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Reproductive Outcomes of Single Embryo Transfer in Women with Previous Cesarean Section

  • Reproductive Endocrinology: Original Article
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Abstract

The aim of this study is to evaluate the reproductive outcomes of patients with previous cesarean section (CS) undergoing single-embryo 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.

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Data Availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

Abbreviations

ART:

assisted reproductive technology

eSET:

elective single embryo transfer

SCT:

single cleavage-stage embryo transfer

SBT:

single blastocyst embryo transfer

DCT:

double cleavage-stage embryo transfer

DBT:

double blastocyst embryo transfer

CS:

cesarean section

VD:

vaginal delivery

CPR:

clinical pregnancy rate

MPR:

multiple pregnancy rate

LBR:

live birth rate

CLBR:

cumulative live birth rate

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Acknowledgments

The authors thank professor Qing ling Yang and Dr. Lan Lan Fang for the revision of the manuscripts, and the patients included in this study.

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Authors and Affiliations

  1. Reproductive Medical Center, The First Affiliated Hospital of Zhengzhou University, 1# Jian she East Road, Zhengzhou, China

    Ting Chen, Bo Li, Hao Shi, Zhi Qin Bu & Ying Chun Su

  2. Reproductive Medical Center, Zhengzhou Maternity Hospital Affiliated to He Nan University, Zhengzhou, China

    Ting Chen & Fu Qing Zhang

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Contributions

TC: protocol development, data collection, data analysis, and manuscript writing. BL: data collection, data analysis, and manuscript writing. HS: data collection and data analysis. QZB: protocol development and revised manuscript. QFZ: protocol development and revised manuscript. CYS: protocol development, revised manuscript, and manuscript writing.

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Correspondence to Ying Chun Su.

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The authors declare that they have no conflict of interest.

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This study was approved by the Institutional ethics committee Review Board of The First Affiliated Hospital of Zheng Zhou University (Science-2019-KY-365).

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Chen, T., Li, B., Shi, H. et al. Reproductive Outcomes of Single Embryo Transfer in Women with Previous Cesarean Section. Reprod. Sci. 28, 1049–1059 (2021). https://doi.org/10.1007/s43032-020-00345-w

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  • DOI: https://doi.org/10.1007/s43032-020-00345-w

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