Guideline sources The following summarized guidelines for the evaluation and management of uterine septum are prepared by our editorial team based on guidelines from the American Society for Reproductive Medicine (ASRM 2016). 1 Guidelines 1. Diagnostic investigations Diagnostic imaging: obtain diagnostic imaging (3D ultrasound, sonohysterography, or MRI) with or without hysteroscopy, as first-line investigations, rather than laparoscopy/hysteroscopy. B 2. Medical management Danazol: insufficient evidence to recommend for or against the use of danazol or GnRH agonists to thin the endometrium prior to hysteroscopic septum incision. I 3. Surgical interventions Hysteroscopic septum incision: several observational studies indicate that hysteroscopic septum incision is associated with improved clinical pregnancy rates in women with infertility. B Show 2 more https://web.pathway.md/diseases/recszjQSjEY5jV52a 1/2 6/29/23, 3:49 AM Uterine septum Pathway Uterine septum incision: insufficient evidence to assess the risks and benefits of uterine septum incision to improve pregnancy outcomes. Post operative care: insufficient evidence to advocate a specific length of time before a woman should conceive after surgery, although the available evidence suggests that the uterine cavity is healed by 2 months postoperatively. I 4. Patient education Effect on fertility: recognize that studies assessing the association between infertility and uterine septum are comprised of principally small descriptive studies that have inconsistent associations. B Show 2 more Effect on pregnancy: recognize that studies assessing the association between pregnancy outcomes and uterine septum are comprised of principally descriptive studies. B Show 4 more References 1. Practice Committee of the American Society for Reproductive Medicine. Uterine septum: a guideline. Fertil Steril. 2016 Sep 1;106 3 530 40. Open https://web.pathway.md/diseases/recszjQSjEY5jV52a 2/2