Hysteroscopic septum resection and reproductive medicine: A SWOT analysis
Checa, Miguel Angel (Parc de Salut MAR de Barcelona)
Bellver, José (Instituto Valenciano de Infertilidad)
Bosch, Ernesto (Instituto Valenciano de Infertilidad)
Espinós, Juan José (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya))
Fabregues, Francisco (Hospital Clínic i Provincial de Barcelona)
Fontes, J (Hospital Universitario Virgen de las Nieves (Granada))
García-Velasco, Juan A. (Instituto Valenciano de Infertilidad)
Universitat Autònoma de Barcelona. Departament de Pediatria, Obstetrícia i Ginecologia i de Medicina Preventiva i Salut Pública

Data:	2018
Resum:	Hysteroscopic septum resection in women with unfavourable reproductive and clinical outcomes has become common practice worldwide to improve reproductive results. No clear evidence on the possible advantages and drawbacks of this procedure has been published. In this opinion paper, based on a SWOT (strengths, weaknesses, opportunities, threats) analysis, the different aspects of this strategy are evaluated. Currently, no level 1 published evidence supports uterine resection in women with septate uterus. Clinical evidence from the studies analysed matches the more recent guidelines and suggests an improvement in reproductive outcomes after hysteroscopic resection of the septum, particularly in infertile women and women who have experienced recurrent miscarriages. In a patient with no history of infertility or prior pregnancy loss, it may be reasonable to consider septum incision after counselling about the potential risks and benefits of the procedure. Published clinical data in favour of the intervention, however, are based on studies with important methodological limitations. In this situation, the clinician and patient should reach an agreement together, based on the pros and cons of this intervention. Well-designed randomized controlled trials are required to confirm the clinical benefits and cost-effectiveness of this procedure.
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Llengua:	Anglès
Document:	Article ; recerca ; Versió sotmesa a revisió
Matèria:	Infertility ; Metroplasty ; Preterm delivery ; Recurrent miscarriage ; Septate uterus ; Septum resection ; Spontaneous abortion
Publicat a:	Reproductive biomedicine online, Vol. 37 Núm. 6 (December 2018) , p. 709-715, ISSN 1472-6491

Preprint 33 p, 559.9 KB

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