Reduced pregnancy and live birth rates after in vitro fertilization in women with cesarean section scar diverticulum: A retrospective cohort study

Abstract

Aim: The primary aim of the study was to investigate the effect of cesarean scar diverticulum on the reproductive outcome of embryo transfer. The secondary aim was to assess the impact of endometrial cavity fluid on the reproductive outcome of embryo transfer among patients with a cesarean scar diverticulum. Methods: This was a retrospective cohort study. The study included 1538 patients, of whom 215 patients with an existing cesarean scar diverticulum and 1323 patients without cesarean scar diverticulum. A subgroup analysis of the impact of endometrial cavity fluid on the reproductive outcome of frozen embryo transfers among patients with a cesarean scar diverticulum was also conducted. Results: The odds of clinical pregnancy in the noncesarean section diverticulum group was higher than that in the diverticulum group (odds ratio [OR]: 1.72, 95% confidence interval [CI]: 1.27-2.34 and adjusted OR: 1.71, 95% CI: 1.25-2.34). The odds of live birth in the noncesarean section diverticulum group was also significantly higher than that in the cesarean section diverticulum group (OR: 1.61, 95% CI: 1.15-2.24 and adjusted OR: 1.59, 95% CI: 1.14-2.23). The existence of endometrial cavity fluid during endometrial preparation significantly reduced the pregnancy and live birth rate of frozen embryo transfer among the patients with cesarean section diverticulum. Conclusion:The presence of cesarean section scar diverticulum had an adverse impact on the pregnancy and live birth rate after in vitro fertilization. The endometrial cavity fluid among the patients with cesarean section scar diverticulum accounted for the reduced pregnancy and live birth rate partly.

Pregnancy and Perinatal Outcomes of Patients With Prior Cesarean Section After a Single Embryo Transfer in IVF/ICSI: A Retrospective Cohort Study

“…Patients with CSD were associated with a significantly lower rate of subsequent live birth (aOR: 0.609, 95%CI: 0.476~0.778, P <0.001) and clinical pregnancy (aOR: 0.779, 95%CI: 0.623~0.973, P =0.027), as well as a higher likelihood of miscarriage (aOR:1.407, 95%CI: 1.03~1.923, P =0.032) compared with those without defect at the site of the cesarean incision. The results were in agreement with previous studies ( 21 , 35 ). The existence of CSD could lead to poor pregnancy outcomes in patients undergoing IVF.…”

Preparation and characterization of polyethylene glycol/chitosan composite water-based wound healing lubricant

“…Although natural birth is still the most common form of delivery, increasingly more pregnant women are choosing painless birthing options, such as water delivery and cesarean section ( Fobelets et al, 2019 ), especially those with a narrow pelvis, abnormal placenta, abnormal birth canal, premature water rupture, and abnormal fetus. However, post-cesarean section scar diverticulum (PCSD), which generally refers to lacunae formed as a result of poor healing of the uterine incision after the cesarean procedure ( Zheng et al, 2020 ; Huang et al, 2022 ), is a common condition that can cause many problems in the new mother, such as chronic inflammation ( Negro et al, 2017 ; Bi et al, 2021 ). Therefore, new medical strategies are required to effectively reduce the occurrence of PCSD.…”

Isthmocele and Infertility

“…Studies have shown that women with isthmocele may experience reduced pregnancy and live birth rates following IVF procedures [127]. Additionally, isthmocele can lead to challenges during embryo transfer due to distorted anatomy, particularly in cases of a retroflexed uterus [128].…”