It is caused by the defective development of the uterus and/or vagina while in the womb. The reason is unclear. The most common ones are the abnormalities that occur as a result of the development of the uterus and vagina starting in two parts and failing to merge in the midline. These are called fusion errors.
The septum is the most common fusion error. Septum (forked uterus; intrauterine curtain tissue) is the name given to the fact that the uterus is divided into two from top to bottom by a wall or curtain. Its severity (mild, medium, deep) changes according to its depth, that is, how far it goes into the lower part of the uterus.
The septum is not seen as a primary cause of infertility. In particular, the septum may be responsible for miscarriage and premature births. Previously, only late miscarriages were connected to the septum, but today it is accepted that it can lead to early miscarriages.
Diagnosis can be made by vaginal ultrasound. Uterine film is also helpful in diagnosis, but it does not make the differential diagnosis of septum and bicornus. Diagnosis is confirmed by hysteroscopy. If it is not necessary to evaluate the patency of the tubes, we do not require uterine film. While performing hysteroscopy, if there is no other reason for laparoscopy, we do not apply it.
The gold standard treatment of the septum is hysteroscopy. Cutting can be done using scissors, electrical energy or laser. The most accepted method is cutting the septum with electrical energy. With experienced surgeons, the treatment is very successful and a pregnancy resulting in delivery can be achieved in 90% of women with a history of previous miscarriage and premature birth. It is not necessary to stay in the hospital after vaginal surgery by means of short general anesthesia. Complications are extremely rare. The most important is the puncture of the uterus during the dilation of the cervix or during the cutting process. This possibility is not uncommon among experienced surgeons.