title: Intra-cycle variation of the uterine cavity indentation assessed with three-dimensional ultrasound in natural and stimulated cycles.
abstract: The recent ESHRE-ESGE classification for female genital anomalies attempts to promote objectivity in diagnosis of normal and septate uteri. The aim of this study was to ascertain whether the uterine cavity indentation - the characteristic feature of septate uteri - varies significantly throughout the cycle. Seventy consecutive women underwent three-dimensional ultrasound twice: 35 during the proliferative and luteal phase of a natural cycle, and 35 during the first and final day of a stimulated cycle. Endometrial thickness, interostial distance, cavity indentation and percentage of cavity indentation were all assessed in accordance with the ESHRE-ESGE consensus on diagnosis of female genital anomalies. Overall, throughout both cycles, there was a significant increase in endometrial thickness (from 4.6 mm to 10.2 mm; P < 0.001) and interostial distance (from 30.1 mm to 35.1 mm; P < 0.001), which was associated with a significant reduction in the percentage of cavity indentation (from 30.3% to 15.0%; P < 0.001). Between the first and second assessment, 3/70 (4.3%) patients had a change in diagnosis from septate to normal uterus, although this did not reach statistical significance. This observation of a significant intra-cycle variation of the uterine cavity indentation has important implications for both clinical practice and research.
authors.affiliation: Assisted Reproductive Technology Unit, Department of Obstetrics and Gynaecology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong.
authors.forename: Sotirios H
authors.initials: SH
authors.lastname: Saravelos
authors.affiliation: Assisted Reproductive Technology Unit, Department of Obstetrics and Gynaecology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong. Electronic address: tinchiu.li@cuhk.edu.hk.
authors.forename: Tin-Chiu
authors.initials: TC
authors.lastname: Li
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D011446:Prospective Studies; D014599:Uterus / Q000002:abnormalities*
keywords: Septate uterus; Three-dimensional ultrasound; Uterine anomalies