title: The Thessaloniki ESHRE/ESGE consensus on diagnosis of female genital anomalies.
abstract: OBJECTIVE
  What is the recommended diagnostic work-up of female genital anomalies according to the European Society of Human Reproduction and Embryology (ESHRE)/European Society for Gynaecological Endoscopy (ESGE) system?
  
  
  CONCLUSIONS
  The ESHRE/ESGE consensus for the diagnosis of female genital anomalies is presented.
  
  
  BACKGROUND
  Accurate diagnosis of congenital anomalies still remains a clinical challenge because of the drawbacks of the previous classification systems and the non-systematic use of diagnostic methods with varying accuracy, some of them quite inaccurate. Currently, a wide range of non-invasive diagnostic procedures are available enriching the opportunity to accurately detect the anatomical status of the female genital tract, as well as a new objective and comprehensive classification system with well-described classes and sub-classes.
  
  
  METHODS
  The ESHRE/ESGE CONgenital UTerine Anomalies (CONUTA) Working Group established an initiative with the goal of developing a consensus for the diagnosis of female genital anomalies. The CONUTA working group and imaging experts in the field have been appointed to run the project.
  
  
  METHODS
  The consensus is developed based on: (i) evaluation of the currently available diagnostic methods and, more specifically, of their characteristics with the use of the experts panel consensus method and of their diagnostic accuracy by performing a systematic review of evidence and (ii) consensus for the definition of where and how to measure uterine wall thickness and the recommendations for the diagnostic work-up of female genital anomalies, based on the results of the previous evaluation procedure, with the use of the experts panel consensus method.
  
  
  RESULTS
  Uterine wall thickness is defined as the distance between the interostial line and external uterine profile at the midcoronal plane of the uterus; alternatively, if a coronal plane is not available, the mean anterior and posterior uterine wall thickness at the longitudinal plane could be used. Gynecological examination and two-dimensional ultrasound (2D US) are recommended for the evaluation of asymptomatic women. Three-dimensional (3D) US is recommended for the diagnosis of female genital anomalies in 'symptomatic' patients belonging to high risk groups for the presence of a female genital anomaly and in any asymptomatic woman suspected to have an anomaly from routine evaluation. Magnetic resonance imaging (MRI) and endoscopic evaluation are recommended for the subgroup of patients with suspected complex anomalies or in diagnostic dilemmas. Adolescents with symptoms suggestive for the presence of a female genital anomaly should be thoroughly evaluated with 2D US, 3D US, MRI and endoscopically.
  
  
  CONCLUSIONS
  The various diagnostic methods should always be used in the proper way and evaluated by experts to avoid mis-, over- and underdiagnosis.
  
  
  CONCLUSIONS
  The role of a combined US examination and outpatient hysteroscopy should be prospectively evaluated. It is a challenge for further research, based on diagnosis, to objectively evaluate the clinical consequences related to various degrees of uterine deformity.
  
