{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T06:09:29Z","timestamp":1789711769676,"version":"4.0.1"},"reference-count":27,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T00:00:00Z","timestamp":1789689600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Reprod. Health"],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate whether concomitant laparoscopy during hysteroscopic uterine septum resection is associated with perioperative characteristics and postoperative reproductive outcomes, and to explore the prognostic roles of ESHRE\/ESGE classification and septum depth.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This single-center retrospective cohort study included 361 patients who underwent hysteroscopic septum resection between 2017 and 2024. Of these, 241 underwent hysteroscopy alone and 120 underwent concomitant laparoscopy. Multivariable logistic regression was used to evaluate postoperative pregnancy, live birth, and miscarriage. Kaplan\u2013Meier analysis and Cox regression were used to assess time to first postoperative pregnancy. Anatomical analyses included U2a\/U2b classification and septum depth.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Postoperative pregnancy rates were 56.8% and 60.8% in the hysteroscopy-only and concomitant-laparoscopy groups, respectively (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.469), while live-birth rates were 42.7% and 39.2% (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.517). After adjustment for clinical characteristics and ESHRE\/ESGE classification, concomitant laparoscopy was not significantly associated with pregnancy (aOR, 1.27; 95% CI, 0.72\u20132.23) or live birth (aOR, 0.82; 95% CI, 0.47\u20131.44). Time to first pregnancy was also similar between groups (adjusted hazard ratio, 1.03; 95% CI, 0.75\u20131.41). U2b morphology, compared with U2a morphology, was not independently associated with pregnancy or live birth. Septum depth was not consistently associated with reproductive outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>No statistically significant association was detected between concomitant laparoscopy and postoperative pregnancy, live birth, miscarriage, or time to first pregnancy. Laparoscopy should be selected according to pelvic indications, anatomical complexity, and intraoperative safety requirements rather than routinely used to improve reproductive outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/frph.2026.1950477","type":"journal-article","created":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T05:37:45Z","timestamp":1789709865000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Association of concomitant laparoscopy with reproductive outcomes after hysteroscopic septum resection: a longitudinal cohort study"],"prefix":"10.3389","volume":"8","author":[{"given":"Yu","family":"Lu","sequence":"first","affiliation":[{"name":"Department of Gynecology, Chengdu Women\u2019s and Children\u2019s Central Hospital, School of Medicine, University of Electronic Science and Technology of China","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mi","family":"Su","sequence":"additional","affiliation":[{"name":"Department of Gynecology, Chengdu Women\u2019s and Children\u2019s Central Hospital, School of Medicine, University of Electronic Science and Technology of China","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qinqin","family":"Yuan","sequence":"additional","affiliation":[{"name":"Department of Gynecology, Chengdu Women\u2019s and Children\u2019s Central Hospital, School of Medicine, University of Electronic Science and Technology of China","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"He","sequence":"additional","affiliation":[{"name":"Department of Gynecology, Chengdu Women\u2019s and Children\u2019s Central Hospital, School of Medicine, University of Electronic Science and Technology of China","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,18]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"761","DOI":"10.1093\/humupd\/dmr028","article-title":"The prevalence of congenital uterine anomalies in unselected and high-risk populations: a systematic review","volume":"17","author":"Chan","year":"2011","journal-title":"Hum Reprod