these procedures remains to be rigorously evaluated.…”