Fertility and pregnancy outcomes following hysteroscopic septum division.

OBJECTIVES

We sought to evaluate retrospectively the efficacy of hysteroscopic metroplasty in a population of women with a history of recurrent pregnancy loss or infertility who were also known to have a uterine septum.

METHODS

Hysteroscopic metroplasty was performed on 26 women with a uterine septum and a history of either recurrent pregnancy loss or infertility. The metroplasty was performed using a Versapoint bipolar needle device (in 23% of cases) or a resectoscopic knife electrode with cutting current (in 77% of cases). The main outcome measures were rates of clinical pregnancy and live birth.

RESULTS

Nineteen women had a hysteroscopic metroplasty because of recurrent pregnancy loss. Postoperatively, the pregnancy rate was 95%, and the live birth rate was 72%. The seven infertile patients had pregnancy and live birth rates of 43% and 29%, respectively.

CONCLUSION

Hysteroscopic metroplasty using either the Versapoint bipolar needle device or a knife electrode is both safe and effective. In women with recurrent pregnancy loss, future fertility is not impaired, and live birth rates are significantly improved.