Hysteroscopic intervention in septate uterus and intrauterine synechiae

Three-dimensional transvaginal ultrasonography was used to diagnose a septate uterus in a 24-year-old woman with infertility for 2 years. On infertility workup, semen analysis of her husband also revealed oligoasthenoteratospermia. Hysteroscopic metroplasty was performed successfully to resolve the uterine septum; however, subsequent in vitro fertilization and intracytoplasmic sperm injection yielded a blighted ovum requiring dilatation and curettage. After curettage, the patient had hypomenorrhea secondary to intrauterine synechiae and was treated with a hysteroscopic resectoscope and lysis of adhesions. Following these procedures, assisted reproductive technology was again implemented and resulted in a successful pregnancy. In our experience, three-dimensional transvaginal ultrasonography is a noninvasive, accurate, and easy method for the diagnosis of Müllerian duct anomalies, including septate uterus. Hysteroscopic metroplasty helps to normalize intrauterine cavity architecture. Additionally, it is important to repeat hysteroscopic examination when intrauterine adhesions are highly suspected.