{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T04:23:04Z","timestamp":1772166184957,"version":"3.50.1"},"reference-count":27,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T00:00:00Z","timestamp":1761523200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T00:00:00Z","timestamp":1761523200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Reprod Biol Endocrinol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The true prevalence and clinical significance of congenital uterine malformations (CUM), particularly the dysmorphic uterus, in infertile populations remain a matter of debate, largely due to historical limitations in diagnostic methods. This study aimed to (1) determine the prevalence of CUM in an infertile cohort using modern, objective three-dimensional transvaginal ultrasound (3D-TVUS) criteria; (2) evaluate reproductive outcomes following surgical correction; and (3) investigate associated intrauterine pathologies that may contribute to infertility.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This a retrospective longitudinal cohort study included 154 women presenting for infertility investigation at a university hospital tertiary referral center between January 2020 and December 2022. All patients underwent 3D-TVUS for uterine assessment based on Congenital Uterine Malformation by Experts (CUME) criteria. Women diagnosed with CMU underwent hysteroscopic metroplasty. The primary outcomes were the prevalence of CMU subtypes and the 1-year cumulative live birth rate (LBR). Statistical analysis was performed using one-way ANOVA and chi-square tests.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      CMU was identified in 47\/154 (30.5%) women. Dysmorphic uterus was the most common anomaly, present in 42\/154 women (27.3% of the total cohort; 89.4% of all anomalies). A significant association was found between dysmorphic\/septate uteri and the presence of endometrial polyps (45.2%\/40.0% vs. 8.5% in normal uteri;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001). After metroplasty, the 1-year cumulative LBR for the dysmorphic uterus group (26.2%) was comparable to the normal uterus group (20.6%;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.907). The miscarriage rate per clinical pregnancy was also similar between the dysmorphic (15.4%) and normal uterus (25.7%) groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Using modern, objective 3D-TVUS criteria, the prevalence of a dysmorphic uterus in infertile women is substantially higher than previously reported. Surgical correction may improve reproductive outcomes to levels comparable to those in infertile women with normal uterine anatomy. Furthermore, the novel association with endometrial polyps warrants further investigation and underscores the importance of a comprehensive uterine assessment during the infertility workup.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12958-025-01472-2","type":"journal-article","created":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T13:20:24Z","timestamp":1761571224000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Prevalence of dysmorphic uterus in infertile women by 3D-TVUS: a retrospective longitudinal cohort study"],"prefix":"10.1186","volume":"23","author":[{"given":"Patsama","family":"Vichinsartvichai","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sappawit","family":"Lertlerphant","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarwinee","family":"Ratchanon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,10,27]]},"reference":[{"key":"1472_CR1","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1093\/humrep\/dev264","volume":"31","author":"GF Grimbizis","year":"2016","unstructured":"Grimbizis GF, Di Spiezio Sardo A, Saravelos SH, et al. The Thessaloniki ESHRE\/ESGE consensus on diagnosis of female genital anomalies. Hum Reprod. 