  
  BACKGROUND
  None.
authors.affiliation: Congenital Uterine Anomalies (CONUTA) common ESHRE/ESGE Working Group and invited Experts, ESGE Central Office, Diestsevest 43/0001, 3000 Leuven, Belgium grigoris.grimbizis@gmail.com grimbi@med.auth.gr.
authors.forename: Grigoris F
authors.initials: GF
authors.lastname: Grimbizis
authors.affiliation: Congenital Uterine Anomalies (CONUTA) common ESHRE/ESGE Working Group and invited Experts, ESGE Central Office, Diestsevest 43/0001, 3000 Leuven, Belgium.
authors.forename: Attilio
authors.initials: A
authors.lastname: Di Spiezio Sardo
authors.affiliation: Congenital Uterine Anomalies (CONUTA) common ESHRE/ESGE Working Group and invited Experts, ESGE Central Office, Diestsevest 43/0001, 3000 Leuven, Belgium.
authors.forename: Sotirios H
authors.initials: SH
authors.lastname: Saravelos
authors.affiliation: Congenital Uterine Anomalies (CONUTA) common ESHRE/ESGE Working Group and invited Experts, ESGE Central Office, Diestsevest 43/0001, 3000 Leuven, Belgium.
authors.forename: Stephan
authors.initials: S
authors.lastname: Gordts
authors.affiliation: Congenital Uterine Anomalies (CONUTA) common ESHRE/ESGE Working Group and invited Experts, ESGE Central Office, Diestsevest 43/0001, 3000 Leuven, Belgium.
authors.forename: Caterina
authors.initials: C
authors.lastname: Exacoustos
authors.affiliation: Congenital Uterine Anomalies (CONUTA) common ESHRE/ESGE Working Group and invited Experts, ESGE Central Office, Diestsevest 43/0001, 3000 Leuven, Belgium.
authors.forename: Dominique
authors.initials: D
authors.lastname: Van Schoubroeck
authors.affiliation: Congenital Uterine Anomalies (CONUTA) common ESHRE/ESGE Working Group and invited Experts, ESGE Central Office, Diestsevest 43/0001, 3000 Leuven, Belgium.
authors.forename: Carmina
authors.initials: C
authors.lastname: Bermejo
authors.affiliation: Congenital Uterine Anomalies (CONUTA) common ESHRE/ESGE Working Group and invited Experts, ESGE Central Office, Diestsevest 43/0001, 3000 Leuven, Belgium.
authors.forename: Nazar N
authors.initials: NN
authors.lastname: Amso
authors.affiliation: Congenital Uterine Anomalies (CONUTA) common ESHRE/ESGE Working Group and invited Experts, ESGE Central Office, Diestsevest 43/0001, 3000 Leuven, Belgium.
authors.forename: Geeta
authors.initials: G
authors.lastname: Nargund
authors.affiliation: Congenital Uterine Anomalies (CONUTA) common ESHRE/ESGE Working Group and invited Experts, ESGE Central Office, Diestsevest 43/0001, 3000 Leuven, Belgium.
authors.forename: Dirk
authors.initials: D
authors.lastname: Timmerman
authors.affiliation: Congenital Uterine Anomalies (CONUTA) common ESHRE/ESGE Working Group and invited Experts, ESGE Central Office, Diestsevest 43/0001, 3000 Leuven, Belgium.
authors.forename: Apostolos
authors.initials: A
authors.lastname: Athanasiadis
authors.affiliation: Congenital Uterine Anomalies (CONUTA) common ESHRE/ESGE Working Group and invited Experts, ESGE Central Office, Diestsevest 43/0001, 3000 Leuven, Belgium.
authors.forename: Sara
authors.initials: S
authors.lastname: Brucker
authors.affiliation: Congenital Uterine Anomalies (CONUTA) common ESHRE/ESGE Working Group and invited Experts, ESGE Central Office, Diestsevest 43/0001, 3000 Leuven, Belgium.
authors.forename: Carlo
authors.initials: C
authors.lastname: De Angelis
authors.affiliation: Congenital Uterine Anomalies (CONUTA) common ESHRE/ESGE Working Group and invited Experts, ESGE Central Office, Diestsevest 43/0001, 3000 Leuven, Belgium.
authors.forename: Marco
authors.initials: M
authors.lastname: Gergolet
authors.affiliation: Congenital Uterine Anomalies (CONUTA) common ESHRE/ESGE Working Group and invited Experts, ESGE Central Office, Diestsevest 43/0001, 3000 Leuven, Belgium.
authors.forename: Tin Chiu
authors.initials: TC
authors.lastname: Li
authors.affiliation: Congenital Uterine Anomalies (CONUTA) common ESHRE/ESGE Working Group and invited Experts, ESGE Central Office, Diestsevest 43/0001, 3000 Leuven, Belgium.
authors.forename: Vasilios
authors.initials: V
authors.lastname: Tanos
authors.affiliation: Congenital Uterine Anomalies (CONUTA) common ESHRE/ESGE Working Group and invited Experts, ESGE Central Office, Diestsevest 43/0001, 3000 Leuven, Belgium.
authors.forename: Basil
authors.initials: B
authors.lastname: Tarlatzis
authors.affiliation: Congenital Uterine Anomalies (CONUTA) common ESHRE/ESGE Working Group and invited Experts, ESGE Central Office, Diestsevest 43/0001, 3000 Leuven, Belgium.
authors.forename: Roy
authors.initials: R
authors.lastname: Farquharson
authors.affiliation: Congenital Uterine Anomalies (CONUTA) common ESHRE/ESGE Working Group and invited Experts, ESGE Central Office, Diestsevest 43/0001, 3000 Leuven, Belgium.
authors.forename: Luca
authors.initials: L
authors.lastname: Gianaroli
authors.affiliation: Congenital Uterine Anomalies (CONUTA) common ESHRE/ESGE Working Group and invited Experts, ESGE Central Office, Diestsevest 43/0001, 3000 Leuven, Belgium.
authors.forename: Rudi
authors.initials: R
authors.lastname: Campo
mesh_terms: D005260:Female; D005836:Genitalia, Female / Q000002:abnormalities* / Q000000981:diagnostic imaging; D006801:Humans; D012955:Societies, Medical / Q000592:standards*; D014463:Ultrasonography; D014564:Urogenital Abnormalities / Q000175:diagnosis* / Q000000981:diagnostic imaging; D014599:Uterus / Q000002:abnormalities* / Q000000981:diagnostic imaging
keywords: European Society for Gynaecological Endoscopy; European Society of Human Reproduction and Embryology; congenital uterine malformations; consensus; female genital anomalies; hysterosalpingo-contrast sonography; hysterosalpingogram; hysteroscopy; laparoscopy; ultrasound