Abstract:
The role of different methods of hysteroscopic metroplasty in women with reproductive
failure against the background of a septate uterus is not fully determined. The purpose of the
study was to evaluate the effectiveness of reproductive function restoration after dissection and
removal of the uterine membrane using a monopolar resectoscope in women with infertility and
miscarriages. Material and methods. 65 patients with a septate uterus and reproductive failure
were under observation: 34 women underwent hysteroscopic monopolar dissection of the uterine
membrane and 31 patients underwent hysteroscopic monopolar resection of the uterine septum.
Results. Metroplasty technique (dissection or resection) with the use of a monopolar resectoscope
in women with a septate uterus did not affect the onset of pregnancy, the number of miscarriages
and premature births, but term deliveries and live births were probably 1.69 times more likely to
occur when the tissue of the uterine septum was removed compared to similar indicators during
its dissection (OR 0.34 [0.12-0.93]), in women with initial miscarriages - 1.96 times, respectively
(OR 0.16 [0.03-0.73]). The technique of performing metroplasty (dissection or resection) using a
monopolar resectoscope in women with initial infertility in the conducted study did not have a
statistically significant difference in terms of the effect on reproductive indicators. Conclusions.
Removal of the uterine septum using a monopolar resectoscope in women with miscarriages has
advantages in restoring reproductive function compared to the dissection technique. The
technique of monopolar metroplasty in women with infertility probably does not affect the
reproductive results.
