Hysteroscopic resection of the septum improves the pregnancy rate of women with unexplained infertility: a prospective controlled trial

Mollo, Antonio; Franciscis, Pasquale De; Colacurci, Nicola; Cobellis, Luigi; Perino, Antonio; Venezia, R; Alviggi, Carlo; Placido, Giuseppe De

doi:10.1016/j.fertnstert.2008.04.011

Cited by 225 publications

(118 citation statements)

References 23 publications

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“…They found signifi cant improvement in pregnancy rate [11][12][13][14][15][16]. Our results were in agreement with these studies.…”

Section: Discussionsupporting

confidence: 91%

The Reproductive Outcome in patients having Primary Infertility or Recurrent Miscarriages after performing Hysteroscopic Septal Resection

Abdou¹,

Abdelfattah²

2018

Int J Sex Reprod Health Care

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Objective: To assess the reproductive outcome after hysteroscopic septal resection in women with unexplained infertility or recurrent miscarriage. Design: Prospective clinical trial.Setting: Zagazig university hospitals, Egypt.Patients: 47 patients (20 patients with primary infertility and 27 patients with recurrent miscarriage diagnosed to have uterine septum) Intervention: hysteroscopic septal resection.Main outcome measures: pregnancy rate and its outcome (miscarriage, preterm birth, term birth and live-birth rates). Results:There was signifi cant improvement in reproductive outcome in patients with primary infertility and uterine septum after hysteroscopic metroplasty; pregnancy rate was 55% (11 pregnancies out of 20 patients). Abortion and preterm labor rates were low (5 and 10% respectively) while term delivery and live-birth rates were high (40 and 45% respectively).Also, there was signifi cant improvement in the reproductive outcome in patients with recurrent pregnancy loss, there was highly signifi cant reduction in the abortion rate to 11.1% (p= 0.00) after hysteroscopic metroplasty but there was non-signifi cant reduction in preterm birth from 11.1% to 7.4% (p= 0.63). There was highly signifi cant rise in term delivery rate that increased from 3.8% to 51.9% (p=0.00007) and highly signifi cant increase in live-birth rate from 7.4% to 55.6% (p=0.0001).Conclusion: performing hysteroscopic metroplasty could markedly improve the reproductive outcome in patients having recurrent miscarriage in the form of reduction in abortion rate and increase in term delivery and live-birth rates. There was also signifi cant improvement in pregnancy rate among patients with unexplained primary infertility.

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“…They found signifi cant improvement in pregnancy rate [11][12][13][14][15][16]. Our results were in agreement with these studies.…”

Section: Discussionsupporting

confidence: 91%

The Reproductive Outcome in patients having Primary Infertility or Recurrent Miscarriages after performing Hysteroscopic Septal Resection

Abdou¹,

Abdelfattah²

2018

Int J Sex Reprod Health Care

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“…In the study by Tomazevic et al [7], they observed that a hysteroscopic correction of intrauterine septa lead to reduced preterm delivery rates and very preterm delivery rates in patients with singleton pregnancies -comparable to levels in control patients. Preterm delivery is significantly associated with intrauterine septa [6][7][8][9][10] and can, therefore, contribute significantly to lower live birth rates [22,23]. In our study, the relative risks of preterm delivery were still higher in the septum patients who had hysteroscopic surgery.…”

Section: Discussionmentioning

confidence: 47%

“…In many cases, the presence of an intrauterine septum may even be associated with cervical incompetence, and if so, this will further complicate pregnancies from progressing to term [1]. These intrauterine changes have been reported to reduce uterine function and performance significantly, resulting in increased rates of implantation failure, pregnancy loss, preterm delivery, adverse fetal presentations, and ultimately long-term infertility [6][7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

“…Women with small intrauterine septa have been reported to have impaired reproductive outcomes similar to those of women with large intrauterine septa [7,9]. Therefore, based mainly on the observational evidence available, hysteroscopic surgery has been recommended for all infertile women diagnosed with intrauterine septa, irrespective of size [2,6,8,9]. Fortunately, the low risk profile (i.e., side effects and complications) of hysteroscopic surgery mitigates the adoption of such a liberal therapeutic approach in ART.…”

Section: Introductionmentioning

confidence: 99%

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Perinatal outcomes in singleton and twin ICSI pregnancies following hysteroscopic correction of partial intrauterine septa

Özgür

Bulut

Berkkanoğlu

et al. 2015

J Assist Reprod Genet

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Purpose To investigate the perinatal outcomes of patients with clinical pregnancies from ICSI treatments who had previously undergone hysteroscopic surgery to correct partial intrauterine septa and compare them to outcomes of patients with no intrauterine anomalies. Method A retrospective observational analysis of 2024 ultrasound confirmed pregnancies from ICSI treatments performed between January 2005 and June 2012. The patients were grouped according to their intrauterine status, and subgrouped according to the number of fetal hearts observed; singleton control (n=1128), twin control (n=566), singleton septum (n=217) and twin septum (n=113). The primary outcomes analyzed were miscarriage, preterm, very preterm, stillbirth, vanishing twin and live delivery rates, as well as low birth weight and very low birth weight rates. Result(s) The live birth rate (89,9 %) in the singleton control subgroup was non-significantly higher than the live birth rate (85,3 %) in the septum subgroup, with a RR of 1,05 (p=0, 0583, 95 % CI 0,9943-1,1182) for live birth. In contrast the live birth rate (91,3 %) in twin control subgroup was significantly higher than the live birth rate (84,1 %) in the septum subgroup, with a RR 1,09 (p=0,0282, 95 % CI 0,9988-1, 1819). Non-significantly, higher miscarriage and stillbirth rates were the main contributors to the reduced live birth rates. The singleton and twin septum subgroups also had higher rates of premature and very premature delivery and LBWs and vLBW, especially in the singleton septum subgroup. Conclusion(s) The hysteroscopic correction of intrauterine septa may not eliminate all risks for premature delivery.

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“…However, there is still an ongoing debate on the benefits of surgery in infertile patients. (6)(7)(8)(9)(10) During the last few years several authors have reported different gene networks important for the endometrium receptivity that controls the expression of key transcription factors (e.g. HOXA10, STAT3, p53) (11)(12)(13)(14)(15) , growth factors and cytokines [e.g.…”

Section: Disorders Of Implantationmentioning

confidence: 99%

Antiphospholipid Autoantibodies in Women with Recurrent Gestational Failures – Controversies in Management

Segovia¹,

Rodríguez‐Mahou²,

Caballero³

et al. 2012

Antiphospholipid Syndrome

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Hysteroscopic resection of the septum improves the pregnancy rate of women with unexplained infertility: a prospective controlled trial

Cited by 225 publications

References 23 publications

The Reproductive Outcome in patients having Primary Infertility or Recurrent Miscarriages after performing Hysteroscopic Septal Resection

The Reproductive Outcome in patients having Primary Infertility or Recurrent Miscarriages after performing Hysteroscopic Septal Resection

Perinatal outcomes in singleton and twin ICSI pregnancies following hysteroscopic correction of partial intrauterine septa

Antiphospholipid Autoantibodies in Women with Recurrent Gestational Failures – Controversies in Management

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