caa a22 4500 357790200 20170617182122.0 cr unu---uuuuu 160305e201505 xx s 000 0 eng 0268-1161 10.1093/humrep/dev061 doi (BORIS)oai:boris.unibe.ch:77846 610 ddc 25788565 pmid The comprehensiveness of the ESHRE/ESGE classification of female genital tract congenital anomalies: a systematic review of cases not classified by the AFS system [Elektronische Daten] [A Di Spiezio Sardo, R Campo, S Gordts, Marialuigia Spinelli, C Cosimato, V Tanos, S Brucker, T C Li, M Gergolet, C De Angelis, L Gianaroli, G Grimbizis] publishedVersion openAccess eu-repo STUDY QUESTION How comprehensive is the recently published European Society of Human Reproduction and Embryology (ESHRE)/European Society for Gynaecological Endoscopy (ESGE) classification system of female genital anomalies? SUMMARY ANSWER The ESHRE/ESGE classification provides a comprehensive description and categorization of almost all of the currently known anomalies that could not be classified properly with the American Fertility Society (AFS) system. WHAT IS KNOWN ALREADY Until now, the more accepted classification system, namely that of the AFS, is associated with serious limitations in effective categorization of female genital anomalies. Many cases published in the literature could not be properly classified using the AFS system, yet a clear and accurate classification is a prerequisite for treatment. STUDY DESIGN, SIZE AND DURATION The CONUTA (CONgenital UTerine Anomalies) ESHRE/ESGE group conducted a systematic review of the literature to examine if those types of anomalies that could not be properly classified with the AFS system could be effectively classified with the use of the new ESHRE/ESGE system. An electronic literature search through Medline, Embase and Cochrane library was carried out from January 1988 to January 2014. Three participants independently screened, selected articles of potential interest and finally extracted data from all the included studies. Any disagreement was discussed and resolved after consultation with a fourth reviewer and the results were assessed independently and approved by all members of the CONUTA group. PARTICIPANTS/MATERIALS, SETTING, METHODS Among the 143 articles assessed in detail, 120 were finally selected reporting 140 cases that could not properly fit into a specific class of the AFS system. Those 140 cases were clustered in 39 different types of anomalies. MAIN RESULTS AND THE ROLE OF CHANCE The congenital anomaly involved a single organ in 12 (30.8%) out of the 39 types of anomalies, while multiple organs and/or segments of Müllerian ducts (complex anomaly) were involved in 27 (69.2%) types. Uterus was the organ most frequently involved (30/39: 76.9%), followed by cervix (26/39: 66.7%) and vagina (23/39: 59%). In all 39 types, the ESHRE/ESGE classification system provided a comprehensive description of each single or complex anomaly. A precise categorization was reached in 38 out of 39 types studied. Only one case of a bizarre uterine anomaly, with no clear embryological defect, could not be categorized and thus was placed in Class 6 (un-classified) of the ESHRE/ESGE system. LIMITATIONS, REASONS FOR CAUTION The review of the literature was thorough but we cannot rule out the possibility that other defects exist which will also require testing in the new ESHRE/ESGE system. These anomalies, however, must be rare. WIDER IMPLICATIONS OF THE FINDINGS The comprehensiveness of the ESHRE/ESGE classification adds objective scientific validity to its use. This may, therefore, promote its further dissemination and acceptance, which will have a positive outcome in clinical care and research. STUDY FUNDING/COMPETING INTERESTS None. Di Spiezio Sardo A. joint author Campo R. joint author Gordts S. joint author Spinelli Marialuigia joint author Cosimato C. joint author Tanos V. joint author Brucker S. joint author Li T C. joint author Gergolet M. joint author De Angelis C. joint author Gianaroli L. joint author Grimbizis G. joint author Human reproduction 30(5), pp. 1046-1058 0268-1161 559794177 http://boris.unibe.ch/77846/1/1046.full.pdf text/html WWW-Backlink auf das Repository 1 info:eu-repo/semantics/article boris NonPeerReviewed boris peerstatus BORIS 856 40 http://boris.unibe.ch/77846/1/1046.full.pdf text/html WWW-Backlink auf das Repository BORIS 700 1- Di Spiezio Sardo A. joint author BORIS 700 1- Campo R. joint author BORIS 700 1- Gordts S. joint author BORIS 700 1- Spinelli Marialuigia joint author BORIS 700 1- Cosimato C. joint author BORIS 700 1- Tanos V. joint author BORIS 700 1- Brucker S. joint author BORIS 700 1- Li T C. joint author BORIS 700 1- Gergolet M. joint author BORIS 700 1- De Angelis C. joint author BORIS 700 1- Gianaroli L. joint author BORIS 700 1- Grimbizis G. joint author BORIS 773 0- Human reproduction 30(5), pp. 1046-1058 0268-1161 559794177 SWISSBIB 357790200 BK010053 XK010053 XK010000 BORIS BORIS BORIS info:eu-repo/semantics/article openAccess