Reproductive outcomes of in vitro fertilization-intracytoplasmic sperm injection after transcervical resection of adhesions: a retrospective cohort study.

STUDY OBJECTIVE: To investigate pregnancy and obstetric outcomes of patients with intrauterine adhesions (IUAs) following treatment with in vitro fertilization-intracytoplasmic sperm injection (IVF-ICSI) and fresh embryo transplantation after transcervical resection of adhesions (TCRA).

DESIGN: Retrospective cohort study.

SETTING: University-based reproductive medical center.

PATIENTS: 535 IUA patients with history of TCRA and 1605 matched patients without history of IUAs underwent IVF-ICSI and received fresh embryo transfers.

INTERVENTIONS: Between January 2014 and December 2018, all patients underwent IVF-ICSI treatment and received fresh embryo transfers.

MEASUREMENTS AND MAIN RESULTS: The patients in the TCRA group were matched with the control group according to strict criteria. Pregnancy and obstetric outcomes were compared. There were no significant differences in clinical pregnancies, ectopic pregnancies, live births, preterm births, and obstetric outcomes between the two groups (P>0.05). However, the TCRA group had a higher risk of miscarriage than the control group (P=0.048).

CONCLUSIONS: TCRA improved the reproductive outcomes of IUA patients, but the risk of miscarriage was higher than that in the general population. To avoid miscarriage, careful monitoring is critical for pregnant patients with a history of TCRA who undergo embryo transfers during IVF treatment.