The main goal of our study was to assess the true incidence
of surgically correctable uterine abnormalities
(congenital uterine anomalies, submucous leiomyoma,
endometrial polyps and intrauterine synechiae) in the
infertile population attending our tertiary infertility
clinic. All of the infertile patients enrolled in the study
were evaluated by three-dimensional ultrasound. Another
objective was to assess pregnancy rates before and
after operative hysteroscopy in patients affected by uterine
causes of infertility.
Good quality 3D images were obtained in all 3850 infertile
patients, and in 23.2% of them 3D US revealed
surgically correctable uterine abnormalities. The incidence
of uterine septum in our general infertile population
was 17.9 %. Uterine septum was the most common
uterine abnormality accounting for 77.1% of the intracavitary
lesions. Out of 310 patients that were followed-up,
225 (72.6%) patients achieved pregnancy. The rate
of term deliveries after septal incision was 57.7%, while
15.4% of patients had preterm deliveries. The rate of
spontaneous abortions dropped from 41.7% before, to
11.9% after hysteroscopic resection of the septum.
Three-dimensional ultrasound can be used as a screening
method for detection of uterine abnormalities in
patients suffering from infertility. We found significant
improvement in reproductive outcome after operative
hysteroscopy in secondary infertile patients with septate
uterus and/or other uterine abnormalities.
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