Three dimensional color Doppler transvaginal ultrasound morphologic features of uterine septum and residual cavity in women with reproductive failure

Objective: To study the morphologic features of the uterine septum and the residual uterine cavity using 3D color Doppler transvaginal ultrasound and their relation to reproductive performance.Study design: This was a case control study.Setting: University Hospital.Methods: The study included 36 patients in the reproductive age presented with infertility or one or more first trimester pregnancy losses with a diagnosis of double uterine cavity following conventional two-dimensional (2D) ultrasound examination. All patients were subjected to 3D color Doppler TVUS with the Virtual Organ Computer Aided Analysis (VOCAL) imaging program in order to calculate the volume of the uterine septum, uterine cavity, residual cavity and septal vascularization index (VI).Results: The difference between both groups was highly significant for septal width and septal length being more in the abortion group for both. Cut-off values for septal widths were ⩾25 mm in which 85.7% had abortion compared to 40% of those <25 mm, and the difference was highly significant (p = 0.004). For septal lengths ⩾15 mm, 87.5% had abortion compared to 25% of those <15 mm, and the difference was highly significant (p = 0.000). Multivariate logistic regression analysis showed that the most significant predictor of abortion was septal length ⩾15 mm.Conclusion: 3D US plays a valuable role in the assessment of morphologic characters of uterine septum and the calculation of the residual cavity volume. Septal length followed by width is a significant variable that affects reproductive outcome