2016;31:2\u20137.","journal-title":"Hum Reprod"},{"key":"1472_CR2","unstructured":"American Society for Reproductive Medicine. Evidence-based diagnosis and treatment for uterine septum: a guideline. Fertil Steril. 2024."},{"key":"1472_CR3","doi-asserted-by":"publisher","first-page":"761","DOI":"10.1093\/humupd\/dmr028","volume":"17","author":"YY Chan","year":"2011","unstructured":"Chan YY, Jayaprakasan K, Zamora J, Thornton JG, Raine-Fenning N, Coomarasamy A. The prevalence of congenital uterine anomalies in unselected and high-risk populations: a systematic review. Hum Reprod Update. 2011;17:761\u201371.","journal-title":"Hum Reprod Update"},{"key":"1472_CR4","first-page":"460","volume":"31","author":"YE Sukur","year":"2024","unstructured":"Sukur YE, Yilmaz S, Kuru O, et al. Prevalence of Y-shaped uterus in an infertile population as diagnosed by 3-dimensional transvaginal ultrasonography. J Minim Invasive Gynecol. 2024;31:460\u20136.","journal-title":"J Minim Invasive Gynecol"},{"key":"1472_CR5","first-page":"1113","volume":"115","author":"MA Coelho Neto","year":"2021","unstructured":"Coelho Neto MA, Ludwin A, Petraglia F, Martins WP. Definition, prevalence, and clinical impact of T-shaped uterus. Fertil Steril. 2021;115:1113\u20134.","journal-title":"Fertil Steril"},{"key":"1472_CR6","doi-asserted-by":"crossref","first-page":"363","DOI":"10.5455\/medarh.2020.74.363-368","volume":"74","author":"Z Godinjak","year":"2020","unstructured":"Godinjak Z, Imsirbegovic A, Pavicic I, Popovic M. Prevalence of congenital uterine anomalies in a general population and in an infertility clinic. Med Arch. 2020;74:363\u20137.","journal-title":"Med Arch"},{"key":"1472_CR7","doi-asserted-by":"publisher","first-page":"161","DOI":"10.1093\/humupd\/7.2.161","volume":"7","author":"GF Grimbizis","year":"2001","unstructured":"Grimbizis GF, Camus M, Tarlatzis BC, Bontis JN, Devroey P. Clinical implications of uterine malformations and hysteroscopic treatment results. Hum Reprod Update. 2001;7:161\u201374.","journal-title":"Hum Reprod Update"},{"key":"1472_CR8","doi-asserted-by":"publisher","first-page":"1361358","DOI":"10.3389\/fendo.2024.1361358","volume":"15","author":"C Liu","year":"2024","unstructured":"Liu C, Liao Z, Gong X, Chen Y. Does septum resection improve reproductive outcomes for women with a septate uterus? A systematic review and meta-analysis. Front Endocrinol (Lausanne). 2024;15:1361358. https:\/\/doi.org\/10.3389\/fendo.2024.1361358.","journal-title":"Front Endocrinol (Lausanne)"},{"key":"1472_CR9","doi-asserted-by":"publisher","first-page":"578","DOI":"10.1002\/uog.127","volume":"21","author":"R Salim","year":"2003","unstructured":"Salim R, Woelfer B, Backos M, Regan L, Jurkovic D. Reproducibility of three-dimensional ultrasound in the diagnosis of congenital uterine anomalies. Ultrasound Obstet Gynecol. 2003;21:578\u201382.","journal-title":"Ultrasound Obstet Gynecol"},{"key":"1472_CR10","doi-asserted-by":"publisher","first-page":"2032","DOI":"10.1093\/humrep\/det098","volume":"28","author":"GF Grimbizis","year":"2013","unstructured":"Grimbizis GF, Gordts S, Di Spiezio Sardo A, et al. The ESHRE\/ESGE consensus on the classification of female genital tract congenital anomalies. Hum Reprod. 2013;28:2032\u201344.","journal-title":"Hum Reprod"},{"issue":"Suppl 1","key":"1472_CR11","first-page":"13","volume":"52","author":"A Ludwin","year":"2018","unstructured":"Ludwin A, Martins WP, Ludwin I. CUME (Congenital uterine malformation by Experts) classification and diagnostic criteria for T-shaped uterus. Ultrasound Obstet Gynecol. 2018a;52(Suppl 1):13\u20134.","journal-title":"Ultrasound Obstet Gynecol"},{"key":"1472_CR12","doi-asserted-by":"publisher","first-page":"815","DOI":"10.1002\/uog.20845","volume":"55","author":"A Ludwin","year":"2020","unstructured":"Ludwin A, Coelho Neto MA, Ludwin I, et al. Congenital uterine malformation by experts (CUME): diagnostic criteria for T-shaped uterus. Ultrasound Obstet Gynecol. 