Even a small uterine septum may negatively affect the multifaceted mechanisms of implantation and reduce the chances of pregnancy, told Dr. Antonio Mollo from University of Naples.
Dr. Mollo and colleagues investigated if 44 women with a septate uterus and no other causes of infertility,could become pregnant in the year after hysteroscopic metroplasty than a similar group of 132 infertile women without uterine malformations (control group).
The authors reported that pregnancy rates after 12 months were 38.6% among women who underwent metroplasty, compared with 20.4% among women with unexplained infertility who had no uterine malformations.
The live birth rate in the metroplasty group was 34.1% which was slightly higher than the group without uterine malformations (18.9%).
There were two abortions and three preterm deliveries in women who underwent metroplasty, and in control group there were two abortions and one preterm delivery.
The findings of the present study, together with availability of minisurgical techniques, strongly encourage the treatment of uterine septa diagnosed during the sterility work-up of women whose primary infertility remains otherwise unexplained, the investigators conclude.
It is unlikely that endometrial abnormality of the septum condition affects implantation in an ‘on-off’ manner, Dr. Mollo explained. For instance, despite the well-known association between septum and higher risk of recurrent miscarriage, in clinical practice we daily see full-term pregnancies in patients affected by such malformations.
Molecular biology and electronic microscopy will help us in understanding the mechanism underlying this association, Dr. Mollo said. We aim to study the ultrastructural aspects of this part of endometrium during the implantation window.