Update"},{"key":"B2","doi-asserted-by":"publisher","first-page":"371","DOI":"10.1002\/uog.10056","article-title":"Reproductive outcomes in women with congenital uterine anomalies: a systematic review","volume":"38","author":"Chan","year":"2011","journal-title":"Ultrasound Obstet Gynecol"},{"key":"B3","doi-asserted-by":"publisher","first-page":"665","DOI":"10.1016\/j.rbmo.2014.09.006","article-title":"Clinical implications of congenital uterine anomalies: a meta-analysis of comparative studies","volume":"29","author":"Venetis","year":"2014","journal-title":"Reprod Biomed Online"},{"key":"B4","doi-asserted-by":"publisher","first-page":"4797","DOI":"10.3390\/jcm10214797","article-title":"Reproductive, obstetric and neonatal outcomes in women with congenital uterine anomalies: a systematic review and meta-analysis","volume":"10","author":"Kim","year":"2021","journal-title":"J Clin Med"},{"key":"B5","doi-asserted-by":"publisher","first-page":"161","DOI":"10.1093\/humupd\/7.2.161","article-title":"Clinical implications of uterine malformations and hysteroscopic treatment results","volume":"7","author":"Grimbizis","year":"2001","journal-title":"Hum Reprod Update"},{"key":"B6","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1016\/j.jmig.2012.09.010","article-title":"Hysteroscopic metroplasty for the septate uterus: review and meta-analysis","volume":"20","author":"Valle","year":"2013","journal-title":"J Minim Invasive Gynecol"},{"key":"B7","doi-asserted-by":"publisher","first-page":"251","DOI":"10.1016\/j.fertnstert.2024.02.033","article-title":"Evidence-based diagnosis and treatment for uterine septum: a guideline","volume":"122","year":"2024","journal-title":"Fertil Steril"},{"key":"B8","doi-asserted-by":"publisher","first-page":"1260","DOI":"10.1093\/humrep\/deab037","article-title":"Septum resection versus expectant management in women with a septate uterus: an international multicentre open-label randomized controlled trial","volume":"36","author":"Rikken","year":"2021","journal-title":"Hum Reprod"},{"key":"B9","doi-asserted-by":"publisher","first-page":"1131","DOI":"10.1007\/s00404-021-05975-2","article-title":"Does hysteroscopic resection of uterine septum improve reproductive outcomes: a systematic review and meta-analysis","volume":"303","author":"Krishnan","year":"2021","journal-title":"Arch Gynecol Obstet"},{"key":"B10","doi-asserted-by":"publisher","first-page":"101","DOI":"10.1016\/j.jmig.2011.08.724","article-title":"Accuracy of three-dimensional ultrasonography in differential diagnosis of septate and bicornuate uterus compared with office hysteroscopy and pelvic magnetic resonance imaging","volume":"19","author":"Faivre","year":"2012","journal-title":"J Minim Invasive Gynecol"},{"key":"B11","doi-asserted-by":"publisher","first-page":"616","DOI":"10.1002\/uog.14825","article-title":"Accuracy of three-dimensional ultrasound compared with magnetic resonance imaging in diagnosis of M\u00fcllerian duct anomalies using ESHRE-ESGE consensus on the classification of congenital anomalies of the female genital tract","volume":"46","author":"Graupera","year":"2015","journal-title":"Ultrasound Obstet Gynecol"},{"key":"B12","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1093\/humrep\/dev264","article-title":"The Thessaloniki ESHRE\/ESGE consensus on diagnosis of female genital anomalies","volume":"31","author":"Grimbizis","year":"2016","journal-title":"Hum Reprod"},{"key":"B13","doi-asserted-by":"publisher","first-page":"3219","DOI":"10.1007\/s00404-024-07814-6","article-title":"Intraoperative ultrasound for uterine septum resection: a systematic review and meta-analysis","volume":"310","author":"Galati","year":"2024","journal-title":"Arch Gynecol Obstet"},{"key":"B14","doi-asserted-by":"publisher","first-page":"2032","DOI":"10.1093\/humrep\/det098","article-title":"The ESHRE\/ESGE consensus on the classification of female genital tract congenital anomalies","volume":"28","author":"Grimbizis","year":"2013","journal-title":"Hum Reprod"},{"key":"B15","doi-asserted-by":"publisher","first-page":"569","DOI":"10.1093\/humrep\/deu344","article-title":"Comparison of the ESHRE-ESGE and ASRM classifications of M\u00fcllerian duct anomalies in everyday practice","volume":"30","author":"Ludwin","year":"2015","journal-title":"Hum Reprod"},{"key":"B16","doi-asserted-by":"publisher","first-page":"1238","DOI":"10.1016\/j.fertnstert.2021.09.025","article-title":"ASRM