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Introduction of Intracapsular Rotary-cut Procedures (IRCP): A Modified Hysteromyomectomy Procedures Facilitating Fertility Preservation

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Septate, subseptate and arcuate uterus decrease pregnancy and live birth rates in IVF/ICSI.

T Tomaževič¹, H Ban-Frangež, I Virant-Klun

¹Reproductive Unit, Department of Obstetrics and Gynecology, University Medical Centre Ljubljana, Šlajmerjeva 3, SI-1000 Ljubljana, Slovenia. tomaz.tomazevic@guest.arnes.si

Reproductive Biomedicine Online

|September 25, 2010

Summary

Uterine anomalies like septate, subseptate, or arcuate uterus significantly reduce pregnancy and live birth rates in IVF/ICSI cycles. Hysteroscopic resection of uterine septum anomalies effectively eliminates this negative impact, improving fertility outcomes.

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Area of Science:

Reproductive Medicine
Gynecologic Surgery
Infertility Research

Background:

Uterine anomalies are associated with reduced success rates in assisted reproductive technologies.
Septate, subseptate, and arcuate uteri are common uterine malformations impacting fertility.
The efficacy of surgical correction for these anomalies in IVF/ICSI outcomes requires further evaluation.

Purpose of the Study:

To evaluate the impact of uterine anomalies on pregnancy and live birth rates in IVF/ICSI.
To assess the effect of hysteroscopic resection of uterine septum on fertility outcomes.
To compare pregnancy and live birth rates before and after surgical correction.

Main Methods:

Retrospective matched-control study involving 2481 embryo transfers.
Comparison of a study group (n=827) with uterine anomalies against a control group (n=1654).
Matching criteria included age, BMI, stimulation, embryo quality, and infertility factors; pre- and post-operative data for the study group were analyzed.

Main Results:

Pregnancy and live birth rates were significantly lower in women with uterine anomalies compared to controls.
Hysteroscopic resection of uterine septum anomalies led to the disappearance of these differences.
Key predictors of pregnancy included embryo number, embryo quality, and absence of uterine anomalies (ORs 1.7, 2.6, 2.5 respectively).

Conclusions:

Uterine anomalies (septate, subseptate, arcuate) negatively impact IVF/ICSI pregnancy and live birth rates.
Hysteroscopic metroplasty is an effective treatment for improving fertility outcomes in women with uterine septum anomalies.
Surgical correction of uterine anomalies is recommended for infertile women undergoing IVF/ICSI.