DOI: https://doi.org/10.36347/sjmcr.2024.v12i12.042

Pages: 2179-2183

The uterine septum is the most common genital malformation. It is responsible for repeated miscarriages (≥ 3). Its responsibility for the infertility itself is still not established. However, its role cannot be ruled out in secondary infertility, particularly when it remains unexplained in 40% of cases. The trans-abdominal surgical treatment of the uterine septum is abandoned in favor of the transcervical route which offers a direct approach to the uterine cavity, avoiding hysterotomy and its subsequent obstetric consequences, and adnexal adhesions and their consequences on fertility. This is therefore hysteroscopic septoplasty: a reference technique, simple, reproducible, with low morbidity, and whose operative consequences are few. It has reduced the rate of miscarriages to 15%, therefore providing an indication of choice in repeated miscarriages, or even after only two incidents. It is increasingly practiced in cases of unexplained infertility, and it often practiced before any medical assistance for procreation. Finally, combined with laparoscopy, it allows at the same time the pelvis to be explored and any associated pelvic pathology to be treated; it thus represents the gold standard in the treatment of uterine septa in these infertile patients.