ABSTRACT
Women with recurrent pregnancy loss have a 3.2 to 6.9% likelihood of having a major
uterine anomaly and a 1.0 to 16.9% chance of having an arcuate uterus. Bicornuate
and septate uterine have a negative impact on reproductive outcomes and are associated
with subsequent euploid miscarriage. The impact of an arcuate uterus on pregnancy
outcome remains unclear. There are no definitive criteria to distinguish among the
arcuate, septate, and bicornuate uteri. The American Fertility Society classification
of Müllerian anomalies is the most common standardized classification of uterine anomalies.
According to estimates, 65 to 85% of patients with bicornuate or septate uteri have
a successful pregnancy outcome after metroplasty. However, 59.5% of the patients with
such anomalies have a successful subsequent pregnancy without surgery, with a cumulative
live birthrate of 78.0%. There is no case-control study to compare live birthrates
in women who had surgery compared with those who did not. Strict criteria to distinguish
between the bicornuate and septate uterus should be established. Further study is
needed to confirm the benefits of metroplasty.
KEYWORDS
Bicornuate uterus - congenital uterine anomaly - recurrent pregnancy loss - septate
uterus
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Mayumi Sugiura-OgasawaraM.D. Ph.D.
Nagoya City University, Graduate School of Medical Sciences
Mizuho-ku, Nagoya 4678601, Japan
eMail: og.mym@med.nagoya-cu.ac.jp
