The incidental septate uterus in IVF — decision and counselling station

Communication and decision station: an incidental septate-uterus finding before IVF. Tests classification knowledge, the ESHRE/ESGE diagnostic tier, the septate-criteria discordance, the evidence-quality counselling for an asymptomatic woman, and shared decision-making. Includes assessor key and marking domains.

Prompt

A 34-year-old woman about to start her first IVF cycle for unexplained subfertility has a routine 3D transvaginal ultrasound that reports a fundal indentation 'possibly consistent with a septate uterus'. She is asymptomatic, has never been pregnant, and is anxious that this will derail her IVF. You are the reproductive medicine registrar; the consultant is available by phone.

Station brief

Format. Communication and decision station, approximately 12 minutes. You are the reproductive medicine registrar. A clinic nurse and a sonographer are available; the consultant is contactable by phone. The assessor will play the patient and feed you her questions and concerns.^[1]

Candidate instruction. Confirm the diagnosis appropriately, counsel the woman on what the finding means and does not mean, present the management options and the strength of the evidence for each, and arrive at a shared plan — with the consultant looped in where appropriate. Demonstrate the counselling out loud.^[1]^[2]

References7Show

[1]Grimbizis GF, Gordts S, Di Spiezio Sardo A, Brucker S, De Angelis C, Gergolet M, Li TC, Tanos V, Brölmann H, Gianaroli L, Campo R The ESHRE/ESGE consensus on the classification of female genital tract congenital anomalies Human reproduction (Oxford, England), 2013.PMID 23771171
[2]Pfeifer SM, Attaran M, Goldstein J, Lindheim SR, Petrozza JC, Rackow BW, Siegelman E, Troiano R, Winter T, Zuckerman A, Ramaiah SD ASRM müllerian anomalies classification 2021 Fertility and sterility, 2021.PMID 34756327
[3]Grimbizis GF, Di Spiezio Sardo A, Saravelos SH, Gordts S, Exacoustos C, Van Schoubroeck D, Bermejo C, Amso NN, Nargund G, Timmermann D, Athanasiadis A, Brucker S, De Angelis C, Gergolet M, Li TC, Tanos V, Tarlatzis B, Farquharson R, Gianaroli L, Campo R The Thessaloniki ESHRE/ESGE consensus on diagnosis of female genital anomalies Gynecological surgery, 2016.PMID 26918000
[4]Ludwin A, Ludwin I, Coelho Neto MA, Nastri CO, Bhagavath B, Lindheim SR, Martins WP Septate uterus according to ESHRE/ESGE, ASRM and CUME definitions: association with infertility and miscarriage, cost and warnings for women and healthcare systems Ultrasound in obstetrics & gynecology, 2019.PMID 30977223
[5]Chan YY, Jayaprakasan K, Zamora J, Thornton JG, Raine-Fenning N, Coomarasamy A The prevalence of congenital uterine anomalies in unselected and high-risk populations: a systematic review Human reproduction update, 2011.PMID 21705770
[6]Joosse MI, Kostova EB, Rikken JF, Mol BWJ, Goddijn M, van Wely M Septum resection for women of reproductive age with a septate uterus The Cochrane database of systematic reviews, 2025.PMID 41268817
[7]Wu X, Zhang M, Sun P, Jiang JJ, Yan L Pregnancy and Adverse Obstetric Outcomes After Hysteroscopic Resection: A Systematic Review and Meta-Analysis Frontiers in surgery, 2022.PMID 35832500

The incidental septate uterus in IVF — decision and counselling station

Station brief

References7Show

[1]Grimbizis GF, Gordts S, Di Spiezio Sardo A, Brucker S, De Angelis C, Gergolet M, Li TC, Tanos V, Brölmann H, Gianaroli L, Campo R The ESHRE/ESGE consensus on the classification of female genital tract congenital anomalies Human reproduction (Oxford, England), 2013.PMID 23771171
[2]Pfeifer SM, Attaran M, Goldstein J, Lindheim SR, Petrozza JC, Rackow BW, Siegelman E, Troiano R, Winter T, Zuckerman A, Ramaiah SD ASRM müllerian anomalies classification 2021 Fertility and sterility, 2021.PMID 34756327
[3]Grimbizis GF, Di Spiezio Sardo A, Saravelos SH, Gordts S, Exacoustos C, Van Schoubroeck D, Bermejo C, Amso NN, Nargund G, Timmermann D, Athanasiadis A, Brucker S, De Angelis C, Gergolet M, Li TC, Tanos V, Tarlatzis B, Farquharson R, Gianaroli L, Campo R The Thessaloniki ESHRE/ESGE consensus on diagnosis of female genital anomalies Gynecological surgery, 2016.PMID 26918000
[4]Ludwin A, Ludwin I, Coelho Neto MA, Nastri CO, Bhagavath B, Lindheim SR, Martins WP Septate uterus according to ESHRE/ESGE, ASRM and CUME definitions: association with infertility and miscarriage, cost and warnings for women and healthcare systems Ultrasound in obstetrics & gynecology, 2019.PMID 30977223
[5]Chan YY, Jayaprakasan K, Zamora J, Thornton JG, Raine-Fenning N, Coomarasamy A The prevalence of congenital uterine anomalies in unselected and high-risk populations: a systematic review Human reproduction update, 2011.PMID 21705770
[6]Joosse MI, Kostova EB, Rikken JF, Mol BWJ, Goddijn M, van Wely M Septum resection for women of reproductive age with a septate uterus The Cochrane database of systematic reviews, 2025.PMID 41268817
[7]Wu X, Zhang M, Sun P, Jiang JJ, Yan L Pregnancy and Adverse Obstetric Outcomes After Hysteroscopic Resection: A Systematic Review and Meta-Analysis Frontiers in surgery, 2022.PMID 35832500