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metroplasty and fertility treatments

Ryosuke Tajiri, Taeko Ueda, Yoko Aoyama, Toshihide Sakuragi, Atsushi Tohyama, Keisuke Okabe, Hitomi Nakagawa, Yasuyuki Kinjo, Toru Hachisuga
A 31-year-old nulligravid woman with a 3 year history of infertility visited our hospital. After consultation and a transvaginal ultrasound and MR imaging, her uterine anomaly was identified as complete septate uterus: class V (a) by the American Fertility Society (AFS). She had a doubled uterine cervix and a vaginal septum. Hysteroscopic metroplasty was performed with the aid of a laparoscopy. Both tubal patencies were confirmed with indigocarmine in a laparoscopic image. Laparoscopic electronic cautery was also done on the left ovarian endometrioma (stage 1 endometriosis; the revised American Society for Reproductive Medicine (rASRM) classification 4 point minimal)...
March 1, 2015: Journal of UOEH
Roberto Paradisi, Rita Barzanti, Raffaella Fabbri
PURPOSE OF REVIEW: To evaluate the reproductive outcomes and surgical techniques of the hysteroscopic metroplasty in women with septate uterus and recurrent abortions or primary unexplained infertility. RECENT FINDINGS: Septate uterus is the most frequent congenital uterine anomaly caused by inadequate resorption of the Müllerian ducts. Hysteroscopic metroplasty has replaced the traditional laparotomy approach because of its positive and satisfactory outcomes in pregnancy and live-birth rates, and also many different postoperative benefits...
August 2014: Current Opinion in Obstetrics & Gynecology
Gianluca Raffaello Damiani, Stefano Landi, Massimo Tartagni, Stefano Bettocchi, Giuseppe Loverro, Antonio Pellegrino
BACKGROUND: Incarceration of the fallopian tube is a rare condition. Symptoms are often misleading, making proper diagnosis difficult because of nonspecific clinical presentations. We report a case of cornual pregnancy occurring 7 months after the treatment of an incarcerated fallopian tube. We believe that the abnormal cornual implantation of the gestational sac was due to myometrial reconstruction of the uterine wall. CASE: A primigravid woman treated for the incarceration of a fallopian tube was subsequently found to have a cornual pregnancy in a septate uterus...
November 2013: Journal of Reproductive Medicine
V Savasi, F P G Leone, F Fusè, F Parisi, I Cetin
Congenital and acquired uterine factors are known to influence the success of assisted reproductive technologies (ARTs). Several studies analyzed the role of uterine septa, adenomyosis, myomas, endometrial polyps and intrauterine adhesions in female infertility. All of them might cause defective endometrial receptivity and consequently decreased embryo implantation and pregnancy rate. In particular, septate uterus represents the most frequent Müllerian anomaly leading to an increased risk of abortion. Many studies evaluated the role of hysteroscopic metroplasty on fertility outcomes, but this topic remains controversial...
October 2013: Minerva Ginecologica
Togas Tulandi, Khalid Akkour
Reproductive surgery could be divided into surgery as a primary treatment for infertility, surgery to enhance in-vitro fertilisation outcome, and surgery for fertility preservation. A shift has occurred away from surgery as a primary treatment of infertility to surgery playing a crucial part in enhancing in-vitro fertilisation outcome and for fertility preservation. A normal uterine cavity is a prerequisite for implantation, and hysteroscopic correction of intrauterine pathology, including polypectomy, myomectomy and metroplasty, increases the chances of having a successful pregnancy...
December 2012: Best Practice & Research. Clinical Obstetrics & Gynaecology
Michaël Grynberg, Amélie Gervaise, Erika Faivre, Xavier Deffieux, René Frydman, Hervé Fernandez
STUDY OBJECTIVE: To assess the fertility and obstetric outcome after surgical treatment of complete uterine and vaginal septum. DESIGN: Retrospective study (Canadian Task Force Classification II-2). SETTING: Teaching hospital in France. PATIENTS: Twenty-two women who have experienced infertility, pregnancy losses, dyspareunia, or dysmenorrhea. INTERVENTION: Hysteroscopic section of complete uterine septum and resection of longitudinal vaginal septum...
