title: Determinants of fertility and reproductive success after hysteroscopic septoplasty for women with unexplained primary infertility: a prospective analysis of 88 cases.
abstract: OBJECTIVE
  To evaluate prospectively the effect of hysteroscopic septoplasty as therapy for unexplained primary infertility in women with uterine septum as a sole cause for reproductive failure and to define the factors influencing reproductive success.
  
  
  METHODS
  In a prospective comparative study, we enrolled 103 infertile women with uterine septum as a sole cause for reproductive failure. They had had unexplained primary infertility >2 years and a follow-up >12 months. Uterine anomalies were diagnosed by means of hysterosalpingography (HSG) and 2D-transvaginal sonography (TVS) with intrauterine saline infusion. Hysteroscopic septoplasty was performed in the early follicular phase. Pregnancy rates (PR) according to patient and septum characteristics (septum size) were the main outcome measures.
  
  
  RESULTS
  Follow-up was complete for 88 patients. The mean (±SD) age of the patients was 36.1±2.1 years. Forty-two patients became pregnant (40.7%). The mean (±SD) delay in conception was 7.5±2.6 months. Nearly 80% of the pregnant women conceived spontaneously. Of 44 pregnancies in 42 women, 36 live newborns were delivered. The PR was significantly higher in women <35 years of age or with <3 years of unexplained primary infertility. Moreover, in women with a septum size larger than one-half of their uterine length the PR was significantly higher than those with septum size <1/2 of their uterus (P=.12).
  
  
  CONCLUSIONS
  Fertility and pregnancy after hysteroscopic septoplasty in women with unexplained primary infertility and uterine septum as a sole cause for reproductive failure seems to depend on patient age, duration of infertility before septoplasty, and septum size. Women with a septum size larger than one-half of their uterine length have a higher chance of successful pregnancy after hysteroscopic septoplasty.
authors.affiliation: Department of Obstetrics and Gynecology, Mansoura University Hospital, Mansoura Faculty of Medicine, Mansoura, Egypt. tarekshokeir1@hotmail.com
authors.forename: Tarek
authors.initials: T
authors.lastname: Shokeir
authors.forename: Mahmoud
authors.initials: M
authors.lastname: Abdelshaheed
authors.forename: Mohamed
authors.initials: M
authors.lastname: El-Shafie
authors.forename: Lotfy
authors.initials: L
authors.lastname: Sherif
authors.forename: Ahmed
authors.initials: A
authors.lastname: Badawy
mesh_terms: D000328:Adult; D000375:Aging; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015907:Hysteroscopy; D007247:Infertility, Female / Q000601:surgery*; D011247:Pregnancy; D011256:Pregnancy Outcome; D018873:Pregnancy Rate; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D014599:Uterus / Q000002:abnormalities* / Q000473:pathology / Q000601:surgery*