Pregnancy After Hysteroscopic Metroplasty Under Laparoscopy in a Woman with Complete Septate Uterus: A Case Report

Abstract

: A 31-year-old nulligravid woman with a 3 year history of infertility visited our hospital. After consultation and a transvaginal ultrasound and MR imaging, her uterine anomaly was identified as complete septate uterus: class V (a) by the American Fertility Society (AFS). She had a doubled uterine cervix and a vaginal septum. Hysteroscopic metroplasty was performed with the aid of a laparoscopy. Both tubal patencies were confirmed with indigocarmine in a laparoscopic image. Laparoscopic electronic cautery was also done on the left ovarian endometrioma (stage 1 endometriosis; the revised American Society for Reproductive Medicine (rASRM) classification 4 point minimal). We distrained an intrauterine device in the uterine cavity and removed it after two cycles of menstruation. The patient subsequently became pregnant during her third menstrual cycle and the current progress of her pregnancy is favorable.

New Ambulatory Hysteroscopic Septoplasty using Ballooning in a Woman with Complete Septate Uterus: A Case Report

“…Before surgery, MRI is useful to measure length and width of septal wall but it is not good enough to show the initial cutting point of septum. Concomitant laparoscopy during hysteroscopy is also useful to prevent perforation but it cannot visualize the initial point of cutting of septum ( Tajiri et al, 2015 ).…”

“…Concomitant laparoscopy is helpful for prevention of uterine perforation but it also cannot visualize the initial point of cutting septal wall ( Tajiri et al, 2015 ). Dye-filled ballooning in a hemiuterus can be easily seen at the opposite site of hemiuterus by hysteroscopy.…”