Uterine Septum

By RRM Academy Reviewed by Dr. Naomi Whittaker, MD, Board-Certified OBGYN, MIGS, NFPMC, FCI Updated May 14, 2026

A uterine septum is a fibromuscular band of tissue that partially or completely divides the uterine cavity, arising from incomplete resorption of the Mullerian ducts during fetal development. It is the most common congenital uterine anomaly. A septum does not alter the external uterine contour, distinguishing it from a bicornuate uterus.

Poor vascular supply in the septum tissue impairs embryo implantation and placentation. Recurrent pregnancy loss is the most common clinical presentation. Some women also experience preterm labor or abnormal fetal position in later pregnancy.

Saline infusion sonohysterography and 3D transvaginal ultrasound are standard first-line imaging. Operative hysteroscopy provides definitive characterization and correction in the same procedure. The diagnostic goal is to confirm a septum rather than a different Mullerian anomaly before planning repair.

Hysteroscopic metroplasty resects the septum and restores a unified uterine cavity. The procedure is minimally invasive and preserves the myometrium. Studies document improved pregnancy continuation rates following resection in women with prior pregnancy loss.¹² Couples with confirmed septum and recurrent loss should be evaluated for repair before a next conception attempt.

A uterine septum is a structural, correctable cause of pregnancy loss. It is not an unexplained one. Evaluation for co-existing conditions is appropriate: intrauterine adhesions can develop after any uterine instrumentation, and submucosal fibroids may coexist and compound cavity distortion.

This content is for educational purposes only and does not constitute medical advice. Consult an RRM clinician or healthcare provider for guidance specific to your situation.