Clinical Outcomes of IVF/ICSI-ET in Patients with Scared Uterus after Cesarean Section

doi:10.12280/gjszjk.20200463

Abstract

Abstract:

Objective: To compare the clinical outcomes of IVF/ICSI-ET in patients with or without scared uterus after cesarean sections. Methods：A total of 3 331 cycles of IVF/ICSI treatment during Jan 2016 to Dec 2018 were recruited in this retrospective study. They were divided into two groups: the cycles in group A had histories of cesarean sections (n=249),the cycles in group B were nulliparous or had histories of vaginal delivery (n=3 082). The overall clinical characteristics were compared between the two groups, and the pregnancy outcomes after blastocyst transfer or cleavage stage embryo transfer were also compared. Results: There were no significant differences in the rate of high quality embryo transferred, embryo implantation rate, clinical pregnancy rate, ectopic pregnancy rate, miscarriage rate, live birth rate, multiple pregnancy rate between the two groups when the blastocyst or single cleavage stage embryo was transferred (all P>0.05), but the preterm delivery rate was significant higher in group A（P<0.05）. The rate of high quality embryo transferred, embryo implantation rate, clinical pregnancy rate, live birth rate, multiple pregnancy rate were significant lower in group A than those in group B when double cleavage stage embryos were transferred (all P<0.05), but the ectopic pregnancy rate, miscarriage rate, and preterm delivery rate were similar in the two groups（all P>0.05）. Conclusions:The clinical outcomes of IVF/ICSI-ET treatment are similar between the patients with or without scared uterus when single embryo is transferred,except an increased rate of preterm delivery in patients with scared uterus. It is necessary to study further the clinical outcomes of double embryos transfer in those patients with scared uterus.

Key words: Cesarean section, Uterus, Cicatrix, Fertilization in vitro, Embryo transfer, Pregnancy outcomes

QIN Xi, ZHANG Fan, QIN Mei, FAN Li, WEI Xiao-hua. Clinical Outcomes of IVF/ICSI-ET in Patients with Scared Uterus after Cesarean Section[J]. Journal of International Reproductive Health/Family Planning, 2021, 40(2): 98-101.

Figures/Tables 5

References 18

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组别	n	年龄（岁）	不孕时间（年）	AFC （个）	bFSH （mIU/mL）	BMI （kg/m²）
A组	249	36（33,38）	3（1,6）	11.17±4.22	6.31±1.85	22.80±3.06
B组	3 082	32（29,35）	4（2,6）	12.34±4.76	6.35±1.72	21.75±3.19
t或Z		-12.427	-3.284	-3.750	-0.426	4.973
P		0.000	0.001	0.000	0.670	0.000

组别	n	年龄（岁）	不孕时间（年）	AFC （个）	bFSH （mIU/mL）	BMI （kg/m²）
A组	249	36（33,38）	3（1,6）	11.17±4.22	6.31±1.85	22.80±3.06
B组	3 082	32（29,35）	4（2,6）	12.34±4.76	6.35±1.72	21.75±3.19
t或Z		-12.427	-3.284	-3.750	-0.426	4.973
P		0.000	0.001	0.000	0.670	0.000

组别	n	Gn时间（d,$\bar{x} \pm s$）	Gn总量（U,$\bar{x} \pm s$）	hCG日LH （mIU/mL,$\bar{x} \pm s$）	hCG日E₂ （pg/mL,$\bar{x} \pm s$）	hCG日P [ng/mL,M（P₂₅,P₇₅）]	hCG日内膜厚度（mm,$\bar{x} \pm s$）
A组	249	10.84±1.65	33.18±9.58	1.23±0.98	2 491.22±1 276.76	0.54（0.34,0.76）	12.49±2.83
B组	3 082	10.84±1.84	29.41±9.57	1.28±1.35	2 801.87±1 478.47	0.59（0.38,0.85）	12.51±3.60
t或Z		-0.034	5.980	-0.544	-3.187	-2.370	-0.132
P		0.973	0.000	0.587	0.001	0.018	0.895

组别	n	Gn时间（d,$\bar{x} \pm s$）	Gn总量（U,$\bar{x} \pm s$）	hCG日LH （mIU/mL,$\bar{x} \pm s$）	hCG日E₂ （pg/mL,$\bar{x} \pm s$）	hCG日P [ng/mL,M（P₂₅,P₇₅）]	hCG日内膜厚度（mm,$\bar{x} \pm s$）
A组	249	10.84±1.65	33.18±9.58	1.23±0.98	2 491.22±1 276.76	0.54（0.34,0.76）	12.49±2.83
B组	3 082	10.84±1.84	29.41±9.57	1.28±1.35	2 801.87±1 478.47	0.59（0.38,0.85）	12.51±3.60
t或Z		-0.034	5.980	-0.544	-3.187	-2.370	-0.132
P		0.973	0.000	0.587	0.001	0.018	0.895

组别	n	优胚移植率	着床率	临床妊娠率	异位妊娠率	早期流产率	晚期流产率	早产率	活产率	多胎率
A组	125	80.80（101/125）	61.60（77/125）	61.60（77/125）	1.30（1/77）	12.99（10/77）	1.30（1/77）	15.58（12/77）	52.00（65/125）	3.90（3/77）
B组	1 258	78.61（989/1 258）	63.99（805/1 258）	63.99（805/1 258）	0.75（6/805）	12.17（98/805）	2.48（20/805）	8.32（67/805）	54.13（681/1 258）	3.11（25/805）
χ²		0.325	0.281	0.281	-	0.043	-	4.544	0.208	-
P		0.569	0.596	0.596	0.474*	0.835	1.000*	0.033	0.648	0.729*