Book contents
- 50 Big Debates in Reproductive Medicine
- Series page
- 50 Big Debates in Reproductive Medicine
- Copyright page
- Contents
- Contributors
- Foreword
- Introduction
- Section I Limits for IVF
- Section II IVF Add-ons
- Section III The Best Policy
- 14A IVF Should Be First-Line Treatment for Unexplained Infertility of Two Years Duration
- 14B IVF Should Be First-Line Treatment for Unexplained Infertility of Two Years Duration
- 15A Single Embryo Transfer Should Be Performed in All IVF Cycles
- 15B Single-Embryo Transfer Should Be Performed in All IVF Cycles
- 16A The Freezing of All Embryos Should Be Used for All IVF Cycles
- 16B The Freezing of All Embryos Should Be Used for All IVF Cycles
- 17A Luteal-Phase Support Should Be Stopped at the Time of a Positive Pregnancy Test
- 17B Luteal Phase Support Should Be Stopped at the Time of a Positive Pregnancy Test
- 18A A Natural Cycle Is the Best Protocol for Frozen Embryo Replacement
- 18B A Natural Cycle Is the Best Protocol for Frozen Embryo Replacement
- 19A All Pregnancies Conceived by IVF Should Be Delivered by Caesarean Section
- 19B All Pregnancies Conceived by IVF Should Be Delivered by Caesarean Section
- 20A Endometriosis Should Be Suppressed for 6–12 Weeks before Frozen Embryo Transfer
- 20B Endometriosis Should Be Suppressed for 6–12 Weeks before Frozen Embryo Transfer
- 21A Infertile Patients with Endometriosis Benefit from Surgery
- 21B Infertile Patients with Endometriosis Benefit from Surgery
- 22A Intramural Fibroids Greater than 4 cm in Diameter Should Be Removed to Aid Fertility
- 22B Intramural Fibroids Greater than 4 cm in Diameter Should Be Removed to Aid Fertility
- 23A All Infertile Women with a Uterine Septum Should Have a Surgical Removal
- 23B All Infertile Women with a Uterine Septum Should Have a Surgical Removal
- Section IV Embryology
- Section V Ethics and Statistics
- Section VI Male-factor Infertility
- Section VII Genetics
- Section VIII Ovarian Stimulation
- Section IX Hormones and the Environment
- Index
- References
23A - All Infertile Women with a Uterine Septum Should Have a Surgical Removal
For
from Section III - The Best Policy
Published online by Cambridge University Press: 25 November 2021
Book contents
- 50 Big Debates in Reproductive Medicine
- Series page
- 50 Big Debates in Reproductive Medicine
- Copyright page
- Contents
- Contributors
- Foreword
- Introduction
- Section I Limits for IVF
- Section II IVF Add-ons
- Section III The Best Policy
- 14A IVF Should Be First-Line Treatment for Unexplained Infertility of Two Years Duration
- 14B IVF Should Be First-Line Treatment for Unexplained Infertility of Two Years Duration
- 15A Single Embryo Transfer Should Be Performed in All IVF Cycles
- 15B Single-Embryo Transfer Should Be Performed in All IVF Cycles
- 16A The Freezing of All Embryos Should Be Used for All IVF Cycles
- 16B The Freezing of All Embryos Should Be Used for All IVF Cycles
- 17A Luteal-Phase Support Should Be Stopped at the Time of a Positive Pregnancy Test
- 17B Luteal Phase Support Should Be Stopped at the Time of a Positive Pregnancy Test
- 18A A Natural Cycle Is the Best Protocol for Frozen Embryo Replacement
- 18B A Natural Cycle Is the Best Protocol for Frozen Embryo Replacement
- 19A All Pregnancies Conceived by IVF Should Be Delivered by Caesarean Section
- 19B All Pregnancies Conceived by IVF Should Be Delivered by Caesarean Section
- 20A Endometriosis Should Be Suppressed for 6–12 Weeks before Frozen Embryo Transfer
- 20B Endometriosis Should Be Suppressed for 6–12 Weeks before Frozen Embryo Transfer
- 21A Infertile Patients with Endometriosis Benefit from Surgery
- 21B Infertile Patients with Endometriosis Benefit from Surgery
- 22A Intramural Fibroids Greater than 4 cm in Diameter Should Be Removed to Aid Fertility
- 22B Intramural Fibroids Greater than 4 cm in Diameter Should Be Removed to Aid Fertility
- 23A All Infertile Women with a Uterine Septum Should Have a Surgical Removal
- 23B All Infertile Women with a Uterine Septum Should Have a Surgical Removal
- Section IV Embryology
- Section V Ethics and Statistics
- Section VI Male-factor Infertility
- Section VII Genetics
- Section VIII Ovarian Stimulation
- Section IX Hormones and the Environment
- Index
- References
Summary
A uterine septum is a congenital abnormality that has been associated with poor reproductive outcome that can be readily corrected by hysteroscopic surgery. For this debate article we argue that all women with a uterine septum should have hysteroscopic septal resection before undergoing any fertility treatment. A uterine septum is a congenital uterine anomaly arising from the failure of canalisation of the uterus during embryological development. Uterine septa are more prevalent in women with a history of pregnancy loss, but not infertility alone, and are associated with an increased risk of first and second trimester miscarriage and preterm birth [1,2]. Diagnosis is straightforward with three-dimensional ultrasound. Adequate assessment of uterine morphology requires concurrent imaging of the external and internal controls of the uterus. Three-dimensional ultrasound facilitates such views and is safer and more acceptable to women than surgical assessment with hysteroscopy and laparoscopy which are required to see the internal and external fundal contours.
- Type
- Chapter
- Information
- 50 Big Debates in Reproductive Medicine , pp. 122 - 123Publisher: Cambridge University PressPrint publication year: 2021
References
Chan, YY, Jayaprakasan, K, Zamora, J, Thornton, JG, Raine-Fenning, N, Coomarasamy, A. The prevalence of congenital uterine anomalies in unselected and high-risk populations: a systematic review. Hum Reprod Update. [Internet] 2011;17(6):761–71. Available from: www.ncbi.nlm.nih.gov/pubmed/21705770.CrossRefGoogle ScholarPubMed
Chan, YY, Jayaprakasan, K, Tan, A, Thornton, JG, Coomarasamy, A, Raine-Fenning, NJ. Reproductive outcomes in women with congenital uterine anomalies: a systematic review. Ultrasound Obs Gynecol. [Internet] 2011;38(4):371–82. Available from: www.ncbi.nlm.nih.gov/pubmed/21830244.Google ScholarPubMed
Valle, RF, Ekpo, GE. Hysteroscopic metroplasty for the septate uterus: review and meta-analysis. J Minim Invasive Gynecol. [Internet] 2013;20(1):22–42. Available from: www.ncbi.nlm.nih.gov/pubmed/23312243.CrossRefGoogle ScholarPubMed