Does the ESHRE/ESGE Classification of Mullerian Anomalies Correlate with the Occurrence Of Pregnancy? A Comparison between Two Definitions of Myometrial Thickness

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Acta Medica International,2016,3,1,24-29.
Published:January 2016
Type:Original Article

Does the ESHRE/ESGE Classification of Mullerian Anomalies Correlate with the Occurrence Of Pregnancy? A Comparison between Two Definitions of Myometrial Thickness

Francesco Padula, Maurizio Giorlandino1, Stella Capriglione2, Maria Cristina Teodoro3, Assunta Lippa4, Salvatrice Elisa Minutolo4, Alessandro Lena5, Alessandro Lanteri6, Pierpaolo Brutti6, Laura D’Emidio1, Lucia Mangiafico1, Pietro Cignini1, Claudio Giorlandino1

1Altamedica, Fetal-Maternal Medical Centre, Department of Prenatal Diagnosis, Rome, Italy,

2Campus Bio Medico University of Rome, Department of Obstetrics and Gynaecology, Rome, Italy,

3University of Catania, Department of Assisted Reproduction, Catania, Italy,

4Altamedica, Fetal-Maternal Medical Centre, Department of Reproductive Medicine, Rome, Italy,

5Altamedica, Fetal-Maternal Medical Centre, Department of Endoscopic Surgery, Rome, Italy,

6Sapienza University of Rome, Department of Statistics, Rome, Italy

Abstract:

Introduction: Since the introduction of the European Society of Human Reproduction and Embryology/European Society for Gynaecological Endoscopy (ESHRE/ESGE) classification of Mullerian anomalies, various authors have raised major concern about its clinical implications, as specific diagnostic criteria that clearly correlate to pregnancy have not yet been validated in clinical practice by any prospective or retrospectives studies. In this study, we aimed to correlate the ESHRE/ESGE classification with the occurrence of pregnancy, considering the two different definitions of myometrial thickness. Methods: A retrospective study, including an ultra-selected cohort of 79 patients, from January 2010 to March 2014. All women with fertilityproblems, who had an isolated andsuspected uterine malformation, t ultrasound and hysteroscopy, were retrospectively included in this study. Myometrial thickness was defined as the entire myometrial layer, as suggested by the ESHRE/ESGE criteria, or the free myometrial layer, as suggested by Gubbini. Results: We failed to evidence an association between the occurrence of pregnancy in the two most representative classes (U0 and U2), considering the free myometrial layer, and the entire myometrial layer. When we considered the effect of hysteroscopic surgery on the occurrence of pregnancy, we also failed to obtain a statistically significant difference. Discussion: The ESHRE/ESGE classification may be useful in classifying Mullerian anomalies, but it needs to be applied in larger series. However, we think that new parameters and algorithms are needed for a better prediction of pregnancy. We recommendto associate the fundal uterine vascularization to the ESHRE/ESGE criteria to be analysed in further studies.

Francesco Padula