Does hysteroscopic resection of uterine septum improve reproductive outcomes: a systematic review and meta-analysis

Abstract Purpose Uterine septum in women with subfertility or previous poor reproductive outcomes presents a clinical dilemma. Hysteroscopic resection has been previously associated adverse but the evidence remains inconclusive. We aimed to thoroughly and systematically appraise relevant on impact of hysteroscopically resecting uterine this cohort women. Methods AMED, BNI, CINAHL, EMBASE, EMCARE, Medline, PsychInfo, PubMed, Cochrane register controlled trials, database systematic reviews CINAHL were assessed April 2020, no language restriction. Only randomised control trials comparative studies which evaluated history and/or treated by hysteroscopic against included. The primary endpoint was live birth rate, whereas pregnancy, miscarriage, preterm malpresentation rates secondary outcomes. Results Seven involving 407 252 conservative management included meta-analysis. lower rate miscarriage (OR 0.25, 95% CI 0.07–0.88) compared untreated No significant effect seen birth, pregnancy delivery. However, there fewer malpresentations during labour group 0.22, 0.06–0.73). Conclusion Our review found birth. given limited available, high-quality are recommended before any conclusive guidance can be drawn.