Uterine unification: indications and technique.

Uterine unification procedures were performed on 17 patients with müllerian anomalies in an attempt to achieve reproductive capability. None of the 17 patients had any living children prior to undergoing these metroplasties. Fifteen patients had a septate uterine anomaly that necessitated use of the modified Jones procedure. The Strassmann procedure was performed in 2 patients, one with a bicornuate uterus and one with a didelphys uterus. After analyzing the follow-up data on 16 of these patients, 12 have conceived at least once (resulting in a total of 15 pregnancies), 3 of those who have not yet conceived have had unprotected intercourse for less than 10 months, and one is utilizing contraception electively. The use of the modified Jones procedure and the Strassman procedure in appropriate circumstances can maximize a patient's chances for fertility with minimal surgical risks.