The Arcuate Uterine Anomaly: A Critical Appraisal of Its Diagnostic and Clinical Relevance

The diagnostic criteria and clinical relevance of the arcuate uterine anomaly have long been debated. Our review critically examines the contemporary and past literature regarding the definition, prevalence, and clinical impact of the arcuate uterine anomaly on reproductive outcomes. To bring a novel perspective to the debate, we examined studies evaluating the clinical significance of the presence of a residual septal stump following surgical resection, which has morphology comparable to that of the arcuate anomaly. The balance of the existing literature does not support an association of the arcuate anomaly to adverse reproductive outcomes. Hysteroscopic resection of arcuate anomaly does not appear to be universally indicated. Treatment decisions should be individualized at clinician discretion for symptomatic patients without otherwise identifiable etiology. Target Audience: General Obstetricians & gynecologists, Reproductive Endocrinology & Infertility Specialists and Radiologists. Learning Objectives: After completion of this article, the reader should be able to distinguish the arcuate uterine anomaly and its diagnosis, demonstrate its clinical significance, and what impact, if any, it may have on reproductive potential. Furthermore, the reader should be able to assess which patient population, if any, might benefit from surgical management of the arcuate anomaly.