Müllerian Anomalies Prevalence Diagnosed by Hysteroscopy and Laparoscopy in Mexican Infertile Women: Results from a Cohort Study

Abstract

Background: To evaluate the prevalence of Müllerian anomalies (MAs) in a cohort of infertile Mexican women candidates for infertility treatments (intrauterine insemination or IVF (In vitro fertilization) cycles). Methods: We performed a retrospective observational study on a cohort of consecutive women, who underwent hysteroscopy and laparoscopy as part of the basic infertility workup from 2002 to 2014, at our center. Our aim was to calculate the prevalence of MAs and each subtype. Results: A total of 4005 women were included in the study. The MA prevalence was 4.4% (95% CI; 3.8-5.1; n = 177). Among women with MAs, the prevalence of different MA types was: septate uterus 54.2% (n = 96), arcuate uterus 15.8% (n = 28), bicornuate uterus 10.7% (n = 19), unicornuate uterus 8.5% (n = 15), didelphys uterus 6.2% (n = 11) and hypoplasia/agenesis 3.4% (n = 6), unclassifiable 1.1% (n = 2). Women with MAs who achieved pregnancy were: 33.3% (n = 59). The MA associated with the highest pregnancy rate was septate uterus after hysteroscopic correction, at 38.5% (37/96). Conclusions: The prevalence of MAs among infertile Mexican women can be considered as low, but not negligible. The septate uterus is the most common MA in women with infertility. Author Contributions: Conceptualization, E.R.-M.; methodology, S.G.V. and D.A.-R.; formal analysis, E.I.-C.; investigation, Y.P.G.-G. and A.V.-B.; data curation, J.R.-Y. and A.M.-E.; writing-original draft preparation, E.R.-M.; writing-review and editing, S.G.V., A.V. and F.M.L.; visualization, F.V.M.-H.; supervision, E.R.-M.; project administration, P.A.-G.; funding acquisition, E.R.-M.

Transmyometrial oocyte recruitment: a safe surgical procedure alternative to the transvaginal retrieval when ovaries are inaccessible

“…Barton SE and Coworkers have reported in their study that the TVUS follicular aspiration was preferable as procedure requiring less time and invasivess, compared to the TAUS which could be considered a safer and useful technique for oocyte retrieval in cases of inaccessible ovaries by the transvaginal approach [26]. In fact, literature data report that the TAUS approach is able to maximize the number of oocytes retrieved, mainly in women with radical hysterectomies, transposed ovaries [27,28], Müllerian agenesis [29] as well as in cases of increased body mass index (BMI) for which the poor ultrasound image quality, make the ovaries unreachable [30,31]. However, despite the feasibility of this approach, the TAUS retrieval, often requiring multiple punctures for each ovary impacting on patients' discomfort and the infectious risk [17], makes preferable the transvaginal approach.…”

Office hysteroscopy in cases of recurrent implantation failure; Do or not to do

“…The occurrence of mullerian duct anomalies also dif-fers significantly, with findings ranging from 0.16-10% [26,27]. They were either congenital mullerian anomalies (U1, U2, U3) or acquired lesions like endometritis, polyps, adhesions or combined lesions.…”

Hysterolaparoscopy: A Gold Standard for Diagnosing and Treating Infertility and Benign Uterine Pathology

“…The results of two retrospective studies performed on a large number of patients (4005 and 3811 women, respectively) showed a prevalence of Müllerian abnormalities between 4.4 and 7.5%. The distribution of malformations reported varies 54.2-54.9% for septate uterus, 14.2-15.8% for arched uterus, 10.2-10.7% for bicornuate uterus, 5.8-8.5% for unicorn uterus and 3.4-6.5% for hypoplasia/agenesis [59,60].…”