Reproductive outcomes following hysteroscopic uterine septum resection in infertile women: a retrospective cohort study.

Abstract

Objective: A septate uterus is a common congenital anomaly often identified during infertility evaluations and is associated with adverse reproductive outcomes. Hysteroscopic septum resection is widely recognized as a standard, safe, and effective treatment. This study aimed to evaluate reproductive and pregnancy outcomes in infertile women who underwent hysteroscopic septum resection.

Method: This retrospective cohort study included infertile women aged 18 to 45 years who were diagnosed with a uterine septum and were candidates for assisted reproductive technology (ART) between 2011 and 2021. Participants had either primary or secondary infertility and underwent hysteroscopic septoplasty. Data were collected from medical records and telephone interviews, which included demographic information and postoperative outcomes, such as chemical and clinical pregnancy rates, live birth rates, and adverse pregnancy outcomes. Statistical analyses employed descriptive methods, including frequencies and means.

Results: Among 735 women, 84.6% had primary infertility, and 51.5% had infertility for 1-5 years. The chemical pregnancy rate was 44.6%, clinical pregnancy 42.8%, and live birth 36.7%. No significant differences were found between primary and secondary infertility groups in pregnancy or live birth rates. Adverse outcomes included preterm labor (6.7%) and preeclampsia (4.8%). Vaginal delivery was the most common mode (81.8%).

Conclusion: Hysteroscopic septum resection appears to improve pregnancy outcomes and live birth rates in individuals undergoing ART. Nevertheless, prospective studies with control groups are needed to confirm these findings and establish stronger evidence.