The dysmorphic uteri are rare Müllerian anomalies which have been always underestimated, at the beginning supposed to be present only in case of history of DES exposure, and misdiagnosed due to a lack of clear diagnostic criteria. The new classification system of uterine anomalies from the European Society of Human Reproduction and Embryology and the European Society for Gynaecological Endoscopy includes the “dysmorphic” uteri, represented by T-shaped and tubular-shaped infantilis uteri, in Class U1. Such malformations have been proven to be associated with poor reproductive performance: increased risk of adverse outcomes in pregnancy, such as preterm delivery, SGA, sore fetal presentations, infertility, and miscarriage in the early ages. The novel Hysteroscopic Outpatient Metroplasty to Expand Dysmorphic Uteri (HOME-DU) technique for dysmorphic uteri is associated with a significant improvement of the reproductive outcomes. Macroscopic uterine changes seem to be also associated with variations of endometrial micro-environment.
KeywordsOffice hysteroscopy Dysmorphic uterus Hysteroscopic metroplasty T-shaped uterus Tubular uterus HOME-DU technique Reproductive outcomes
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