The effect of hysteroscopic metroplasty on fertility in T-shaped and Y-shaped dysmorphic uterus

Abstract

Objective

T/Y-shaped dysmorphic uterus is frequently associated with subfertility, abortion, preterm delivery, and recurrent implantation failure. In this study, the impact of hysteroscopic metroplasty for a T/Y-shaped uterus on obstetric outcomes was investigated in patients with infertility and recurrent pregnancy loss (RPL) and compared the uterine anomaly subgroups.

Method

Cases with infertility and/or RPL diagnosed with T/Y-shaped uterus by hysterosalpingography (HSG) and 3D transvaginal ultrasonography (3D TVUSG) with no other male or female pathology have recruited the study. Medical history and the obstetric outcome after two years of follow-up were recorded.

Results

Out of the 92 cases recruited, T-shaped uteri (Group-1) were observed in 30, while 62 (67.3%) patients had Y-shaped uteri. Pregnancy was achieved in 50 (54.3%) of the cases, 28 (56%) of the pregnancies occurred spontaneously, and in 22 (44%) pregnancy was achieved through assisted reproductive techniques (ART). Term delivery occurred in 29 (76.3%) of the pregnancies while 9 (23.6%) had preterm deliveries and a total of 38 (76%) resulted in a live birth. Out of the 31 patients with previous RPL history, 13 (41.9%) achieved pregnancy and 11 out of 13 (84.6%) had a term pregnancy followed by live birth.

Conclusion

Spontaneous pregnancy, and term pregnancy rates after surgery were found to be promising in these uterine anomalies. The pregnancy outcome of the primary infertile patients was found the same in two groups (50%–46.1%), but the results of the RPL patients were found to be better in the T-shaped group than in the Y-shaped group (70%–28.5%).

摘要

目的：T形/Y形畸形子宫常与生育力低下、流产、早产和反复性着床失败相关。在本研究中, 研究了宫腔镜下T形/Y形子宫子宫成形术对不孕症和反复性流产（RPL）患者产科结局的影响, 并比较了子宫异常亚组的区别。

方法：通过子宫输卵管造影术（HSG）和经阴道三维超声检查（3D TVUSG）诊断为T形子宫的不孕症和/或RPL的患者（无其他男性或女性疾病）纳入本研究。记录两年随访后的病史和产科结局。

结果：在纳入的92例患者中, 30例发现T形子宫（第一组）, 62例（67.3%）患者发现Y形子宫。其中50例（54.3%）成功妊娠, 28例（56%）自发妊娠, 22例（44%）通过辅助生殖技术（ART）妊娠。29例（76.3%）足月妊娠后分娩, 9例（23.6%）早产, 38例（76%）活产。在31例既往有RPL病史的患者中, 13例（41.9%）成功妊娠, 11例（84.6%）足月妊娠后活产。

结论：这类子宫畸形患者术后自然妊娠和足月妊娠率是可观的。两组原发性不孕患者的妊娠结局相同（50%-46.1%）, 但T形组RPL患者的妊娠结局优于Y形组（70%-28.5%）。

Keywords:

• Hysteroscopy
• 3-dimensional ultrasonography
• hysterosalphingography
• dysmorphic uterus
• T/Y shaped uterus

Acknowledgments

All authors thank to the residents and nurses of the Infertility Department in Etlik Zubeyde Hanim Women’s Health, Training and Research Hospital.

Disclosure statement

No potential conflict of interest was reported by the author(s).