M\u00fcllerian anomalies classification 2021","volume":"116","author":"Pfeifer","year":"2021","journal-title":"Fertil Steril"},{"key":"B17","doi-asserted-by":"publisher","first-page":"1578","DOI":"10.1093\/humrep\/dez284","article-title":"Septum resection in women with a septate uterus: a cohort study","volume":"35","author":"Rikken","year":"2020","journal-title":"Hum Reprod"},{"key":"B18","doi-asserted-by":"publisher","first-page":"465","DOI":"10.1016\/j.jmig.2021.10.001","article-title":"Effect of hysteroscopic metroplasty on reproductive outcomes in women with septate uterus: systematic review and meta-analysis","volume":"29","author":"Carrera","year":"2022","journal-title":"J Minim Invasive Gynecol"},{"key":"B19","doi-asserted-by":"publisher","first-page":"CD008576","DOI":"10.1002\/14651858.CD008576.pub4","article-title":"Septum resection for women of reproductive age with a septate uterus","volume":"1","author":"Rikken","year":"2017","journal-title":"Cochrane Database Syst Rev"},{"key":"B20","doi-asserted-by":"publisher","first-page":"3290","DOI":"10.3390\/jcm11123290","article-title":"Uterine septum with or without hysteroscopic metroplasty: impact on fertility and obstetrical outcomes\u2014a systematic review and meta-analysis of observational research","volume":"11","author":"Noventa","year":"2022","journal-title":"J Clin Med"},{"key":"B21","doi-asserted-by":"publisher","first-page":"100762","DOI":"10.1016\/j.ajogmf.2022.100762","article-title":"Reproductive outcomes of natural pregnancy after hysteroscopic septum resection in patients with a septate uterus: a systematic review and meta-analysis","volume":"5","author":"Jiang","year":"2023","journal-title":"Am J Obstet Gynecol MFM"},{"key":"B22","doi-asserted-by":"publisher","first-page":"300060519893836","DOI":"10.1177\/0300060519893836","article-title":"Reproductive outcome of a complete septate uterus after hysteroscopic metroplasty","volume":"48","author":"Wang","year":"2020","journal-title":"J Int Med Res"},{"key":"B23","doi-asserted-by":"publisher","first-page":"671","DOI":"10.1007\/s00404-013-3003-9","article-title":"Hysteroscopic metroplasty: reproductive outcome in relation to septum size","volume":"289","author":"Paradisi","year":"2014","journal-title":"Arch Gynecol Obstet"},{"key":"B24","doi-asserted-by":"publisher","first-page":"727","DOI":"10.1093\/oxfordjournals.humrep.a019242","article-title":"Residual uterine septum of less than 1cm after hysteroscopic metroplasty does not impair reproductive outcome","volume":"11","author":"Fedele","year":"1996","journal-title":"Hum Reprod"},{"key":"B25","doi-asserted-by":"publisher","first-page":"40","DOI":"10.22074\/IJFS.2023.560746.1354","article-title":"Hysteroscopic endometrial fundal incision in oocyte recipients before embryo transfer may improve reproductive outcomes: a prospective study","volume":"18","author":"Najdecki","year":"2024","journal-title":"Int J Fertil Steril"},{"key":"B26","doi-asserted-by":"publisher","first-page":"689","DOI":"10.5935\/1518-0557.20230037","article-title":"Diagnostic hysteroscopy with endometrial fundal incision may improve reproductive outcomes in oocyte recipients after implantation failure","volume":"27","author":"Peitsidis","year":"2023","journal-title":"JBRA Assist Reprod"},{"key":"B27","doi-asserted-by":"publisher","first-page":"3","DOI":"10.22074\/ijfs.2024.2009369.1523","article-title":"Hysteroscopic endometrial fundal incision versus hysteroscopy only in oocyte recipients: a randomized controlled trial assessing the reproductive outcomes","volume":"18","author":"Peitsidis","year":"2024","journal-title":"Int J Fertil Steril"}],"container-title":["Frontiers in Reproductive Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/frph.2026.1950477\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T05:37:47Z","timestamp":1789709867000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/frph.2026.1950477\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,18]]},"references-count":27,"alternative-id":["10.3389\/frph.2026.1950477"],"URL":"https:\/\/doi.org\/10.3389\/frph.2026.1950477","relation":{},"ISSN":["2673-3153"],"issn-type":[{"value":"2673-3153","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,18]]},"article-number":"1950477"}}