Reproductive outcome after hysteroscopic septoplasty in patients with septate uterus and unexplained infertility: prospective cohort study
Introduction: Septate uterus is the most common congenital malformation of the uterus in patients with recurrent pregnancy loss. Hysteroscopy is known as the standard diagnostic and therapeutic procedure forseptate uterus. In this study, our aim was to evaluate the effects of hysteroscopic septoplasty in improving pregnancy outcomes. Materials and Methods: Prospective cohort study was conducted in Shariati Hospital from April 2012 to May 2013. Forty patients were recruited through a prospective cohort study and treated for septate uterus. Septum size was measured by hysteroscopy. Patients underwent hysteroscopic metroplasty with an equatorial semicircular loop cutting 12 resect scope. Some of them resected by 5 French hysteroscopic scissors. Patients followed 2 months later by hysteron salpingography. The mean time of follow up for reproductive outcomes was 6.43±10.33 months. Results: The mean age of patients was 31.5±3.02 years. In whole, 48 patients underwent hysteroscopic metroplasty. In 52.1% length of septum occupied two third of uterine cavity.8 patients were excluded from the study because of non-reproductive related complains. There were 29 pregnant patients (72.5%). 15patients became pregnant without intervention (51.7%). 14 patients had pregnancy under ART. Among pregnant population there were 9 miscarriages (31%), 3 preterm (13.3%) and 17 term delivery (50%). Live birth rate in our study was 68.9%.Incontrol hysterosalpingography; no patients had adhesion or residual ridge. Conclusion: The findings of this study indicate that hysteroscopic septoplasty is acceptable for improving reproductive outcomes inpatients with septate uterus.