Is hysterosalpingography able to diagnose all uterine malformations correctly? A retrospective study.
BACKGROUND
Mullerian duct anomalies are an uncommon but often a treatable cause of infertility.


METHODS
From January 2002 until November 2003, a total of 705 hysterosalpingographies were realised of which 658 were analysed retrospectively in order to determine the importance of uterine malformations in infertile and sterile patients. In ten cases, the results of hysterosalpingography were compared with hysteroscopy and laparoscopy.


RESULTS
The frequency of uterine malformations in infertile and sterile women was 10%. In this population, arcuate uterus (57.6%) was the most common malformation, followed by subseptate uterus (18.2%), uterus bicornis unicollis (10.6%), uterus bicornis bicollis (3.0%), septate uterus (6.1%), unicornuate uterus (3.0%) and unicornuate uterus with double vagina (1.5%).


CONCLUSIONS
Our bibliographic research confirmed that arcuate uterus is the most frequent congenital malformation, but in gestations it does not show a significantly reduced live birth rate. Nevertheless, the septate uterus presents an important decrease of live birth rate that can be improved significantly by doing hysteroscopic metroplasty. As this is a completely different surgical intervention compared to bicornuate uterus, a correct diagnosis is very important. Differentiation of these two malformations is quite difficult by hysterosalpingographic exploration, wherefore an additional exploration by means of endovaginal or three-dimensional ultrasound is recommended.
Braun
Petra
P
Maternal Department of Radiology, La Fe Hospital, Avenida Campanar 21, 46009 Valencia, Spain. petrabraun@gmx.de
Grau
Francisco Vercher
FV
Pons
Raúl Mut
RM
Enguix
Daniel Perez
DP
D000328:Adult; D005260:Female; D006801:Humans; D007047:Hysterosalpingography; D007247:Infertility, Female / Q000000981:diagnostic imaging / Q000209:etiology*; D012189:Retrospective Studies; D014599:Uterus / Q000002:abnormalities*