2020;55:815\u201329.","journal-title":"Ultrasound Obstet Gynecol"},{"key":"1472_CR13","doi-asserted-by":"publisher","first-page":"101","DOI":"10.1002\/uog.18923","volume":"51","author":"A Ludwin","year":"2018","unstructured":"Ludwin A, Coelho Neto MA, Ludwin I, et al. Congenital uterine malformation by experts (CUME): better criteria for distinguishing between normal\/arcuate and septate uterus. Ultrasound Obstet Gynecol. 2018b;51:101\u20139.","journal-title":"Ultrasound Obstet Gynecol"},{"key":"1472_CR14","doi-asserted-by":"publisher","first-page":"340","DOI":"10.1016\/j.jmig.2021.10.001","volume":"29","author":"M Carrera","year":"2022","unstructured":"Carrera M, P\u00e9rez Millan F, Alc\u00e1zar JL, et al. Effect of hysteroscopic metroplasty on reproductive outcomes in women with septate uterus. Systematic review and meta-analysis. J Minim Invasive Gynecol. 2022;29:340\u20139.","journal-title":"J Minim Invasive Gynecol"},{"key":"1472_CR15","doi-asserted-by":"publisher","first-page":"607","DOI":"10.7863\/jum.2006.25.5.607","volume":"25","author":"AZ Abuhamad","year":"2006","unstructured":"Abuhamad AZ, Singleton S, Zhao Y, Bocca S. The Z technique: an easy approach to the display of the mid-coronal plane of the uterus in volume sonography. J Ultrasound Med. 2006;25:607\u201312.","journal-title":"J Ultrasound Med"},{"key":"1472_CR16","first-page":"368","volume":"8","author":"A Ludwin","year":"2019","unstructured":"Ludwin A, Coelho Neto MA, Ludwin I, et al. Two- and three-dimensional ultrasound for the diagnosis of congenital uterine anomalies. Transl Pediatr. 2019;8:368\u201384.","journal-title":"Transl Pediatr"},{"key":"1472_CR17","first-page":"e133","volume":"132","author":"Committee on Practice Bulletins-Gyn","year":"2018","unstructured":"Committee on Practice Bulletins-Gynecology and the American College of Obstetricians and Gynecologists. ACOG practice bulletin 198: prevention of postoperative adhesions in gynecologic surgery. Obstet Gynecol. 2018;132:e133\u201345.","journal-title":"Obstet Gynecol"},{"key":"1472_CR18","doi-asserted-by":"publisher","first-page":"1260","DOI":"10.1093\/humrep\/deab037","volume":"36","author":"JFW Rikken","year":"2021","unstructured":"Rikken JFW, van der Veen F, van Wely M, et al. Hysteroscopic septum resection in women with a septate uterus: a cohort study. Hum Reprod. 2021;36:1260\u20137.","journal-title":"Hum Reprod"},{"key":"1472_CR19","doi-asserted-by":"publisher","first-page":"755","DOI":"10.1016\/j.jmig.2019.05.011","volume":"27","author":"A Di Spiezio Sardo","year":"2020","unstructured":"Di Spiezio Sardo A, Campo R, Zizolfi B, et al. Long-term reproductive outcomes after hysteroscopic treatment of dysmorphic Uteri in women with reproductive failure: a European multicenter study. J Minim Invasive Gynecol. 2020;27:755\u201362.","journal-title":"J Minim Invasive Gynecol"},{"key":"1472_CR20","first-page":"1097248","volume":"9","author":"E Moratalla","year":"2022","unstructured":"Moratalla E, Alonso-Perez L, Perez-Millan F, Alcazar JL. Hysteroscopic metroplasty in patients with dysmorphic uterus: a systematic review and meta-analysis. Front Surg. 2022;9:1097248.","journal-title":"Front Surg"},{"key":"1472_CR21","doi-asserted-by":"publisher","first-page":"431","DOI":"10.1097\/OGX.0000000000000807","volume":"75","author":"S Garzon","year":"2020","unstructured":"Garzon S, Lagan\u00e0 AS, Di Spiezio Sardo A, et al. Hysteroscopic metroplasty for T-shaped uterus: a systematic review and meta-analysis of reproductive outcomes. Obstet Gynecol Surv. 2020;75:431\u201344.","journal-title":"Obstet Gynecol Surv"},{"key":"1472_CR22","doi-asserted-by":"publisher","first-page":"101763","DOI":"10.1016\/j.jogoh.2020.101763","volume":"49","author":"G Bifulco","year":"2020","unstructured":"Bifulco G, De Rosa N, Di Spiezio Sardo A, et al. Impact of hysteroscopic metroplasty on reproductive outcomes of women with a dysmorphic uterus and recurrent miscarriages: A systematic review and Meta-Analysis. J Gynecol Obstet Hum Reprod. 