Fertility and pregnancy outcomes following hysteroscopic metroplasty of uterine septa: an update.

The septate uterus is still a matter of debate and discussion today in different medical forums. The controversy is divided between 2 different quite divergent opinions, on the one hand that of those who promote its surgical correction and on the other that of those who advocate expectant management with no recommended surgical intervention. It is extremely difficult to determine the association between septum and infertility. Infertility is a multifactorial condition, furthermore, the mechanism by which the septate uterus is associated with infertility is still unknown, although the most probable causes seem to be related to implantation alterations. There is lack of high quality randomized controlled studies with an adequate number of patients demonstrating the efficacy of the surgical treatment of patients with septated uterus. However, the limited available data based on observational studies, support minimally invasive treatment using hysteroscopy as the method of choice for the treatment of patients with septated uterus and history of infertility or poor obstetrical outcomes.