A 35-year-old woman with a bicornuate uterus and otherwise unexplained primary infertility is being evaluated. According to the evidence, which statement regarding congenital uterine anomalies and infertility is correct?
- A Septate uterus is the anomaly most strongly associated with infertility and recurrent miscarriage ✓
- B Bicornuate uterus is the most common cause of recurrent first-trimester miscarriage
- C Unicornuate uterus has the best reproductive outcome among all major uterine anomalies
- D Arcuate uterus significantly impairs implantation and requires surgical correction
Correct answer: A. Septate uterus is the anomaly most strongly associated with infertility and recurrent miscarriage
Explanation
Septate uterus is most strongly associated with adverse reproductive outcomes, particularly recurrent second-trimester miscarriage (not first trimester), due to the poorly vascularized fibrous septum. Metroplasty is indicated for septate uterus with recurrent loss. Bicornuate uterus affects reproductive outcomes less than septate. Unicornuate uterus has poor outcomes. Arcuate uterus is a normal variant with no proven impact on fertility.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.