Reproductive performance in women with uterus didelphys.

The reproductive history of 19 women with the diagnosis of uterus didelphys is reported. With this goal the patients were divided into two groups: A) composed of 15 patients who did not undergo any surgical correction of uterine anomaly; B) composed of 4 patients where metroplasty was performed. Diagnosis was made in 17 cases (85.9%) for reasons not related to the uterine anomaly, only in 2 cases did patients present with infertility complaints. Vaginal malformation was associated in 16 (85%) cases; in 11 cases longitudinal septum was present; whereas in 5 hemivagina atretica was found. Eleven group A patients had a total of 23 pregnancies of which 3 (13%) ended in spontaneous abortions, 2 (8.7%) were voluntarily interrupted, 3 ended in premature birth and 15 in term births, with 17 live babies for a live birth rate of 74%. If we consider that two pregnancies were voluntarily interrupted, we had 17 live babies out of 21 naturally evolved pregnancies, for a live birth rate of 81%. In group B 3 patients before treatment had 3 pregnancies all ending in spontaneous abortion. After treatment all had a live baby. Reproductive and gestational performances of women with uterus didelphys are preserved. In patients with infertility complaints, all associated causes must be ruled out before surgical correction. If these are present its correction must be attempted as first therapeutic step, and term pregnancy with live baby is the rule. Only if repeated abortions are not related to any other cause, can metroplasty, according to Bret-Palmer technique, be performed.