Septate Info

INFO i found on a forum about septate uteri (?) -->



The first is the Yahoo Group I found and they have a very helpful FAQ link:

http://www.chibardun.net/~mickbeth/faq2008.htm

Here is a link to the group page:

http://health.groups.yahoo.com/group/MullerianAnomalies/

I also belong to a fertility website that publishes highlights of recent IF studies that have been published. Since my operation to remove my septum in June there have been two really interesting articles that I will include here.

First Article

Issue 14: 24 Jul 2008
Source: Fertility and Sterility 2008;

A prospective controlled trial has confirmed that hysteroscopic resection of the septum improves the pregnancy rate in women with unexplained infertility.

Specialists from the University of Naples and the University of Palermo, Italy, conducted the study at three academic infertility clinics in order to investigate the fecundity of infertile women after surgery to correct a uterine septum.

The study group comprised 44 women with a septate uterus and otherwise unexplained infertility, who underwent hysteroscopic resection (metroplasty). The control group consisted of 132 women with unexplained infertility, who were managed expectantly. All of the women were followed up for a total of 1 year.

In their paper to be published in the journal Fertility and Sterility, the researchers (Mollo A et al) report that pregnancy and live birth rates were both significantly higher in the study group. The pregnancy rate was 38.6 percent in the study group, compared with 20.4 percent in the control group, while the live birth rates were 34.1 percent and 18.9 percent respectively.

A survival analysis showed that the cumulative probability of pregnancy during the 1-year follow-up period was significantly higher in the patients who underwent hysteroscopic resection, compared with the control group.

Finally, the fecundity rate (the number of pregnancies per 100 person-months) was also significantly higher in the study group, compared with the control group: 4.27 versus 1.92, respectively.

The researchers note that the study results support the idea that a uterine septum can affect implantation and early pregnancy processes, as suggested by previous studies. They suggest that women with a septate uterus and no other cause of infertility have a significantly higher chance of conceiving after removal of the septum than women with idiopathic infertility.

The researchers conclude: “The findings of the present study, together with availability of mini-surgical techniques, strongly encourage the treatment of uterine septa diagnosed during the sterility work-up of women whose primary infertility remains otherwise unexplained.”

Second Article

Issue 12: 16 Jun 2008
Source: European Journal of Obstetrics & Gynecology and Reproductive Biology 2008

A small partial uterine septum confers a significantly increased risk of spontaneous abortion in pregnancies after IVF/ICSI, but this risk can be reduced by hysteroscopic resection before planning pregnancy, new data show.
Previous research has linked a large uterine septum with an increased risk of spontaneous abortion or premature delivery, but the effects of a small partial uterine septum are less clear.

To investigate, specialists from the University Medical Center in Ljubljana, Slovenia, conducted a retrospective study to evaluate the effect of the timing of hysteroscopic resection of a large uterine septum and of a small partial uterine septum on the spontaneous abortion rate in singleton pregnancies after IVF/ICSI.

The study population consisted of a total of 137 women who conceived following IVF/ICSI before (31 women) and after (106 women) hysteroscopic resection of a large or small partial uterine septum.

Each of these 137 women were matched with two consecutive pregnant women from the medical center’s IVF/ICSI registry who had a normal uterus, matched for age, body mass index, stimulation protocol, use of IVF or ICSI, and infertility cause.

The researchers present their findings in a new paper due to be published in the European Journal of Obstetrics & Gynecology and Reproductive Biology. In the women who conceived before hysteroscopic resection, the spontaneous abortion rate was significantly higher for both types of septum compared with controls:

In women with a large uterine septum, the spontaneous abortion rate was 83.3 percent, compared with 16.7 percent in controls (odds ratio 25.0; 95 percent confidence interval 3.9-160).
In women with a small partial uterine septum, the spontaneous abortion rate was 78.9 percent, compared with 23.7 percent in controls (odds ratio 12.1; 95 percent confidence interval 3.2-45. 8 ).
In contrast, in the women who conceived after hysteroscopic resection, there were no significant differences in the spontaneous abortion rates for both types of septum compared with controls. The spontaneous abortion rates were 30.6 percent in women who originally had a large uterine septum, compared with 20.4 percent in controls, and 28.1 percent in women who originally had a small partial uterine septum, compared with 19.3 percent in controls.

The researchers conclude that, as with a large uterine septum, a small partial uterine septum is an important and hysteroscopically preventable risk factor for spontaneous abortion in pregnancies after IVF/ICSI.

They write: “In view of our results and the reports from the literature, we believe that a small partial uterine septum or arcuate uterine abnormality is an important risk factor for spontaneous abortion, and should be hysteroscopically resected before planning pregnancy.” This is especially important in women who have fertility problems and who are candidates for IVF/ICSI, they add.
« Last Edit: 25/09/08, 22:39 by AlmaMay »