Search Results (3)

Background/Objectives: This study compared the cost-effectiveness of 4D transvaginal ultrasonography (TVUSG), hysterosalpingography (HSG), and hysteroscopy (HS) in evaluating postoperative uterine correction among patients who underwent hysteroscopic metroplasty for a dysmorphic uterus. Additionally, pregnancy outcomes following surgery were assessed. Materials and Methods: Thirty-one patients who underwent hysteroscopic metroplasty due to a dysmorphic uterus between July 2023 and June 2024 were retrospectively analysed. Postoperative uterine cavity evaluations were performed exclusively using 4D transvaginal ultrasonography (4D-TVUSG). The characteristics of alternative imaging modalities (HSG and HS) were evaluated conceptually in terms of invasiveness, feasibility, and cost based on official Ministry of Health data and previously published literature, rather than through direct patient-based comparison. One-year postoperative pregnancy outcomes were also recorded. Results: Notably, 4D-TVUSG was considered preferable to HSG and HS due to its non-invasive nature, ease of use, lack of anaesthesia requirement, and lower cost. Postoperatively, 14 patients (45.2%) achieved pregnancy, of whom 3 (21.4%) experienced miscarriages and 11 (78.6%) had ongoing pregnancies or live births. All patients demonstrated a normalised uterine cavity on follow-up and a 100% surgical success rate. Conclusions: It was found that 4D-TVUSG is a reliable, cost-effective, and non-invasive method for postoperative assessment in patients with a dysmorphic uterus undergoing hysteroscopic metroplasty. This is the first study to compare the cost-effectiveness of these three imaging methods, highlighting 4D-TVUSG as a potential first-line follow-up tool in clinical practice. Full article

A T-shaped uterus is a rare uterine malformation that is classically associated with diethylstilbesterol (DES) exposure. Surprisingly, the prevalence of T- and Y-shaped uterus has increased in recent years despite the absence of a diagnostic consensus and a correlation with the reproductive outcomes has been observed. A systematic electronic database search for all English-language studies published on reproductive outcomes associated with dysmorphic uteri over the past 10 years using PubMed, Google Scholar, and Scopus was performed. This uterine malformation is associated with impaired reproductive outcomes, including primary infertility, miscarriage, ectopic pregnancy, and preterm birth. Hysteroscopic metroplasty is a simple surgical procedure that could potentially improve outcomes in subfertile women, but the data are not robust. Studies reported significant improvements in implantation and pregnancy rates after corrective metroplasty in women undergoing in vitro fertilization. However, multicenter, prospective, randomized, and controlled trials are needed to validate these findings and to help define clear diagnostic criteria, surgical indications, and appropriate follow-up of reproductive outcomes after the procedure. Full article

To compare the obstetric results achieved after hysteroscopic office metroplasty (HOME-DU) in infertile and recurrent pregnancy loss (RPL) patients diagnosed with dysmorphic uterus, women hysteroscopically diagnosed with dysmorphic uterus who underwent uterine-enlargement metroplasty were prospectively enrolled from June 2016 until April 2020. Patients were followed up and obstetric outcomes were recorded (pregnancy and live birth rate). Sixty-three women (30 infertile; 33 RPL) were enrolled, of which 48 became pregnant post-HOME-DU, with an overall pregnancy rate of 76.2% (66.7% among infertile participants; 84.9% among those with RPL). Overall, 64.3% (n = 36/63) achieved live birth. Among infertile women, 62.07% (n = 18/29) achieved live birth, as well as 66.7% of women with RPL (n = 18/27). The difference in live birth rates between both cohorts was 4.6% (p > 0.05). The rate of miscarriage amongst infertile patients was 3.3% (n = 1/30) and 12.1% amongst women with RPL (n = 4/33). Office metroplasty via the HOME-DU technique improves obstetric results (namely increasing live birth rate) in patients with dysmorphic uterus and a history of reproductive failure. No significant difference was found in the clinical efficacy of HOME-DU in infertile and RPL patients. Full article