Surgical approach to and reproductive outcome after surgical correction of a T-shaped uterus

Fernandez, H.; Garbin, O.; Castaigne, Vanina; Gervaise, A.; Levaillant, Jean‐Marc

doi:10.1093/humrep/der056

Cited by 85 publications

(69 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In the past, operative hysteroscopy for metroplasty was used to expand the uterine cavity; currently, office hysteroscopy with a bipolar system is used, which appears to have minimally invasive effects, thus making it feasible for metroplasty ( 7 ) . The encouraging results of the case series of 114 women remain in small numbers in the literature ( 3 , 4 , 5 , 6 , 7 ) . The correlation between dysmorphic uterus and infertility still remains enigmatic.…”

Section: Introductionmentioning

confidence: 99%

“…A dysmorphic uterus, which was formerly known as “T-shaped uterus” in the American Fertility Society classification of anomalies of the Müllerian duct, is denoted as a second-class (Class U1) uterine anomaly in the European Society of Human Reproduction and Embryology (ESHRE) and the European Society for Gynaecological Endoscopy (ESGE) (ESHRE/ESGE) consensus on the classification of congenital genital tract anomalies, and it leads to poor reproductive and obstetric outcomes ( 1 , 2 ) . Although the prevalence of dysmorphic uterus is not yet known, the reproductive performance of a dysmorphic uterus after hysteroscopic metroplasty is poorly documented; only five trials have been reported to date ( 3 , 4 , 5 , 6 , 7 ) . In the past, operative hysteroscopy for metroplasty was used to expand the uterine cavity; currently, office hysteroscopy with a bipolar system is used, which appears to have minimally invasive effects, thus making it feasible for metroplasty ( 7 ) .…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Reproductive outcomes of office hysteroscopic metroplasty in women with unexplained infertility with dysmorphic uterus

Haydardedeoğlu

Durdağ

Şimşek

et al. 2018

tjod

View full text Add to dashboard Cite

Objective:The correlation between dysmorphic uterus and infertility still remains enigmatic. We evaluated the reproductive outcomes of metroplasty via office hysteroscopy in unexplained infertile women with dysmorphic uteri.Materials and Methods:In this retrospective cohort study, metroplasty via office hysteroscopy using a bipolar system was performed to 272 women with unexplained infertility with dysmorphic uteri from January 2013 to January 2016. Of all the patients, 162 had primary infertility, and 110 had secondary infertility.Results:In the primary infertility group, the clinical pregnancy rate was 45.68% (74/162) and the live birth rate was 38.9% (63/162), and in the secondary infertility group, the clinical pregnancy rate was 55.45% (61/110) and the live birth rate was 49% (54/110) after metroplasty. In the secondary infertility group, the miscarriage rate and especially the ectopic pregnancy rate declined dramatically [from 84.5% (93/110) to 9.8% (6/61) and from 15.5% (17/110) to 1.6% (1/61), respectively] (p<0.01).Conclusion:Reproductive outcome can be impaired by Müllerian anomalies, hence, infertile women with dysmorphic uteri should undergo hysteroscopy to improve reproductive outcomes. Our study demonstrated that office hysteroscopic metroplasty of a dysmorphic uterus might improve fertility, particularly in patients with unexplained infertility with dysmorphic uteri, which was an ignored factor previously. Office hysteroscopy is an alternative option in terms of non-invasive procedure.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Reproductive outcomes of office hysteroscopic metroplasty in women with unexplained infertility with dysmorphic uterus

Haydardedeoğlu

Durdağ

Şimşek

et al. 2018

tjod

View full text Add to dashboard Cite

show abstract

“…However, over the past 2 decades, hysteroscopic metroplasty for T-shaped uteri has been advocated by some researchers with promising results. 11 The patient described in this case report had two failed IVF-ET cycles, and she was running out of time in view of her reproductive age. What complicated the management of this patient was the fact that she had a hysteroscopy that was reported to show normal results, despite the finding on her HSG.…”

Section: Discussionmentioning

confidence: 91%

Successful Management of Infertile Patient with Trans-Fundal Uterine Membrane

Alami

Hébert

Ashraf

et al. 2013

Journal of Gynecologic Surgery

View full text Add to dashboard Cite

Background: This case report describes an infertile patient with a rare endometrial cavity pathology diagnosed on hysteroscopy. Case: The patient was a 39-year-old female with primary infertility of 9 years' duration. A diagnosis of a possible T-shaped uterus on a previous hysterosalpingogram was not confirmed on diagnostic hysteroscopy 5 years earlier at a different infertility center, where she had undergone a cycle of in-vitro fertilization with embryo transfer (IVF-ET) but was unable to conceive. At the time of diagnostic hysteroscopy at the current, unit the patient was found to have a T-shaped cavity and a trans-fundal uterine membrane obscuring an arcuate fundus. Hysteroscopic division of this thin membrane was performed successfully, followed by hysteroscopic division of the uterine septum and hysteroscopic metroplasty of her T-shaped uterus. Results: Subsequently, the patient conceived with IVF-ET but had an early miscarriage. A second IVF-ET cycle resulted in resulted in delivery of a healthy male infant at term. Conclusions: This report described a case of an infertile patient with a trans-fundal membrane in association with a uterine anomaly. The discovery of such a membrane and the uterine anomaly described above, and their hysteroscopic surgical correction, may have contributed to the successful reproductive outcome for this patient. ( J GYNECOL SURG 29:88)

show abstract

“…Several studies have showed very poor reproductive performance when this uterine malformation is not treated [ 50 , 51 ]. The study of Fernandez shows that hysteroscopic metroplasty improves the live birth rate for women with a T-shaped uterus and a history of primary infertility, recurrent abortion or preterm delivery, although it is not a treatment of infertility [ 52 ].…”

Section: Congenital Anomaliesmentioning

confidence: 99%

Principles of Hysteroscopic Surgery

Gordts

2015

Reproductive Surgery in Assisted Conception

View full text Add to dashboard Cite

Surgical approach to and reproductive outcome after surgical correction of a T-shaped uterus

Abstract: Hysteroscopic metroplasty improves the live birth rate for women with a T-shaped uterus and a history of primary infertility, recurrent abortion or preterm delivery, although it is not a treatment of infertility.

Cited by 85 publications

References 11 publications

Reproductive outcomes of office hysteroscopic metroplasty in women with unexplained infertility with dysmorphic uterus

Reproductive outcomes of office hysteroscopic metroplasty in women with unexplained infertility with dysmorphic uterus

Successful Management of Infertile Patient with Trans-Fundal Uterine Membrane

Principles of Hysteroscopic Surgery

Contact Info

Product

Resources

About