Reproductive outcome after hysteroscopic septoplasty in patients with septate uterus--a retrospective cohort study and systematic review of the literature.
BACKGROUND
Septate uterus, one of the most common forms of congenital uterine malformations, negatively affects female reproductive health.


METHODS
In a retrospective cohort study, we evaluated the reproductive outcome after hysteroscopic septoplasty in 64 women with septate uterus and primary or secondary infertility. We performed a systematic review of studies evaluating the reproductive outcome after hysteroscopic septoplasty.


RESULTS
Sixty-four women underwent hysteroscopic septoplasty. In 2/64 (3%) women, intraoperative uterine perforation occurred. Complete follow-up was available for 49/64 (76%) patients. Mean follow-up time was 68.6+/-5.2 months. The overall pregnancy rate after hysteroscopic septoplasty was 69% (34/49). The overall life birth rate (LBR) was 49% (24/49). The mean time interval between surgery and the first life birth was 35.8+/-22.5 months. Including our own data, we identified 18 studies investigating the effect of septoplasty on reproductive outcome in 1501 women. A pooled analysis demonstrated that hysteroscopic septoplasty resulted in an overall pregnancy rate of 60% (892/1501) and a LBR of 45% (686/1501). The overall rate of intra- and postoperative complications was 1.7% (23/1324) and the overall rate of re-hysteroscopy was 6% (79/1324).


CONCLUSIONS
In women with septate uterus and a history of infertility, hysteroscopic septoplasty is a safe and effective procedure resulting in a pregnancy rate of 60% and a LBR of 45%.
Nouri
Kazem
K
Department of Gynecology and Gynecologic Oncology, Medical University of Vienna, Vienna, Austria.
Ott
Johannes
J
Huber
Johannes C
JC
Fischer
Eva-Maria
EM
Stögbauer
Lucija
L
Tempfer
Clemens B
CB
D015331:Cohort Studies; D005260:Female; D006801:Humans; D015907:Hysteroscopy / Q000379:methods; D007247:Infertility, Female / Q000209:etiology / Q000601:surgery; D011247:Pregnancy; D012098:Reproduction / Q000502:physiology*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014591:Uterine Diseases / Q000150:complications / Q000534:rehabilitation / Q000601:surgery; D014599:Uterus / Q000002:abnormalities* / Q000601:surgery*