Effects of hysteroscopic septum incision versus expectant management on IVF outcomes in women with complete septate uterus: a retrospective study.

Jiajia Zhang, Jia Kang, Xueling Song, Shuo Yang, Yan Yang, Jie Qiao, Caihong Ma
Author Information
  1. Jiajia Zhang: Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, 100191, China.
  2. Jia Kang: Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, 100191, China.
  3. Xueling Song: Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, 100191, China.
  4. Shuo Yang: Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, 100191, China.
  5. Yan Yang: Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, 100191, China.
  6. Jie Qiao: Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, 100191, China. jie.qiao@263.net.
  7. Caihong Ma: Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, 100191, China. macaihong@263.net.

Abstract

OBJECTIVE: This retrospective study aimed to assess the impact of hysteroscopic septum incision on in vitro fertilization (IVF) outcomes among infertile women diagnosed with a complete septate uterus and no history of recurrent pregnancy loss.
METHODS: The study was conducted at a tertiary reproductive center affiliated with a university hospital and involved 78 women with a complete septate uterus. Among them, 34 women underwent hysteroscopic septum incision, while 44 women opted for expectant management. The primary outcome measure was the live birth rate, while secondary outcomes included clinical pregnancy rate, preterm birth rate, miscarriage rate, and ongoing pregnancy rate.
RESULTS: women who underwent hysteroscopic septum incision demonstrated a comparable likelihood of achieving a live birth compared to those managed expectantly (25% vs. 25%, Relative Risk (RR): 1.000, 95% Confidence Interval (CI): 0.822 to 1.216). No preterm births occurred in either group. The clinical pregnancy rate, ongoing pregnancy rate, and miscarriage rate showed no significant differences between the surgical group and the expectant management group. Subgroup analyses based on the type of embryo transferred also revealed no significant differences in outcomes.
CONCLUSIONS: Hysteroscopic septum incision does not appear to yield improved IVF outcomes compared to expectant management in infertile women with a complete septate uterus and no history of recurrent pregnancy loss.

Keywords

References

  1. Front Med (Lausanne). 2022 Feb 03;9:765827 [PMID: 35186988]
  2. Am J Obstet Gynecol. 2011 Dec;205(6):558.e1-5 [PMID: 21907963]
  3. J Minim Invasive Gynecol. 2022 Apr;29(4):465-475 [PMID: 34648934]
  4. Hum Reprod Update. 2011 Nov-Dec;17(6):761-71 [PMID: 21705770]
  5. Am J Obstet Gynecol MFM. 2023 Jan;5(1):100762 [PMID: 36220552]
  6. Fertil Steril. 2009 Aug;92(2):808-13 [PMID: 18692833]
  7. Hum Reprod. 2022 Mar 01;37(3):428-446 [PMID: 35048124]
  8. Fertil Steril. 2021 Nov;116(5):1238-1252 [PMID: 34756327]
  9. Ultrasound Obstet Gynecol. 2011 Oct;38(4):371-82 [PMID: 21830244]
  10. Hum Reprod. 2021 Apr 20;36(5):1260-1267 [PMID: 33793794]
  11. Gynecol Surg. 2013 Aug;10(3):199-212 [PMID: 23894234]
  12. Facts Views Vis Obgyn. 2014;6(4):194-202 [PMID: 25593694]
  13. J Gynecol Obstet Hum Reprod. 2021 Nov;50(9):102149 [PMID: 33872814]
  14. J Clin Med. 2022 Jun 08;11(12): [PMID: 35743362]
  15. Reprod Biomed Online. 2010 Nov;21(5):700-5 [PMID: 20864409]
  16. J Ultrasound Med. 2023 May;42(5):1129-1137 [PMID: 36394304]

Grants

  1. 82101696/National Natural Science Foundation of China
  2. BX20200021/National Postdoctoral Program for Innovative Talents
  3. 2021M700286/China Postdoctoral Science Foundation
  4. 21JZD032/Philosophy and Social Science Research Project of Ministry of Education of China

MeSH Term

Infant, Newborn
Pregnancy
Female
Humans
Uterus
Retrospective Studies
Infertility, Female
Septate Uterus
Watchful Waiting
Premature Birth
Fertilization in Vitro
Live Birth
Abortion, Habitual
Hysteroscopy

Word Cloud

Created with Highcharts 10.0.0rateincisionwomenpregnancyseptumoutcomeshysteroscopiccompleteseptateuterusexpectantmanagementstudyIVFbirthgroupretrospectivevitroinfertilehistoryrecurrentlossunderwentliveclinicalpretermmiscarriageongoingcompared25%:1significantdifferencesOBJECTIVE:aimedassessimpactfertilizationamongdiagnosedMETHODS:conductedtertiaryreproductivecenteraffiliateduniversityhospitalinvolved78Among3444optedprimaryoutcomemeasuresecondaryincludedRESULTS:WomendemonstratedcomparablelikelihoodachievingmanagedexpectantlyvsRelativeRiskRR00095%ConfidenceIntervalCI0822216birthsoccurredeithershowedsurgicalSubgroupanalysesbasedtypeembryotransferredalsorevealedCONCLUSIONS:HysteroscopicappearyieldimprovedEffectsversusuterus:InFertilizationSeptateSeptum

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