Reproductive outcome of septate uterus after hysteroscopic treatment with neodymium:YAG laser.

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. Forty-one patients with incomplete septate uterus were under the guidance of B-ultrasonography, while the other 5 patients with complete septate uterus were treated by laparoscopy.

RESULTS: The metroplasty was successfully conducted in 45 patients, with a success rate of 98% (45 /46). Postoperative follow-up examinations of 28 patients revealed pregnancy within 12 months in 20 patients, 16 of whom acquired term delivery. The pregnancy rate within 1 year was 71%.

CONCLUSION: Hysteroscopic treatment of septate uterus with Nd:YAG laser is effective. The cervix may not be excessively dilated, the intraoperative bleeding can be thoroughly controlled, and the procedure under local anesthesia is relatively safe.