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

Aim: 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.