Reproductive and ICSI outcomes after hysteroscopic metroplasty for T-shaped uterus, a prospective follow up study.

BACKGROUND

The incidence of uterine anomalies is approximately 0.5-4.7%. In infertile women, this rises to 6.3%. T-shaped uterine anomalies have been associated with infertility, recurrent implantation failure (RIF), and recurrent miscarriage (RM). Hysteroscopic metroplasty (HM) may improve the reproductive outcomes of such cases.

STUDY OBJECTIVE

We assessed the effects of hysteroscopic metroplasty on the reproductive and in vitro fertilization (IVF) outcomes in women with T-shaped uteri.

DESIGN

A prospective controlled study.

SETTING

A teaching hospital.

PATIENTS

The reproductive outcomes of 182 patients with primary infertility (PI), RIF, or RM who underwent hysteroscopic metroplasty to treat T-shaped uteri were prospectively analyzed.

INTERVENTIONS

Between January 2017 and April 2021, hysteroscopic metroplasty was performed by a single experienced surgeon. The primary outcome was the live birth rate (either spontaneous or assisted).

MEASUREMENTS AND PRINCIPAL RESULTS

In all, 182 patients who underwent bilateral, longitudinal, uterine-lateral wall incisions without complications were included. The clinical pregnancy rates after metroplasty were 50.9% (primary infertility group), 71.4% (RM group), and 39.5% (RIF group). During the 1-year follow-up, 25.5% of patients conceived spontaneously (all groups).

CONCLUSION

Hysteroscopic metroplasty should be considered for women with primary infertility, RIF, and RM with T-shaped uteri.