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Uterine septum

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The following summarized guidelines for the evaluation and management of uterine septum are prepared by our editorial team based on guidelines from the American Society for Reproductive Medicine (ASRM 2016).
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Guidelines

1.Diagnostic investigations

Diagnostic imaging: obtain diagnostic imaging (3D ultrasound, sonohysterography, or MRI) with or without hysteroscopy, as first-line investigations, rather than laparoscopy/hysteroscopy.
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2.Medical management

Danazol: insufficient evidence to recommend for or against the use of danazol or GnRH agonists to thin the endometrium prior to hysteroscopic septum incision.
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3.Surgical interventions

Hysteroscopic septum incision: several observational studies indicate that hysteroscopic septum incision is associated with improved clinical pregnancy rates in women with infertility.
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  • Uterine septum incision

  • Postoperative care

4.Patient education

Effect on fertility: recognize that studies assessing the association between infertility and uterine septum are comprised of principally small descriptive studies that have inconsistent associations.
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  • Effect on pregnancy