January 2012: Journal of Minimally Invasive Gynecology
Giampietro Gubbini, Attilio Di Spiezio Sardo, Daniela Nascetti, Elena Marra, Marialuigia Spinelli, Elena Greco, Paolo Casadio, Carmine Nappi
STUDY OBJECTIVE: To produce and validate a simple, systematic and reproducible subclassification system for uterine anomalies previously classified by the American Ferility Society as Class V and VI to achieve a precise definition of each uterine anomaly, confirm the feasibility and safety of surgical correction of the anomalies, determine the type of hysteroscopic treatment, and provide a standard by which patient selection, treatment, and reproductive outcomes can be compared between centers...
September 2009: Journal of Minimally Invasive Gynecology
Jan Bosteels, Steven Weyers, Patrick Puttemans, Costas Panayotidis, Bruno Van Herendael, Victor Gomel, Ben W J Mol, Chantal Mathieu, Thomas D'Hooghe
BACKGROUND: Although hysteroscopy is frequently used in the management of subfertile women, a systematic review of the evidence on this subject is lacking. METHODS: We summarized and appraised the evidence for the benefit yielded by this procedure. Our systematic search was limited to randomized and controlled studies. The QUOROM and MOOSE guidelines were followed. Language restrictions were not applied. RESULTS: We identified 30 relevant publications...
January 2010: Human Reproduction Update
Kaiqing Lin, Xiaoming Zhu, Hong Xu, Zhaoxia Liang, Xinmei Zhang
OBJECTIVE: To evaluate reproductive outcomes in women with complete uterine septum with double cervix and vagina following resectoscope metroplasty. METHODS: The pregnancy outcomes of 21 women who underwent vaginal and uterine septum resection were compared with those of 15 untreated women with similar clinical characteristics. The Fisher exact test and the Mann-Whitney test were used for statistical analysis. RESULTS: Cycle fecundity was better (33...
April 2009: International Journal of Gynaecology and Obstetrics
Rachel F Spitzer, Nicolette Caccia, Sari Kives, Lisa M Allen
OBJECTIVE: To report a case of complete obstructing uterine septum repaired in a minimally invasive manner by operative hysteroscopy under laparoscopic guidance. A complete obstructing uterine septum is a rare congenital abnormality. To date, management of such abnormalities has traditionally been by metroplasty. DESIGN: Case report and review of the literature. SETTING: Pediatric and adolescent gynecology service at a tertiary care hospital...
November 2008: Fertility and Sterility
F-X Aubriot, C Chapron
The diethylstilbestrol (DES) is a synthetic estrogen which was prescribed from 1941 onwards for the prevention of miscarriage. As well as a possible risk of cancer, another side effect of this treatment was the possible abnormality of the genitalia in the female issue of the prescribed user. Apart from possibly having a hypoplasic uterus, the patient is also prone, in the case where she has an undersized uterus, to having a much narrower than normal cavity. Consequently, there is a tendency for an excess of muscle tissue on the uterus walls...
September 2007: Gynécologie, Obstétrique & Fertilité
C Rongières
The infertility in women with an abnormal uterus seems a subject of controversy. The prognosis of in vitro fertilization among these patients with such an anomaly is even less founded. The results of in vitro fertilization have been only studied with few patients and recently. Through the literature, we will focus step by step, on the impact of uterine anomalies on natural reproduction, then the impact of metroplasty on natural reproduction, the role of anomalies on the endometrium quality and lastly, the results of Assisted Rerpoductive Techniques with women with such an anomaly...
September 2007: Gynécologie, Obstétrique & Fertilité
C Poncelet, F Aissaoui
The frequency of uterine malformations impacting on reproduction seems not easy to determine. Their diagnosis needs specific explorations (hysterosalpingography, hysteroscopy and laparoscopy). Spontaneous fertility may be impaired in relation with uterine abnormalities. All these abnormalities could have repercussions on the conceptus' evolution like abortion, preterm delivery, vascular pathologies and intrauterine growth restriction. Ovarian function does not seem to be altered even though implantation rate could be reduced...
