Uterine Septum

Uterine septum is an anomaly of the female reproductive system that is associated with infertility and miscarriage

Uterine septum is a defect that occurs during development of the uterus that causes the uterine cavity to be divided, partially or completely.

What is uterine septum?

Uterine septum is the most common type of uterine anomaly. It occurs when part or all of the mullerian ducts – two embryonic ducts that develop into the vagina, uterus and fallopian tubes – fail to reabsorb either partially or completely, resulting in muscle or tissue that divides the uterus partly or fully into two separate cavities.

Diagnosing uterine septum

Since there are usually no symptoms, uterine septum is often discovered through the following diagnostic tests:

  • Transvaginal ultrasound – an ultrasound exam that is done through the vagina using a special probe
  • MRI – Magnetic Resonance Imaging scan that uses a magnetic field and radio waves to take pictures of the uterus
  • Hysteroscopy – a scope inserted through the cervix and into the uterus to examine the inside portion of the organ
  • Hysterosalpingogram (HSG)- an x-ray test that uses dye to test the structure and function of the uterus and fallopian tubes

Infertility related to uterine septum

Many women with uterine septum are able to become pregnant, although carrying the pregnancy to term may be difficult. When infertility is an issue, it is likely due to problems with implantation, since the tissue in a uterine septum has poor blood supply.

Miscarriage and uterine septum

Even when pregnancy does occur in uterine septum, outcome is often poor, especially when the site of implantation is the uterine septum itself. The poor blood supply is not enough to nourish the embryo and miscarriage often occurs as a result.

Although some women with uterine septum do experience successful pregnancy and delivery, a large number suffer miscarriage, and repeat miscarriage is common. The condition is also associated with a higher risk of preterm delivery.

Treatment of uterine septum

Being diagnosed with uterine septum doesn’t necessarily warrant surgery. However, there are some symptoms that are indications for surgical correction, including:

  • Pelvic pain
  • Endometriosis
  • Obstruction
  • Recurrent miscarriage
  • History of preterm delivery

Surgical repair of the uterus (metroplasty) has been shown to be very successful in reducing infertility. Hysteroscopic surgical repair is typically a minor procedure and can often be done on an outpatient basis.