Reproductive Outcomes of Single Embryo Transfer in Women with Previous Cesarean Section
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REPRODUCTIVE ENDOCRINOLOGY: ORIGINAL ARTICLE
Reproductive Outcomes of Single Embryo Transfer in Women with Previous Cesarean Section Ting Chen 1,2 & Bo Li 1 & Hao Shi 1 & Zhi Qin Bu 1 & Fu Qing Zhang 2 & Ying Chun Su 1 Received: 9 May 2020 / Accepted: 5 October 2020 # Society for Reproductive Investigation 2020
Abstract The aim of this study is to evaluate the reproductive outcomes of patients with previous cesarean section (CS) undergoing singleembryo transfer (SET). A total of 5479 patients previously underwent CS or vaginal delivery (VD) were included. The patients with previous CS included single/double cleavage (SCT/DCT), single/double blastocyst stage embryo transfer (SBT/DBT). The comparison of reproductive outcomes between CS and VD, SET, and double-embryo transfer of CS was conducted. The main outcome measures included clinical pregnancy rate (CPR), multiple pregnancy rate (MPR), live birth rate (LBR), and cumulative live birth rate (CLBR). There were no differences in CPR and LBR between patients previously underwent CS and VD, and the preterm birth rate of multiple births in patients underwent CS were significantly higher than underwent VD. As for patients underwent CS, the CPR, MPR, and LBR were lower in patients treated with SCT than DCT in IVF/ICSI cycles. The CPR and LBR of patients treated with SCT were not statistically different compared with DCT and SBT when patients’ age were younger than 35 years in FET cycles, and the MPR of patients treated with SCT was lower. The CPR and LBR of patients treated with SCT were lower than DCT/SBT when patients’ age were 35 years or older in FET cycles. The CPR, LBR, and CLBR of patients treated with SBT were not lower than DCT in IVF/ICSI-ET, FET, and complete cycles, but the MPR was lower. Reducing the number of embryos transferred should be considered seriously for CS. SCT under the 35 years of FET cycles is feasible. SBT is an effective strategy to reduce MPR of IVF/ICSI, FET, and complete cycles regardless of overall or age stratification. Keywords Cesarean section . Single embryo transfer . Multiple pregnancy rate . Clinical pregnancy rate . Live birth rate
Introduction The cesarean section (CS) rate boomed in the past 20 years across China, which saved lives of mothers and children in the abnormal process of delivery [1–3]. CS could change the anatomical structure of female pelvic organs. It was reported that natural fertility ability of women decreased after previous CS, and the pregnancy rate and live birth rate decreased by 9% and 11%, respectively [4, 5]. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s43032-020-00345-w) contains supplementary material, which is available to authorized users. * Ying Chun Su [email protected] 1
Reproductive Medical Center, The First Affiliated Hospital of Zhengzhou University, 1# Jian she East Road, Zhengzhou, China
2
Reproductive Medical Center, Zhengzhou Maternity Hospital Affiliated to He Nan University, Zhengzhou, China
Since the second-child policy was releas
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