Table 1.
General features of studies included in the meta-analysis: Uterine septum versus controls (no septum).
| Study | Design | Period | Population | Exclusion Criteria | Cases | Controls | Sample Size; Case/Control | Outcomes | Follow-Up | Mode of Diagnosis | Method of Classification |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Acien et al., 1993, [14] | Retrospective | 1980–1991 | Infertile: if attempts to achieve pregnancy remained unsuccessful for >two years. Recurrent miscarriage Natural conception |
Patients with: Rokitansky syndrome, hypoplastic, arcuate, bicornuate, didelphis, unicornuate uterus. | Septate uterus Subseptate uterus |
No malformations. | 31/28 | Pregnancy rate Live birth rate Spontaneous abortion Preterm labour |
24 months | Clinical examination, ultrasound hysterosalpingographypyelography. |
Jarcho (1946) [24], Buttram and Gibbons (1979) [25] and the AFS (1988) criteria [5] |
| Woelfer et al., 2001, [26] |
Prospective | Aug 1997 to Sep 2000 | Infertile Recurrent miscarriage Natural conception |
Women ongoing pregnancy, history of infertility or recurrent miscarriage, presence of uterine fibroids that distorted the uterine cavity. |
Subseptate uterus |
No malformations. | 29/983 | Pregnancy rate Spontaneous abortion Preterm labour |
- | 3D TV-US | AFS (1988) criteria [5] |
| Ozgur et al., 2007, [27] |
Retrospective | Jan 2002 to June 2004 | Infertile: Male factor Tubal factor Other female factor Unexplained Multifactorial ART conception: IVF |
Not reported. | Septate uterus | No malformations. | 119/116 | Spontaneous abortion | - | 2D TV-US HSC |
N/A |
| Zlopaša et al., 2007, [28] |
Retrospective | 1997–2000 | Recurrent miscarriage: experienced at least two early spontaneous abortions Natural conception |
Twin gestations, submucosal myomas, fetal chromosomopathy, IVF; arcuate bicornuate, didelphys, unicornuate uterus. | Septate uterus Subseptate uterus |
No malformations. | 31/182 | Spontaneous abortion Preterm labour |
- | Surgery hysterosalpingograph sonohysterography laparoscopy HSC |
AFS (1988) criteria [5] |
| Ban-Frangez et al., 2009, [29] |
Retrospective | 1993–2004. | Infertile: Tubal factor Endometriosis Endocrinologic Male factor Idiopathic ART conception: IVF or ICSI |
Extrauterine pregnancies, multiple pregnancies and cases with an empty gestational sac. | Septate uterus | No malformations. | 106/212 | Spontaneous abortion | - | 2D TV-US HSC |
AFS (1988) criteria [5] |
| Sugiura-Ogasawara et al., 2010, [30] |
Retrospective | 1986–2007. | Recurrent miscarriage: two or more (two–12) consecutive miscarriages whose subsequent pregnancies Natural conception |
Patients with chromosome abnormalities, unicornuate, bicornuate, didelphis uterus. | Septate uterus | No malformations. | 10/1528 | Pregnancy rate Spontaneous abortion |
- | Laparoscopy Laparotomy MRI |
AFS (1988) criteria [5] |
| Tomazevic et al., 2010, [31] |
Retrospective | 1993–2005 | Infertile: Tubal factor Endometriosis Endocrinologic Male factor Idiopathic ART conception: IVF or ICSI |
Not reported. | Septate uterus | No malformations. | 289 embryo transfers, 1654 embryo transfers as controls. | Pregnancy rate Live birth rate Spontaneous abortion |
- | 2D TV-US HSC |
AFS (1988) criteria [5] |
| Saravelos et al., 2010, [32] |
Retrospective | N/A | Recurrent miscarriage: was defined as three or more consecutive pregnancy losses prior to 24 weeks of gestation Natural conception |
Pregnancies in which patients received medical treatment or surgery. | Septate uterus | No malformations. | 29/107 | Live birth rate Spontaneous abortion |
- | 2D TV-US Hysterosalpingography | AFS (1988) criteria [5] |
| Jayaprakasan et al., 2011, [33] |
Prospective | 2005–2009 | Infertile: Tubal factor Endometriosis Endocrinologic Male factor Idiopathic ART conception: IVF or ICSI |
Patients found to have one or more uterine fibroids or polyps distorting the endometrial cavity. | Septate uterus |
No malformations. | 7/364 | Pregnancy rate Spontaneous abortion |
- | 3D TV-US | AFS (1988) criteria [5] |
| Prior et al., 2017, [10] |
Prospective | May 2009 to November 2015 | Infertile: Tubal factor Endometriosis Endocrinologic Male factor Idiopathic ART conception: IVF or ICSI |
Patients with a bicornuate uterus Not possible to make a definitive diagnosis for limited views, distortion of endometrial cavity by fibroids, and intrauterine contraceptive device in situ. |
Septate uterus Subseptate uterus |
No malformations. | 23/1943 | Pregnancy rate Live birth rate Spontaneous abortion |
Present but not specified | 3D TV-US | AFS (1988) criteria [5] |
HSC: Hysteroscopy. TV-US: transvaginal-ultrasound. MRI: Magnetic Resonance Imaging.