{"id":50,"title":"Hysteroscopic septum resection and reproductive outcomes - a retrospective cohort study","title_zh":"宫腔镜子宫纵隔切除术与生殖结局：一项回顾性队列研究","url":"https://pubmed.ncbi.nlm.nih.gov/42988592","doi":"10.48095/cccg2026390","pmid":"42988592","journal":"Ceska Gynekol","kind":"paper","lang":"en","published_at":"2026-01-01T00:00:00+00:00","fetched_at":"2026-11-08T03:43:52+00:00","authors":["Özgül ZS","Madakbaş AÇ","Yıldız P","Topçu G","Alay MT","Karakuş SS","Karakuş R"],"primary_topic":"art-clinical","topics":[{"slug":"art-clinical","score":3.0,"hits":["infertility","live birth","live birth rate"]},{"slug":"endometrium","score":1.0,"hits":["uterine"]},{"slug":"early-pregnancy","score":1.0,"hits":["recurrent pregnancy loss"]},{"slug":"contraception-health","score":1.0,"hits":["birth rate"]}],"topic_score":3.0,"preference_score":0.0,"preference_labels":[],"llm_score":66.0,"final_score":66.0,"score_dims":{"novelty":45,"rigor":55,"impact":58,"relevance":92,"translation":65},"recommend_reason":"临床问题常见且样本量尚可，术后活产率提升明显，对子宫纵隔手术咨询有参考价值；但为单中心回顾性前后对照，缺乏对照组且混杂偏倚明显，结论需谨慎解读。","keywords":["子宫纵隔","宫腔镜切除术","复发性流产","不孕","活产率","回顾性队列"],"selected":1,"story_id":482,"llm_provider":"deepseek","llm_model":"deepseek-flash","llm_effort":"low","source_key":"pubmed-art","source_name":"PubMed · 辅助生殖临床","source_tier":1,"mention_count":2,"has_interpretation":false,"journal_key":null,"journal_tier":"unknown","journal_if":null,"is_mock":false,"summary_zh":"该回顾性队列纳入2015—2020年伊斯坦布尔三级中心218例宫腔镜子宫纵隔切除术女性，其中不孕160例、复发性流产58例，比较术前术后活产及妊娠并发症。全队列活产率由17.4%升至53.7%，不孕组由10.6%升至46.9%，复发性流产组由36.2%升至72.4%；重复切除者活产率更高，妊娠并发症占23.9%。作者认为手术可能与活产改善相关，但受回顾性设计限制需前瞻性研究验证。","summary":"OBJECTIVE: Uterine septum is one of the most common congenital uterine anomalies associated with infertility, recurrent pregnancy loss, and adverse reproductive outcomes. This study aimed to evaluate reproductive outcomes after hysteroscopic septum resection and to identify factors associated with live birth. MATERIALS AND METHODS: In this retrospective cohort study, 218 women who underwent hysteroscopic septum resection at a tertiary referral center in Istanbul between January 1, 2015 and August 31, 2020 were included. Among them, 160 had a history of infertility and 58 had a history of recurrent pregnancy loss. Demographic characteristics, preoperative and postoperative live birth outcomes, and pregnancy complications were obtained from hospital electronic records, the national e-Nabız system, and follow-up telephone interviews. RESULTS: Among the overall cohort, the live birth rate increased from 17.4% before septum resection to 53.7% after the procedure (P < 0.001). In the infertility subgroup, the live birth rate increased from 10.6% to 46.9% (P < 0.001), whereas in the recurrent pregnancy loss subgroup it increased from 36.2% to 72.4% (P < 0.001). Patients who underwent repeat septum resection had a higher live birth rate than those who underwent a single procedure (74.0 vs. 44.0%, P < 0.001). Pregnancy complications were observed in 23.9% of pregnancies. CONCLUSION: Hysteroscopic septum resection may be associated with improved live birth outcomes in women with infertility or recurrent pregnancy loss. However, these findings should be interpreted cautiously given the retrospective design, and prospective studies are needed to define the benefit of surgical intervention.","interpretation_basis":null,"fulltext_status":null,"interpretation":null,"fulltext":{"available":false,"status":null,"reason":"尚未抓取全文（未入选、分数未达阈值，或还没跑 fulltext 步骤）","pmcid":null,"license":null,"chars":0,"source":null,"fetched_at":null}}