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Dysmorphic Uterus

The new classification system of Müllerian anomalies developed by the ESGE/ESHRE CONUTA working group has dedicated a specific interest to those uteri, named “dysmorphic”, characterized by a normal outline but with an abnormal lateral wall’s shape of the uterine cavity ( i.e. T-shaped uterus and tubular-shaped/infantilis uteri). These uteri are associated with infertility and pregnancy loss and in the previous
American Fertility Society classification were included in class VII and mainly related to
diethylstilbestrol-related (DES) exposure. However clinical experience has shown that
these uteri are more common than expected, mostly diagnosed in young infertile patients with no history of DES exposure.

Recently, Dr. Attilio di Spiezio Sardo has developed a new outpatient minimally invasive
technique yielding an increase in volume and an improved morphology of both tubular
uterine cavities and T-shaped (Hysteroscopic Outpatient Metroplasty To Expand Dysmorphic Uteri: the HOME-DU technique). The technique, performed under conscious sedation, involves that two incisions of 3–4 mm in depth are made with a 5- Fr bipolar electrode along the lateral walls of the uterine cavity in the isthmic region, followed by additional incisions placed on the anterior and posterior walls of the fundal region up to the isthmus.

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