When a female develops in the embryo, her uterus is formed by the union of two separate uteri (plural for uterus) that merge to become a single uterus shaped like a tri-cornered hat. After the two halves merge together, the interior wall of tissue at their fusion point is resorbed, thus creating a fully formed uterus.
A uterine septum occurs when the tissue dividing the two uteri fails to fully resorb, leaving a wedge of tissue between the two halves of the uterine cavity. Sometimes this wedge is small, but other times it can be a complete septum, extending the entire length of the uterus, forming an interior wall that splits the uterus into two halves (known as a septate uterus).
A uterine septum is a fairly common cause of infertility and recurrent pregnancy loss seen in gynecology practices today. This is because a septum is a fibrous band of tissue with poor circulation, so any fertilized egg that attaches to it will not have an adequate blood supply to sustain a normal embryo. That’s why uterine malformations such as these are associated with high miscarriage rates.
How is a uterine septum diagnosed?
Unfortunately, because the only symptom of a uterine septum is a failure to bring a baby to term, most women aren’t aware that they have this condition until they undergo an infertility evaluation after having one or more miscarriages. A uterine septum can be diagnosed through a pelvic ultrasound or via a hysteroscopy.
A hysteroscopy is a diagnostic procedure that is performed under general anesthesia. During a hysteroscopy, your doctor inserts a long thin instrument with a lighted camera at one end into your uterus to inspect it from the inside and look for any structural problems that may be preventing conception or allowing an embryo to grow.
If a uterine septum is diagnosed during a hysteroscopy, patients have the option to remove it right then and there, so that they undergo general anesthesia only once.
Sadly, there is no medication that can correct this structural problem. Surgical removal is the only way to get rid of the unwanted tissue in order to improve your odds of having a successful pregnancy. This procedure is known as a uterine septum resection.
Luckily, there is a minimally invasive procedure known as a Hysteroscopic Uterine Septum Resection that does not involve any incisions or visible scars. What’s more, the procedure is performed as outpatient surgery, meaning that you can go home the same day.
What happens during a hysteroscopic resection of the uterine septum?
We begin by administering general anesthesia so that you are relaxed and comfortable during the procedure. Next, your cervix (the opening to the uterus) is dilated and your surgeon inserts a long thin instrument with a lighted camera (called a hysteroscope) through the cervix and into your uterus.
The camera allows the surgeon to not only diagnose the uterine septum but also to guide the surgery as it is carefully detached and removed (resected) using thin, long instruments that are passed through the hysteroscope. After this wall of tissue is removed, the uterus is better prepared to carry a pregnancy to term.
What are the advantages of undergoing a uterine septum resection?
If you have been diagnosed with a uterine septum and are experiencing difficulty getting or staying pregnant, undergoing a septum resection offers the following benefits:
Successful uterine septum surgery opens the top of the uterus, restoring its normal shape and function
Improved pregnancy outcomes. There is a high success rate for improving pregnancy chances after uterine septum surgery.
In fact, after uterine septum resection surgery, between 50 – 80% of women with a history of recurrent miscarriage will go on to have a healthy future pregnancy. In women who had been previously unable to get pregnant, up to 20% may be able to become pregnant after this procedure
Hysteroscopic resection is a relatively painless procedure
There are no visible incisions
A hysteroscopic surgery allows you to go home the same day
A hysteroscopic surgery also enables you to have a much faster recovery period after surgery
Welcome to the first minimally invasive outpatient surgical practice dedicated to women.
Dr. Thais Aliabadi and Dr. Ramon Yera have dedicated their careers to sparing women from experiencing invasive open surgeries involving disfiguring surgical scars, extended hospital stays, and long painful recoveries.
All of this unnecessary suffering was simply because women weren’t aware that minimally invasive out-patient surgery was available. This is why Drs. Yera and Aliabadi decided to create a surgical center dedicated exclusively to address women’s health needs.
The women of Southern California (and those who wish to travel here) are fortunate to now have top specialists in the field of minimally invasive surgery at their doorstep.
Doctors Aliabadi and Yera are among a handful of elite American OB-GYN surgeons who perform Minimally Invasive Outpatient surgical procedures using advanced techniques to minimize incision size, tissue disruption, and recovery times.
