Impact of isthmocele on assisted reproductive treatment outcomes: an age-matched retrospective study.

Abstract:

STUDY OBJECTIVE:To evaluate whether the presence of an ultrasonographic visible isthmocele has an impact on the chance of pregnancy in women undergoing embryo transfer. DESIGN:An age-matched retrospective study SETTING: Private assisted reproductive center PATIENTS: The study included a total of 150 patients with a previous history of CD: 75 isthmocele cases and 75 controls. All patients underwent embryo transfer from January 2017 through June 2018. The diagnosis of isthmocele was based on transvaginal ultrasound assessment. Isthmocele was defined as an anechoic indentation on the previous cesarean scar at the midsagittal plane, with the deepness of >1 mm. INTERVENTIONS:Embryo transfer MEASUREMENTS AND MAIN RESULTS: The groups were similar in patient and treatment characteristics. The live birth rate was 44% in the isthmocele group and 46.7% in the control group (OR:0.89, 95%CI:0.47-1.71 p=0.743). The clinical pregnancy rates were 49.3% and 50.7%, respectively (OR:0.94, 95%CI:0.50-1.79, p=0.870). The miscarriage rate was greater in the isthmocele group (8%) than in the control group (4%); however, it did not reach statistical significance (OR:2.09, 95%CI:0.50-8.67, p=0.302). The multiple pregnancy rate was similar between the groups (8% vs. 5.3%, respectively, OR:1.54, 95%CI:0.41-5.70, p=0.513). The groups were also similar in ectopic pregnancy rates (p=0.560). These outcomes remained similar when adjusted for potential confounders on the regression analysis. CONCLUSIONS:Isthmocele does not seem to have a significant impact on the chance of pregnancy in ART settings. However, embryo transfer procedure may be more difficult in the presence of an isthmocele.

authors

Asoglu MR,Celik C,Ozturk E,Cavkaytar S,Bahceci M

doi

10.1016/j.jmig.2020.10.002

subject

Has Abstract

pub_date

2020-10-07 00:00:00

eissn

1553-4650

issn

1553-4669

pii

S1553-4650(20)31081-5

pub_type

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