How Hysteroscopic Metroplasty can reduce your Fertility?

Be careful if your doctor advises you to have Hysteroscopic Metroplasty. It is an unnecessary surgical procedure that does not improve fertility - it can actually reduce it.

We are now seeing a virtual epidemic of this unnecessary surgical procedure.Originally, hysteroscopic metroplasty was developed in order to remove a uterine septum, a congenital anomaly which was responsible for recurrent miscarriages in some women. This septum resection is a useful procedure, and is a significant advance in our management of women with uterine anomalies.

The "Minor Surgery"

The danger is that doctors with a hysteroscope tend to see uterine anomalies everywhere!The size of a normal uterus varies from woman to woman, and many fertile women have a small uterus ( a normal anatomic variant) when they not pregnant. The uterus enlarges normally during pregnancy, allowing them to give birth to a healthy baby. However, when a doctor notes a "small uterus" in an infertile women on vaginal ultrasound scanning, they diagnose this as a case of " uterine hypoplasia" and propose hysteroscopic surgery, to increase the size of the uterine cavity. This "minor surgery" called a hysteroscopic metroplasty, is supposed to improve the uterus's ability to "hold the baby" - and since it's such a simple procedure, and seems so logical, many patients agree to it.

Overuse of the procedure

Many doctors also overuse this procedure to correct minor anatomic variants of the shape of the uterine cavity, as "diagnosed" by a HSG ( hysterosalpingogram). Many normal fertile women have a "T-shaped uterus" or an "arcuate uterus". These are normal variants - just like some people have a straight nose, while others have a crooked nose. However, if an infertile women has this sort of cavity on her HSG when seeing a trigger-happy doctor, she is very likely to be diagnosed as having a "uterine anomaly" which needs to be corrected by a hysteroscopic metroplasty !

Unfortunately, not only does this surgery not help to improve fertility, it can actually reduce fertility, by causing endometrial scarring, and preventing embryo implantation. If your doctor suggests hysteroscopic metroplasty, please say No !

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Authored by : Dr Aniruddha Malpani, MD and reviewed by Dr Anjali Malpani.