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Proposal for diagnostic criteria of Y-shaped dysmorphic uterus based on 3-dimensional transvaginal ultrasound measurements.

STUDY OBJECTIVE: To define objective and readily applied diagnostic criteria for Y-shaped uteri using three-dimensional transvaginal ultrasound (3D-TVUS) volume recordings.

DESIGN: A retrospective case-control diagnostic measurements study.

SETTING: A tertiary university hospital's reproductive health and research centre.

PATIENTS: 213 patients who presented with infertility between January 2020 and December 2022.

INTERVENTION: Two blinded physicians re-evaluated the 3D-TVUS images of all patients for the presence of a uterine abnormality. The images of patients with a Y-shaped uterus were re-evaluated, and descriptive measurements were done.

MEASUREMENTS AND MAIN RESULTS: The most common uterine abnormality in this cohort was the Y-shaped uterus with a prevalence of 12.2%, followed by the arcuate, T-shaped, and septate uteri, respectively. Reviewers identified 26 and 28 Y-Shaped uteri, respectively and came to a consensus on 25 images. Diagnostic criteria for the Y-shaped uterus based on 3D-TVUS findings have been specified as; lateral indentation depths between 4-7 mm, fundal indentation depth between 5-9 mm, lateral indentation angles between 121-149◦ and fundal indentation angle between 121-145◦, and Y-angles 25-46◦.

CONCLUSION(S): Some subtypes of dysmorphic uteri, such as the Y-shaped uterus, whose clinical significance is unknown and may be variants of the normal, may actually be more common than thought. Determining objective diagnostic criteria with 3D-TVUS will allow standard research on these anomalies and their clinical significance.

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