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Primary uterine infertility

Last edited: 4/10/2026

Overview

Primary uterine infertility refers to difficulties in achieving pregnancy due to abnormalities of the uterus. Uterine septa are a common congenital anomaly that can impact fertility and pregnancy outcomes 1.

Diagnosis

  • Diagnosis of a uterine septum is typically made via imaging studies 1.
  • Imaging modalities include hysterosalpingography (HSG), saline infusion sonohysterography (SIS), and three-dimensional (3D) ultrasound 1.
  • Hysteroscopy is considered the gold standard for diagnosis and allows for simultaneous treatment 1.

    • Management

  • Surgical resection of a uterine septum via hysteroscopy or laparoscopy can improve fertility outcomes 1.
  • In cases of infertility, a shared decision-making model is recommended after counseling to determine the necessity of septum resection 1.
  • Resection of a uterine septum has been shown to decrease the likelihood of malpresentation during pregnancy 1.

    • Key Recommendations

  • Resection of a uterine septum has been shown to improve outcomes in patients with recurrent pregnancy loss and to decrease the likelihood of malpresentation 1. (Evidence: Moderate)
  • In the setting of infertility, it is recommended to use a shared decision-making model after appropriate counseling to determine whether or not to proceed with septum resection 1. (Evidence: Expert opinion)

    • References

    1 . Evidence-based diagnosis and treatment for uterine septum: a guideline. Fertility and sterility 2024. link

    Original source

    1. [1]
      Evidence-based diagnosis and treatment for uterine septum: a guideline. Fertility and sterility (2024)
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