Hysteroscopic resection of uterine septum improves reproductive performance in women with unexplained infertility

To evaluate the reproductive outcome after hysteroscopic metroplasty in women with a septate uterus, with particular focus on patients suffering from unexplained infertility. Materials and methods: Hysteroscopic septum resection was performed on 181 patients with uterine septa, including 98 patients with infertility and 83 patients with secondary infertility. Patients were placed into 1 of 3 groups: those with unexplained infertility, those who had experienced 1 miscarriage, and those who had experienced 2 or more miscarriages. All were analyzed retrospectively in terms of their reproductive outcome. Results: After undergoing the hysteroscopic septum resection, 43 out of 98 primary infertility patients became pregnant (43.8%). This figure was lower than the pregnancy rates for patients who had experienced 1 miscarriage or 2 or more miscarriages, 70.2% and 82.6%, respectively (P < 0.05). In spontaneous pregnancies, the miscarriage rate for those who had experienced 1 previous miscarriage decreased from 88.1% (37/42) to 13.6% (3/22, P < 0.001); for those who had experienced 2 or more previous miscarriages, it decreased from 96.5% (168/174) to 17.1% (7/41, P < 0.001). The term delivery rate and live birth rate also rose significantly in all of the groups (P < 0.05). The rate of cesarean sections was 28 out of 107 births, or 26.1%. Conclusion: The reproductive prognosis for patients with unexplained infertility can be improved significantly by performing hysteroscopic metroplasty. Vaginal delivery is a safe way of giving birth for these patients.