If you wish to schedule a consultation to learn how we can help you or to establish care with us, please request a consultation online or call us at 844-541-7900.
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Frequently Asked Questions
What triggers anomalous uterine development?
Anomalous uterine development can be triggered by the incomplete fusion of the two uteri in the embryo, leading to the formation of a uterine septum. This septum can vary in size, with complete septums dividing the uterus into two halves. Symptoms, such as recurrent miscarriages, often prompt diagnosis during infertility evaluations.
Is minimally invasive correction possible?
Minimally invasive correction for a uterine septum is possible through outpatient surgery. The surgery removes the septum with minimal tissue disruption, allowing for a quicker recovery and improved pregnancy outcomes.
Does resection impact future gestations?
Yes, uterine septum resection can positively impact future gestations by restoring the uterus' normal shape and function, leading to improved pregnancy outcomes. Following the surgery, a significant percentage of women with a history of recurrent miscarriages go on to have successful pregnancies.
Can diagnostic imaging confirm anomalies?
Diagnostic imaging can confirm anomalies through techniques like ultrasounds, MRIs, and CT scans. These tools provide detailed images that help identify structural issues within the body. Consulting a medical professional for proper interpretation is crucial for accurate diagnosis and appropriate treatment planning.
Are anomalies linked to genetics?
Anomalies can be linked to genetics, as genetic mutations or abnormalities can result in the development of anomalies. These genetic factors can play a significant role in the occurrence of anomalies in individuals.
Does corrective surgery enhance conception?
Corrective surgery, such as uterine septum resection, can enhance conception by restoring the normal shape and function of the uterus, leading to improved pregnancy outcomes. It can increase the chances of having a healthy future pregnancy for women with a history of recurrent miscarriage.
What preoperative tests are essential?
Preoperative tests essential for uterine septum resection may include a hysteroscopy to diagnose the septum and guide surgery, blood tests to assess general health, and possibly imaging studies like ultrasound to evaluate the structure of the uterus. These tests help ensure a safe and successful surgical outcome.
Are postoperative fertility treatments necessary?
Postoperative fertility treatments may be necessary depending on individual circumstances and fertility goals. It is recommended to consult with your healthcare provider to discuss options tailored to your specific situation after undergoing a uterine septum resection.
Can anomalies disrupt menstrual regularity?
Anomalies like a uterine septum can disrupt menstrual regularity by impacting the structure and function of the uterus, potentially leading to issues such as heavy bleeding, irregular periods, and fertility challenges. Identifying and treating such anomalies through procedures like uterine septum resection can help restore normal menstrual function.
Are miscarriages recurrent with anomalies?
Recurrent miscarriages can occur with uterine anomalies like a septum, contributing to difficulties in sustaining a pregnancy. Early detection and septum resection surgery can significantly improve future pregnancy outcomes for women with uterine septum issues.
Do anomalies necessitate cesarean deliveries?
Anomalies do not always necessitate cesarean deliveries. Each case is unique, and the decision is made based on the specific factors of the anomaly, the health of the mother and baby, and the recommendations of the healthcare team involved.
Are anomaly corrections permanent solutions?
Anomaly corrections can provide permanent solutions, depending on the specific condition treated and the success of the procedure. However, there are no absolute guarantees in medicine, and individual outcomes may vary. Consultation with a healthcare provider is necessary to determine the long-term effectiveness of the correction for each case.
Does anomaly presence affect implantation?
Anomalies in the uterus, such as a uterine septum, can impact implantation, potentially leading to infertility or miscarriages. Removing the septum through a surgical procedure may improve the chances of successful implantation and pregnancy.
Is anomaly correction typically outpatient?
Anomaly correction procedures are often performed on an outpatient basis, allowing patients to go home the same day. These surgeries, like uterine septum resection, are minimally invasive, leading to faster recovery times and reduced hospital stays.
What anesthesia is used during correction?
During the correction of a uterine septum, general anesthesia is typically used to ensure that the patient is comfortable and pain-free throughout the procedure.
Do anomalies affect hormonal balance?