2020;49:101763.","journal-title":"J Gynecol Obstet Hum Reprod"},{"issue":"6","key":"1472_CR23","doi-asserted-by":"publisher","first-page":"520","DOI":"10.1016\/j.jmig.2024.12.022","volume":"32","author":"P Tanovska","year":"2025","unstructured":"Tanovska P, Samartzis N, Zografou MT, Burla L, Eberhard M, Kalaitzopoulos DR, Leeners B. Association between endometriosis and congenital uterine malformations: a single-center retrospective study. J Minim Invasive Gynecol. 2025;32(6):520\u20136.","journal-title":"J Minim Invasive Gynecol"},{"key":"1472_CR24","doi-asserted-by":"publisher","first-page":"1632","DOI":"10.1093\/humrep\/deh822","volume":"20","author":"T Perez-Medina","year":"2005","unstructured":"Perez-Medina T, Bajo-Arenas JM, Salazar F, et al. Endometrial polyps and their implication in the pregnancy rates of patients undergoing intrauterine insemination: a prospective, randomized study. Hum Reprod. 2005;20:1632\u20135.","journal-title":"Hum Reprod"},{"key":"1472_CR25","first-page":"218","volume":"21","author":"J Bosteels","year":"2015","unstructured":"Bosteels J, van Wessel S, Weyers S, et al. The effect of hysteroscopic removal of endometrial polyps in subfertile women: a systematic review and meta-analysis. Hum Reprod Update. 2015;21:218\u201328.","journal-title":"Hum Reprod Update"},{"key":"1472_CR26","first-page":"8895","volume":"27","author":"CC Vaduva","year":"2023","unstructured":"Vaduva CC, Constantinescu C, Serbanescu M, et al. The association between endometrial polyps, chronic endometritis, and IVF outcomes. Eur Rev Med Pharmacol Sci. 2023;27:8895\u2013904.","journal-title":"Eur Rev Med Pharmacol Sci"},{"key":"1472_CR27","first-page":"271","volume":"10","author":"A Ciavattini","year":"2016","unstructured":"Ciavattini A, Delli Carpini G, Clemente N, et al. Endometrial polyps and subfertility: is there a correlation? Int J Fertil Steril. 2016;10:271\u201381.","journal-title":"Int J Fertil Steril"}],"container-title":["Reproductive Biology and Endocrinology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12958-025-01472-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12958-025-01472-2\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12958-025-01472-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T13:20:29Z","timestamp":1761571229000},"score":1,"resource":{"primary":{"URL":"https:\/\/rbej.biomedcentral.com\/articles\/10.1186\/s12958-025-01472-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,27]]},"references-count":27,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["1472"],"URL":"https:\/\/doi.org\/10.1186\/s12958-025-01472-2","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-7161040\/v1","asserted-by":"object"}]},"ISSN":["1477-7827"],"issn-type":[{"value":"1477-7827","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,27]]},"assertion":[{"value":"19 July 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 September 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 October 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This retrospective study was conducted in accordance with the Declaration of Helsinki. The study protocol was approved by the Institutional Review Board of the Faculty of Medicine Vajira Hospital, Navamindradhiraj University. Written informed consent was obtained from all participants for their anonymized data to be used in this research.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable. This manuscript does not contain any individual person\u2019s data in any form (including any individual details, images or videos).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"137"}}