Exploring uterine contractility frequency in infertile population: A comparative study among different control groups...

Area of Science:

• Reproductive endocrinology and infertility
• Gynecological surgery and obstetrics

Background:

• Women undergoing in vitro fertilization (IVF) with a history of Cesarean section (CS) exhibit lower live birth rates.
• The underlying physiological mechanisms, particularly uterine contractility, require further investigation.

Purpose of the Study:

• To investigate the impact of a previous Cesarean section (CS) on uterine contractility patterns during frozen blastocyst embryo transfer.
• To determine if a uterine niche, a common consequence of CS, influences uterine contractility.

Main Methods:

• Prospective study involving patients undergoing frozen blastocyst embryo transfer with medicated endometrial preparation.
• Patients were categorized into groups: nulliparous, previous vaginal delivery, previous CS without niche, and previous CS with niche.
• Uterine contractility was assessed using 3D ultrasound on the day of embryo transfer.

Main Results:

• No statistically significant differences in mean uterine contractility per minute were observed between groups (nulliparous, previous vaginal delivery, CS without niche, CS with niche).
• A slight, non-significant increase in contractions was noted in patients with a sonographic niche (p=0.48).
• Uterine contractility did not differ significantly between patients with and without a previous CS history, nor between those who achieved pregnancy and those who did not.

Conclusions:

• A previous Cesarean section, with or without a sonographic niche, does not significantly alter uterine contractility during medicated frozen embryo transfer cycles.
• Further research is needed to elucidate the physiological mechanisms affecting implantation in patients with a uterine niche (isthmocele).