uterine septum, septated uterus. uterine partition
The uterus is formed during embryogenesis by the fusion of the two Müllerian ducts. During this fusion a resorption process eliminates the partition between the two ducts to create a single cavity. This process begins caudally and advances cranially, thus a complete septum formation represents an earlier disturbance of this absorption than the incomplete form.
Uterine malformations are associated with genetic and teratogenic factors. Seen as problematic can be contact with any substance with teratogenic potential during pregnancy. Fetus is the most vulnerable in the period of 2 to 12 weeks.
The condition may not be known to the affected individual and not result in any reproductive problems; thus normal pregnancies may occur. However, it is associated with a higher risk for miscarriage, premature birth, and malpresentation. According to the classical study by Buttram there is a 60% risk of a spontaneous abortion, this being more common in the second than in the first trimester. However, there is no agreement on this number and other studies show a lower risk. Woelfer found that the miscarriage risk is more pronounced in the first trimester.
Uterus septus is characterized by a wall or septum partially or fully dividing the uterus into two cavities, cervix and the vagina can be also partitioned. Clinically, symptoms may range from being asymptomatic thus remaining undiagnosed, to the development of poor reproductive outcome including:
Mostly additional to surgical solution, to help epithelization processes, against adhesion development.
It is not considered necessary to remove a septum that has not caused problems, especially in women who are not considering pregnancy. There is controversy over whether a septum should be removed prophylactically to reduce the risk of pregnancy loss prior to a pregnancy or infertility treatment.
If condition ask for that, a septum can be resected with surgery. Hysteroscopic removal of a uterine septum is generally the preferred method, as the intervention is relatively minor and safe in experienced hands.
In patients for whom IVF-ICSI is indicated, septum resection is required before the beginning of the cycle in order to minimize the adverse effect of the septum on fecundity and early pregnancy. However, a prospective randomized trial is needed to compare IVF outcome in patients with such uterine anomaly after surgical correction versus those without surgical correction. Reproductive outcome of IVF-ET after hysteroscopic correction of incomplete uterine septum anomaly in women with primary infertility is not different from women with normal uterine cavity. Multiple pregnancies may have a negative impact on the likelihood of a full term pregnancy; therefore, every effort should be made to achieve a singleton pregnancy in these patients and only eSET (elective single embryo transfer) is accepted in these patients.
A medical condition, where the walls of the uterus stick to one another due to bands of scar tissue.
A type of female genital malformation resulting from an abnormal development of the Müllerian duct(s) during embryogenesis.
Congenital uterine malformation where both Müllerian ducts develop but fail to fuse, thus the woman has a "double uterus".
The narrow inferior portion of the uterus that projects into the vagina.
Two very fine tubes that transport sperm toward the egg, and allow passage of the fertilized egg back to the uterus for implantation.
The uterus is the largest and major organ of the female reproductive tract that is the site of fetal growth and is hormonally responsive
Sex organ that is a part of the female genital tract having two primary functions: sexual intercourse and childbirth.
Cells composing an inner layer of the uterine lining.
The innermost layer of uterus forming the uterine lumen where the implantation of an oocyte happens.
The primary female sex hormone responsible for the development and regulation of the female reproductive system and secondary sex characteristics.
The very early stage of pregnancy at which the embryo adheres to the wall of the uterus.
Longitudinal division of the vagina into two separate organs.
The failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse.
The painful feelings during sexual intercourse.
A birth of the baby before 37 completed weeks of gestational age.
A disease distinct from infertility, defined by two or more failed pregnancies.
Process by which a woman donates eggs for purposes of assisted reproduction or biomedical research.
The procedure of transfer one single good quality embryo in cleavage stage or in stage of blastocyst that was selected as the most appropriate.
A micromanipulative fertilization technique in which a single sperm is injected directly into an egg.
The procedure in which a man (sperm donor) provides his sperm for fertility treatment.
A process in which an egg is fertilised by sperm outside the body: in vitro. Own or donated gametes may be used.