Uterine malformations consist of a group of miscellaneous congenital anomal
ies of the female genital system. Their mean prevalence in the general popu
lation and in the population of fertile women is similar to4.3%, in inferti
le patients similar to3.5% and in patients with recurrent pregnancy losses
similar to 13%. Septate uterus is the commonest uterine anomaly with a mean
incidence of similar to 35% followed by bicornuate uterus (similar to 25%)
and arcuate uterus (similar to 20%). It seems that malformed uterus and es
pecially septate uterus is not an infertility factor in itself. However, it
may have a part in the delayed natural conception of women with mainly sec
ondary infertility. On the other hand, patients with uterine malformations
seem to have an impaired pregnancy outcome even as early as their first pre
gnancy. Overall term delivery rates in patients with untreated uterine malf
ormations are only similar to 50% and obstetric complications are more freq
uent. Unicornuate and didelphys uterus have term delivery rates of similar
to 45%, and the pregnancy outcome of patients with untreated bicornuate and
septate uterus is also poor with term delivery rates of only similar to 40
%. Arcuate uterus is associated with a slightly better but still impaired p
regnancy outcome with term delivery rates of similar to 65%. Women who have
undergone hysteroscopic septum resection and have been reported in the dif
ferent series comprise a highly selected group of symptomatic patients with
term delivery and live birth rates of only similar to5%. Hysteroscopic tre
atment seems to restore an almost normal prognosis for the outcome of their
pregnancies with term delivery rates of similar to 75% and live birth rate
s of similar to 85%. It seems, therefore, that hysteroscopic septum resecti
on can be applied as a therapeutic procedure in cases of symptomatic patien
ts but also as a prophylactic procedure in asymptomatic patients in order t
o improve their chances for a successful delivery.