OP11.08: Reproductive outcome after hysteroscopic metroplasty for septate and T‐shaped uterus

To compare the reproductive outcome after hysteroscopic metroplasty for septate and T-shaped uterus. Consecutive patients with septate (S-group) and T-shaped uterus (T-group) complaining of primary infertility and poor obstetric outcomes (miscarriages, ectopic pregnancy, preterm delivery) were recruited. Septate and T-shaped uterus was diagnosed by 3D-TVS performed with the GE Voluson E8 unit, using a wide-band 3-9 MHz transducer, by Multiplanar Display and Volume Contrast Imaging (VCI) analysis (by two millimetres slices) for the evaluation of the fundal and lateral septa thickness at its thickest on the coronal planes. Hysteroscopic metroplasty was the standard suggested surgical treatment, performed by either monopolar or bipolar electrosurgical instruments. All patients had a 3D-TVS scan two months afterwards to assess the success of the procedure. Pre- and postoperative demographic and obstetric data were recorded. At ad interim analysis, 294 patients were considered: 185 and 109 women underwent surgery for septate and T-shaped uterus, respectively. Mean age (±SD) of the pregnant women after surgery in S- and T-group was 33 ± 4 and 35 ± 5 years, respectively (p = 0.13); mean BMI (±SD) was 22 ± 4 and 22 ± 5 years, respectively (p = 0.60). At ad interim analysis, 51 patients became pregnant after metroplasty in S-group with 84 pregnancies: 55 (66%) live birth at term, 22 (26%) miscarriages and 7 (8%) ongoing (>24 weeks). In T-group, 31 patients became pregnant after metroplasty with 41 pregnancies: 29 (71%) live birth at term, 10 (24%) miscarriages and 2 (5%) ongoing. The overall live birth rate per pregnancy in the 28 S-group patients before and after surgery was 21% (9/42) and 62% (30/48), respectively. The overall live-birth rate per pregnancy in the 15 T-group patients before and after surgery was 17% (5/29) and 61% (14/23), respectively. The clinical impact of hysteroscopic metroplasty on the reproductive outcome was similar comparing patients with a T-shaped and a septate uterus.