Anomalies can indeed impact hormonal balance, causing disruptions in the endocrine system. These imbalances may lead to various health issues, affecting fertility, menstruation, and overall reproductive health. Seeking medical advice and treatment can help manage these hormonal fluctuations effectively.
What follow-up care is necessary?
Follow-up care after outpatient uterine septum resection typically involves a post-operative appointment with your surgeon to monitor healing progress and discuss any concerns. Your doctor will provide guidance on activities, potential restrictions, and future fertility plans based on your individual recovery. Follow all post-operative instructions carefully for optimal outcomes.
Is anomaly detection possible prenatally?
Anomaly detection is possible prenatally through various tests like ultrasounds, amniocentesis, and chorionic villus sampling. These screenings can help identify potential abnormalities in the fetus before birth, providing valuable information for medical intervention and planning.
How soon do periods resume post-correction?
After a uterine septum resection, periods typically resume within 4-6 weeks post-correction. This timing may vary for each individual, so it's essential to follow up with your healthcare provider for personalized guidance on post-operative recovery.
Can anomalies cause menorrhagia or dysmenorrhea?
Uterine anomalies such as a uterine septum can contribute to both menorrhagia (heavy menstrual bleeding) and dysmenorrhea (painful periods) by disrupting the normal structure and function of the uterus, leading to irregular bleeding patterns and increased pain during menstruation. Treatment, such as uterine septum resection, may alleviate these symptoms.
Are corrective outcomes immediate or gradual?
The corrective outcomes of outpatient uterine septum resection surgery are gradual, with improved pregnancy outcomes seen between 50-80% of women with a history of recurrent miscarriage achieving successful future pregnancies.
Do anomalies impact uterine lining?
Anomalies, like a uterine septum, can impact the uterine lining, affecting fertility and pregnancy outcomes. Removing a uterine septum through outpatient surgery may restore the uterus's normal shape and function, potentially improving pregnancy success rates for individuals facing fertility challenges.
Is hysterosalpingography used for diagnosis?
Yes, hysterosalpingography is used for diagnosis to evaluate the shape of the uterine cavity and the condition of the fallopian tubes. It is often performed to investigate infertility or recurrent miscarriages by detecting blockages, abnormalities, or issues within the uterus and fallopian tubes.
Are anomalies associated with pain?
Anomalies associated with pain include endometriosis and ovarian cysts, which can cause discomfort. Consult a gynecologist for proper diagnosis and treatment.
Can anomalies cause non-structural complications?
Anomalies can indeed cause non-structural complications, impacting functions, development, or overall health. These issues may affect various body systems and can lead to symptoms like infertility, recurrent miscarriages, or other health challenges, highlighting the importance of timely diagnosis and intervention in these cases.
Are repeat resections ever needed?
In some cases, repeat resections may be necessary if a uterine septum reoccurs or if the initial resection was incomplete. Consulting with your healthcare provider is crucial for determining the best course of action.
How is reproductive prognosis assessed?
Reproductive prognosis is assessed by evaluating factors like age, medical history, ovarian reserve testing, anatomical abnormalities, and previous fertility treatments, along with considering potential underlying conditions like endometriosis or uterine septum, to determine fertility potential and the likelihood of successful pregnancy.
Are corrective procedures covered by insurance?
Insurance coverage for corrective procedures varies. Contact your insurance provider to understand coverage details for uterine septum resection or any gynecological surgery. Prior authorization may be required for reimbursement.
Can anomalies affect labor progression?
Anomalies can impact labor progression by causing complications such as obstructed labor, prolonged labor, or fetal distress. Depending on the anomaly, medical intervention or alternative delivery methods may be necessary to ensure a safe birth process. Regular monitoring and adjustments are crucial in these cases to optimize outcomes for both mother and baby.
Do anomalies influence obstetric outcomes?
Anomalies can impact obstetric outcomes negatively, leading to complications during pregnancy, delivery, or postpartum. Early identification and proper management are key in addressing potential risks and ensuring the best possible outcome for both the mother and the baby. Regular monitoring and timely interventions can help mitigate the effects of anomalies on obstetric outcomes.
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