September 2007: Gynécologie, Obstétrique & Fertilité
Jing Yang, Tai-Lang Yin, Tai-Ung Yin, Wang-Ming Xu, Liang-Bin Xia, Lian-Gbin Xia, Ai-Bin Li, Jing Hu
OBJECTIVE: The aim of this study was to assess fertility outcome and obstetrical prognosis of 46 patients after hysteroscopic section of uterine septa with neodysmium:yttrium-aluminum-garnet (Nd:YAG) laser. BACKGROUND DATA: Approximately 15-25% of spontaneous miscarriages are related to Müllerian fusion defects, most of which are associated with uterine septa. Operative hysteroscopy is a safe and effective treatment for uterine septa. METHODS: Forty-six sterile patients with septate uterus received hysteroscopic metroplasty with Nd:YAG laser...
October 2006: Photomedicine and Laser Surgery
Barry Sanders
A literature review was performed to explore the available information regarding the association of uterine factors--intrauterine adhesions, uterine septa, uterine myomas and endometrial polyps--with infertility and reproductive loss. The literature was reviewed also to ascertain evidence that treatment of these abnormalities improves fertility. A MEDLINE search was performed to identify the relevant publications in the English-language literature. There is minimal published evidence to demonstrate that intrauterine adhesions lead to infertility or pregnancy loss, but the literature does contain several observational series that demonstrate successful fertility, with term pregnancy rates ranging from 32% to 87% following hysteroscopic division of intrauterine adhesions...
March 2006: Journal of Reproductive Medicine
Jackie Hollett-Caines, George A Vilos, Basim Abu-Rafea, Riad Ahmad
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)...
February 2006: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
Pentti K Heinonen
OBJECTIVE: To review clinical implications, reproductive outcome, and long-term consequences in women with complete septate uterus and longitudinal vaginal septum. DESIGN: A retrospective study. SETTING: A university hospital. PATIENT(S): Sixty-seven patients who had a complete septate uterus including the cervix and a longitudinal vaginal septum. INTERVENTION(S): The longitudinal vaginal septum was incised in 36 cases and metroplasty for uterine septum was undertaken in 4 patients...
March 2006: Fertility and Sterility
G Porcu, L Cravello, C D'Ercole, D Cohen, V Roger, R de Montgolfier, B Blanc
OBJECTIVES: The aim of this study is to assess fertility outcome and obstetrical prognosis of 63 patients after hysteroscopic section of uterine septa. MATERIALS AND METHODS: This is a retrospective study about 63 patients consulting for septate uterus and repeated pregnancy loss or abnormal fetal presentation between January 1988 and December 1996 in La Conception hospital in Marseille. Septal lysis was performed with microscissors or resectoscope. Statistical analysis was performed using the CHI2-test...
January 2000: European Journal of Obstetrics, Gynecology, and Reproductive Biology
M Martínez Reveles, C G Salazar López-Ortíz, F Gaviño Gaviño, J L Castro López, H L Mondragón Alcocer
Determine the type and the possibility of corrective surgery, reproductive results of infertility patients with Müllerian malformations. The clinic and the laparoscopic and hysteroscopic evaluation were performed to 40 patients with Müllerian anomalies and infertility history analyzing the reproductive results. The uterine septum was present in 23/40 patients (57.5%), bicornual uterus in 6/40 (15%), didelfus uterus 5/40 (12.5%), arcuate uterus 4/40 (10%), unicorn uterus 2/40 (5%). After septum resection we had 13 pregnancies (56...
January 1999: Ginecología y Obstetricia de México
L Cravello, G Porcu, V Roger, C D'Ercole, B Blanc
In the treatment of uterine lesions associated with infertility, such as septate uterus and synechiae, hysteroscopic surgery has replaced conventional abdominal surgery. Hysteroscopic metroplasty improves obstetrical prognosis in patients with septate uterus. Advantages of hysteroscopy are low morbidity rate, decreased hospitalization time, and absence of hysterotomy. Hysteroscopic surgery of synechiae allows to achieve good anatomical results in most of the cases. The first risk of this surgery is perforation...
July 1998: Contraception, Fertilité, Sexualité
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