Surgical resection of a uterine septum should be considered under certain circumstances. The septum is removed during hysteroscopy, while laparoscopy is performed to assess and treat extrauterine disorders.
Metroplasty is a term indicating reconstructive surgery (plasty) on the uterus (metro).
Indications for hysteroscopic transcervical metroplasty:
(1) presence of a resectable septum (and not a more complex Muellerian duct defect)
(2) one or more of the following:
(2a) history of 2 or more miscarriages
(2b) otherwise unexplained infertility after a complete workup
(2c) prior to assisted reproductive therapy
Overall fertility is improved by metroplasty but some women continue to have miscarriages.
Grimbizis et al and others have suggested that prophylactic removal of the septum should be considered (without the need to demonstrate repeated miscarriages).
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